USODROGAS.PT: Portugal's drug use: a web based survey
Background: Internet is increasingly used as a sampling tool and web surveys offer an efficient way of obtaining valuable information from hidden populations and stigmatized behaviors like using drugs. In this study we aimed to describe in detail the patterns, modes and circumstances of illicit drug use among adult drug users in the last 12 months.
Methods: USODROGAS.PT used a self-administered anonymous structured questionnaire, available online from April to August 2018. The study was promoted through "Facebook" and in the media. Data on sociodemographic, patterns, modes and circumstances of drug use, health care utilization, health status, drug policy and violence were collected. After giving consent, individuals with 18 years or older who used any illicit drug at least once in the last 12 months were eligible for participation. There were 2593 submissions of the questionnaire, of which 2120 were eligible participations.
Results: Of the participants, 76% were men, two thirds were under 25 years old, 32% were students,48% were employed, 44% completed high-school and 34% completed college. The most reported illicit drugs used in the last 12 months were cannabis (94%), Ecstasy/MDMA (40%), cocaine (32%), LSD (17%), magic mushrooms (12%), amphetamines (8%), ketamine (4%) and new psychoactive substances (3%). Among those who used cannabis, 51% reported everyday use over the last 12 months and 56% used cannabis every day in the last 30 days. For ecstasy/MDMA use in the last 30 days, 7% used it at least once a week. For cocaine use in the last 12 months, 14% used it at least once a week. The main routes of administration reported for each drug were, smoked (97%) for cannabis, snorted (94%) for cocaine and swallowed for ecstasy/MDMA (94%) and LSD (97%).
1225 (58%) participants answered more specific questions about their drug use. The most commonly used cannabis preparations were weed (89%) and resin/hash (79%), 97% reported joints as the preferred way of consumption and 95% usually mix cannabis with tobacco. The last place most participants used cannabis was at home (63%). Cocaine users used 1.3g of cocaine on average per occasion, the mean number of grams of cocaine per purchase was 2.3 and 40% reported music club/bar as the last place they used cocaine. The use of MDMA crystal/powder was reported by 52%, Ecstasy/MDMA preparation while ecstasy pills use was less reported (19%). The mean number of ecstasy pills used per occasion was 1.6, and 1.0g was the mean number of grams of MDMA crystal/powder used per occasion. The last occasion participants used ecstasy/MDMA they were either in a music club/bar (51%).
Conclusions: USODROGAS.PT was the largest Portuguese web survey for people using illicit drugs, resulting in a younger and more educated sample than most studies on the topic. Data shows, the importance of this studies to fully characterize stigmatized behaviors, for example, our results show that in this sample cocaine and ecstasy/MDMA are mainly used in music clubs/bars however, recreational drug use harm reduction strategies in Portugal are mainly offered in music festivals. This information can therefore be used to tailor interventions.