How do users perceive risk in relation to illicit drugs?

Background: Technical definitions and decision making on ‘risk’ typically takes into account the probability of a particular (harmful) outcome taking place and the severity of that outcome. This is especially relevant with recreational substance use, where drug testing and information about potential risks need to be communicated to substance users in a timely manner. However, work in practical fields such as medicine and developing technologies (e.g. nuclear power, GM food) suggests that when members of the public consider and explain risk they do so in non-technical ways. Previous research suggests that risk perception is informed by factors such as characteristics of the risk communicator the perceived voluntariness of the risk (i.e. does the individual think they have control over the risk) and the level of dread it invokes emotional (affective) responses (e.g. fear and anxiety) ethnicity and gender experiences of discrimination and stigmatisation. Understanding public risk perception is important in order to develop effective health risk communications. Risk communications are likely to only be persuasive and efficacious if the communicator has a good understanding of how the message recipients perceive risk. However, despite risks of harm being significant (including the risk of death), there has been minimal research on risk perception and the role of trust and credibility in relation to communications around harms emerging from illicit drug use. Methods: This study investigated how substance users perceive risk in relation to illicit substances, which could help us inform communication of risks related to illicit substances in the night-time economy. Participants were recruited to take part in an online survey from the UK, Switzerland and Australia. The survey was translated/modified from English for use in Australia and Switzerland, and was hosted on the survey platform Qualtrics. Overall 1100 participants completed the survey. Results: Descriptive analyses indicated that there were differences in prevalence of use of a range of substances between the 3 countries, with higher use of cocaine in the UK, higher use of MDMA in Switzerland and higher use of psychedelics and Z drugs in Australia. Regression analyses indicated that perceived stigma, mood state and sensation seeking all predict total perceived risk, health risk and social risk.   Conclusions: perceived risk is mediated by personal and psychological variables. Creating indivdual risk profiles for groups of substance users could allow us to produce effective harm reduction messaging targeting factors associated with perceived risks.