Work related cocaine use: prevalence and interventions

Background

There is an increase is the use of cocaine in Belgium. In 2018, 1.5% of the global population in Belgium aged 15-64 used cocaine at least once in the previous year. This prevalence tripled compared to 2013 (0,5%) (Gisle & Drieskens, 2018). Among workers a similar trend occurs. Cannabis (7.4%) and cocaine (1.4%) were the most frequently used illicit drugs (last year use), and these substances were significantly more prevalent among male workers and workers under the age of 36 (Lambrechts et al, 2019). 

Such prevalence rates demonstrate the importance of prevention in the workplace, and includes a focus on the use of cocaine, next to the more commonly addressed substances like alcohol, psychoactive medicine and cannabis. Internationally, a multicomponent policy is considered as an important tool to avoid or address work-related alcohol and other drug (AOD) problems in an early stage (Fellbaum et al, 2023; Liira et al, 2016). However, little is known about the need and the importance of specific cocaine prevention interventions related to the workplace.

Methods (initiatives)

Based on the recommendations of an exploratory research on cocaine use in Flanders (Blomme & Lambrechts, 2023), a cocaine  prevention project was lauched. The project consisted of: 

1/ ‘Learning clip’ on social media. In 2024, we launched 6 learning clips through social media, aimed at people who use cocaine. We focused on people with interests in the EDM scene and people in high pressure jobs, because they have a higher chance of exposure to cocaine use. With a teaser, people who use drugs are directed to the De Druglijn website (information line) where people can watch the longer version of these informational short videos, conduct knowledge tests and self-tests, and start an online self help trajectory. In addition, specific information is accessible. 

2/ Development of an E-learning for intermediaries

We also focus on enhancing expertise among intermediaries (e.g. occupational physicians, prevention advisors on psychosocial aspects) who are in (regular) contact with people who use cocaine in a work-related context. We developed an e-learning training to identify and tackle risk factors, and to discuss their role (e.g. minimal interventions, motivational interviewing). In addition, we stressed the importance of the integration of cocaine prevention in a broader alcohol and drug policy.

Discussion

A preliminary evaluation illustrated the value of a stepped care approach, and demonstrated the potential of online and social media based interventions to reach out to hard-to-reach target groups of prevention. There was an increase in visitors on the ‘Druglijn’ website and in the knowledge and self tests, and the target group reported on the positive effect on knowledge and information among the target group. During the structured session, these results are further discussed.