healthscotland.com

Health Education Population Survey (HEPS) 1996-2003

11. Drugs

The evidence from a range of sources suggests an increase in the use of illicit drugs during the late 1980s and early 1990s‚ partly because of the rave or dance phenomenon (Institute for the Study of Drug Dependence‚ 1997; Collin‚ 1997). However‚ since then‚ different indicators have given different signals and the pattern is becoming more complex (Ramsay and Partridge‚ 1999). On the whole‚ prevalence and frequency of use increases after age 16 and peaks in the early- to mid-twenties‚ but there is also evidence of increasing levels of experimentation at an earlier age. In response‚ growing emphasis has been given to the development of various programmes‚ including health education‚ to address the potential harm due to drug misuse among young people and to prevent such misuse. The report of the Ministerial Drugs Task Force‚ Drugs in Scotland: Meeting the Challenge (The Scottish Office‚ 1994)‚ identified a number of key elements in tackling the problem of drug misuse. These involved community action to dissuade young people from taking drugs‚ active policing and legislative measures to reduce the availability of illicit drugs‚ and effective services to deal with more problematic drug users. These elements also form the backbone of the government policy document Tackling Drugs to Build a Better Britain (HM Government‚ 1999b) and require multisectorial collaboration using a range of approaches for maximum impact.

The current national objectives and priorities for action in Scotland are set out in the strategy document Tackling Drugs in Scotland (The Scottish Office‚ 1999). Know The Score is the brand name of the drugs misuse education campaign in Scotland that brings together those national organisations which provide advice and information about drugs for young people‚ parents‚ friends and relatives (Scotland Against Drugs‚ Scottish Drugs Forum‚ HEBS‚ Scottish Executive) and local Drug Action Teams which are the focal point for local initiatives and services.

The aim of health education work in this area is to reduce the harm associated with the use of illicit drugs by:

• raising awareness and understanding about drugs and drug-related issues‚ focusing on young people and parents in particular
• promoting attitudes and behaviours which encourage abstinence from illicit drugs
• encouraging alternatives to illicit drug use

While questions assessing use of and attitudes toward illicit drug use were part of the core questionnaire‚ these were omitted from the March 1998 wave due to shortage of space. Therefore the 1998 data in this section are based on a smaller number of respondents than data from other years.

It must be noted that observed patterns of illicit drug use vary considerably in terms of level and context of use between different population groups‚ as well as for individuals over time. Therefore the broad indicators used in this particular survey can provide only a general measure of activity in this area‚ as they do not include frequency of use‚ nor do they distinguish between very different patterns of use such as experimental‚ recreational and chronic (MacDonald and Patterson‚ 1991; Tasker et al‚ 1999; Houston‚ 2000). In the context of this report‚ the terms drug misuse and drug use are defined as illicit drug use.

Around a third of respondents reported having used illicit drugs at some point‚ and this proportion showed a significant increase between 1997 and 1998 (Table 11.1). However‚ data from subsequent waves did not support continuation of this trend‚ indicating that the 1998 figure was perhaps anomalous and should be treated with caution. In addition‚ indicators of lifetime use are likely to be fairly insensitive to changing patterns of use over the relatively short time period during which HEPS data have been collected. Therefore‚ an indicator of recent use in the past year was considered more appropriate to assess possible changes over time among sub-groups of respondents (Ramsay and Partridge‚ 1999).

Table 11.1: Percentage ever having taken illicit drugs

Approximately 15% of respondents had used drugs in the past year‚ and this indicator remained fairly stable over time (Table 11.2).

*Less than 0.5%

This pattern is supported by that observed in the 1994-1998 British Crime Surveys in England and Wales (Ramsay and Partridge‚ 1999) which points to a substantial measure of continuity in the mid-1990s. While data from the Scottish Crime Surveys showed a statistically significant increase in drug use between 1993 and 1996 (Anderson & Frischer‚ 1997)‚ more recent data from the 2000 survey show a return to 1993 levels (Fraser‚ 2002). This highlights the importance of considering trends over longer time periods in order not to be misled by what may be short-term fluctuations in the data.

As illustrated in Table 11.2‚ men and younger people were more likely to have used drugs in the past year‚ with use declining sharply for respondents over 35. Again‚ this supports findings from other data sources such as the Health Education Monitoring Survey and the Scottish and British Crime Survey (Hansbro et al‚ 1997; Anderson & Frischer‚ 1997; Ramsay & Partridge‚ 1999). There were no clear patterns of change over time by sex or age.

On the whole‚ respondents in the AB group were less likely to have used drugs recently. Use tended to be higher for those in social grade C1‚ with more fluctuating findings for DE respondents. The use among C1 respondents supports to some extent the findings from Tasker et al and the British Crime Survey which shows higher rates of drug use among relatively affluent or upwardly mobile younger social groups. However‚ evidence suggests that the use of illicit drugs in other‚ less privileged‚ groups may be characterised by more frequent and problematic use. Thus‚ health and social impacts associated with drug use would tend to be more detrimental for these latter groups (Institute for the Study of Drug Dependence‚ 1997). This is further supported by a pattern by DEPCAT‚ with those in the more deprived areas generally most likely to have taken drugs in the past year. There is‚ however‚ some fluctuation year on year.

The most commonly used drugs were cannabis‚ amphetamines and tranquillisers. There was no change in levels of use over time (Table 11.3).

Table 11.3: Use of cannabis‚ amphetamines and tranquillisers in past year

Main points

• Overall‚ reported drug use remained relatively stable over the eight-year period‚ with around 15% reporting having used drugs in the past year.
• Drug use was reported predominantly among 16-24 year olds and men. Reported use declines sharply for respondents aged over 35.
• Those living in the more deprived areas were more likely to have taken drugs in the past year.