Adolescent recreational alcohol and drugs careers gone wrong: developing a strategy for reducing risks and harms

Across Europe, but especially in the UK, a large youthful ‘going out’ sector is being identified which prioritises ‘psycho-active’ weekends in which tobacco use, heavy drinking, recreational drug use and substance mixing play a key role. Based on an on-going longitudinal cohort study of a thousand young Britons followed from 13 to 18 years of age, this paper describes the onset and development of these ‘recreational’ multi-substance careers using repeat survey and interview data. At 18 years a third of the cohort were long term smokers. Almost three-quarters (74%) were regular drinkers of which one-third drank more than twice recommended levels. Over half (54%) had tried an illicit drug by 18 years of age with 41% being drug active (past year). Most drug experiences were rated positively but respondents disclosed a range of worries and negative outcomes including out of character behaviour, being sick, feeling paranoid, spending too much money on substances, getting into dangerous situations, etc. Formal sources of information about drugs were little trusted and consequently young substance users relied on informal and incomplete drugs ‘stories’ from peers. A harm reduction-public health agenda to meet the needs of this sector is described.