Lifetime illegal drug use prevalent among smokers, drinkers, youths in SG

In Singapore, younger people, current and former smokers, as well as individuals with hazardous alcohol consumption are more likely to engage in lifetime use of illicit drugs, according to a recent study.

“It is essential to maintain a strong commitment to monitoring relevant changes in the prevalence of drug consumption and the early identification of emerging trends in the attitudes towards the consumption of illicit drugs in the future,” said lead author Mythily Subramaniam, ACMB, Research, Institute of Mental Health, Buangkok Green Medical Park, Buangkok View, Singapore.

“Such data will further strengthen preventive and treatment efforts across Singapore,” she added.

A total of 6,509 Singapore residents (citizens and permanent residents) aged 15‒65 years were randomly selected for this survey. Subramaniam and her team administered questionnaires to examine the consumption of illicit drugs and obtain data on correlates. Analyses were weighted to determine the prevalence estimates for the use of drugs and other measured outcomes.

In addition, the research team conducted logistic regression analyses and Rao-Scott chi-square test to explore the relationship of sociodemographic and clinical characteristics with lifetime consumption of illicit drugs.

Of the participants, 73.2 percent completed the survey. The lifetime prevalence of consuming illegal drugs stood at 2.3 percent (95 percent confidence interval [CI], 1.9‒2.8; n=180). [Ann Acad Med Singap 2024;53:222-232]

Individuals aged 15‒34 years were more likely to have lifetime drug consumption than those aged 50‒65 years (odds ratio [OR], 0.3, 95 percent CI, 0.2‒0.7). Current (OR, 4.7, 95 percent CI, 2.7‒8.3) and former smokers (OR, 5.9, 95 percent CI, 3.2‒11.1) also had a greater likelihood of lifetime drug consumption than nonsmokers.

In addition, participants with hazardous alcohol use (OR, 3.3, 95 percent CI, 1.7‒6.5) showed a higher probability of lifetime drug consumption than those without.

Cannabis use

The most consumed first drug and the most frequently used drug in the lifetime among participants who endorsed lifetime illicit drug consumption is cannabis, said Subramaniam.

Cannabis is also the most widely cultivated, trafficked, and abused illegal drug worldwide, based on data from the Alcohol, Drugs and Addictive Behaviours Unit at the World Health Organization. Nearly 147 million people, or 2.5 percent of the global population, use cannabis yearly compared with just 0.2 percent of those consuming either cocaine or opiates. [www.who.int/teams/mental-health-and-substance-use/alcohol-drugs-and-addictive-behaviours/drugs-psychoactive/cannabis]

“The short- and long-term consumption of cannabis is associated with several health and social consequences. However, the harm caused by cannabis is often underestimated, which may have contributed to its increased consumption in the past few decades,” the researchers said.

“Our data also revealed that age, ethnicity, employment status, smoking status, and hazardous alcohol use were significantly associated with lifetime illicit drug consumption,” Subramaniam said. “The association of drug consumption with the younger age group, smoking, and hazardous alcohol use are well-established globally. [BMC Pediatr 2021;21:233; www.unodc.org/unodc/en/data-and-analysis/wdr2021.html]

Moreover, earlier studies reported the association of birth cohort effects with differences in substance use, partially indicating trends in drug popularity, availability, and perceptions of reduced harm. [Int J Behav Dev 2017;41:621-631; Youth Soc 2008;39:453-479]