Title: Understanding the Interplay between Cultural, Biological and Subjective Factors in Drug Use Pathways
Funder: Department of Health and Social Care

Abstract: This multidisciplinary ImagenPathways (IP) research project extends the ongoing research with the IMAGEN cohort (2000 young adults from 4 EU countries, followed since age 14), with in-depth quantitative and qualitative assessments at age 22/23. This project combines within-person variables (already assessed extensively in IMAGEN, including personality, brain functioning and genetics) with in-depth analysis of psychosocial variables including drug use identities, motives related to specific use patterns, social networks and social media use. Combining the strengths of both approaches, this add-on project is in a unique position to study the interplay of variables at different levels of description in the etiology of drug use pathways, including pathways into non-drug use, functional recreational and problematic drug use. During the next wave of data-collection of the IMAGEN cohort (starting September 2016), we add hair-analysis in (i) all participants who reported to have used illicit drugs during the past three months, and (ii) in a randomly selected subset of other participants who use licit drugs. IMAGEN participants who report use of illegal drugs during the past year are invited to participate, for additional reward. Based on existing data at 18 years and prevalence data, we anticipate that the first drug-using group will consist of approximately 450 eligible participants, of whom an estimated 350 will participate. The second group (ii) is expected to consist of approximately 1000 participants from whom we will select a random sample of 400 individuals (200 light drinkers and 200 binge drinkers). Based on self-report and biological data (hair-analysis), participants are clustered with respect to type(s) and quantity of drug use patterns. Thus selected participants will receive invitations for assessment sessions, using a secure multilingual platform which can be used on computers, tablets and smartphones developed at UvA for a FP7 project. They are requested to perform tests to assess drug-related associations, to describe their social context of drug use, to report motives to use, subjective experiences, social networks, social media use patterns, etc. In addition, drug-using participants are asked to send a hair sample after 3, 6, 9 and 12 months, to provide an objective verification of drug use patterns. In a subgroup of the IP-sample (representing both different user-groups and different countries), qualitative interviews are assessed to obtain further in-depth descriptions of different drug-use pathways. These data are used to describe initiation and subsequent dynamic drug use pathways: 1. Initiation. Previously obtained social and individual difference variables in IMAGEN are used to predict progression from using licit drugs (alcohol, cigarettes) to illicit drugs. These data are enriched by the data obtained in IP, which further assesses social variables related to this first distinction (licit only or licit and illicit), and data on contexts in which illicit drugs are first used, the influence of peers, and reasons for not engaging with illicit drugs (yet). 2. Dynamic pathway changes. Importantly, once an individual has initiated illicit drug use, s/he might discontinue use (e.g., after a strong first negative experience), develop relatively harmless, occasional use patterns with minimal negative side-effects or escalate into heavy illicit drug use, often using multiple drugs and developing associated problems. By expanding the IMAGEN database, this project is in a unique position to investigate how these different pathways are characterized using (1) the existing data from previous IMAGEN waves (individual differences and social background variables) and (2) our newly collected in-depth data from this sample, both regarding quantitative data (e.g., individual factors, objectively verified drug use) and qualitative data assessed online and enriched with ethnographic interviews, which will be used to describe trajectories into either functional or problematic use to inform development of new interventions and policies.

Lay abstract: Why does one individual start using illegal drugs, while another does not? Why is one able to use them in a controlled, functional way, while another escalates use and problems? Here we will build on genetic, brain imaging, individual and social data that has already been collected in the IMAGEN project of over 2000 Europeans since they were aged 14. Critically, we will add to the next stage of this project by characterizing dynamic drug use pathways using a multidisciplinary approach. We will use longitudinal hair analysis to objectively map drug use over 12 months. We will use mobile apps as well as rich qualitative analyses to portray the multiple layers of drug use pathways over time. In expanding the ongoing longitudinal IMAGEN cohort, we will determine for the first time how progression from adolescence to young adulthood influences drug use pathways and their consequences for individual and society.

Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: MENTAL HEALTH