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Siv Byqvist: Cannabis, Amphetamine, or Opiates? Addicts' Choices of Drugs from First use to Established Abuse

The progression of narcotics abuse from first use to regular use (> 2 days per week) to established abuse (a year prior to enrollment in a rehabilitation program) was analysed from a sample of 1 268 men and women in Sweden, who were interviewed at the beginning of treatment (BAK/SWEDATE-project). Cannabis was the most common initial substance, but amphetamine (CS), heroin (opiates) and hallucinogens were also cited. There were a number of paths from debut toward regular use and established abuse. However, from first use to regular use, most subjects continued with the initial substance. Between regular use and established abuse, subjects began using other substances as well. After approximately 10 years of abuse, extensive multiple drug abuse could be noted. Four main paths are described. Also cannabis, CS and heroin abuser progression is described. The results show significant gender differences. The progression was quicker for women: first use occurred earlier, the transition to regular use took place quickly and they were younger when they entered treatment. A larger share of women than men used heroin and amphetamine. Alcohol consumption was high and most extensive among cannabis-abusing women. The results are discussed in relation to earlier research on the stepping stone model and the drug career and show the importance of early intervention.