Trends, motivations and settings of recreational cocaine use by adolescents and young adults in the Netherlands

BACKGROUND: In recent years the use of powder cocaine among socially integrated adolescents and young adults has normalised. It is no longer an extraordinary drug to use in trendy/innovative as well as mainstreams clubs. Not much research has been done on motivations for and settings in which this cocaine use takes place.<br/>METHODS: To gain insight in normalisation and trends in cocaine use, we used quantitative data from the National Prevalence Study on Substance Use (NPS) 1997, 2001 and 2005. To gain insight in social settings and motivations (initiation and continuation), and in the combined use of cocaine with alcohol and/or other drugs, we analysed mostly qualitative data from in-depth interviews with 55 adolescents and young adults who used cocaine in the past year.<br/>RESULTS: The NPS studies show a rising trend in lifetime cocaine use, a fall in incidence, and a fall in continuation rates. From the interviews we learn that cocaine has further normalised. Cocaine is - and stays - attractive because of the ritual of snorting (the route of administration). Initiation is often planned. Effects play a role in the continuation of use, not in initiation. Motivations for use are divided into three categories: physical, mental and social. Cocaine is used in nightlife and home settings, together with friends, and it is often combined with alcohol (on the same occasion), because of feeling mentally clear and being able to drink more.<br/>CONCLUSION: About 5% of adolescents have used cocaine at least once in their lives. They feel it can be used in every setting, since it leaves a user in control. While acknowledging the negative side effects, young users try to regulate their cocaine use in order to regulate these effects. Although high frequent use is an exception in our sample, we cannot foretell how many might develop a pattern of problematic use.