Cannabis and other illicit drug use

The latest ESPAD survey showed that in 2019, on average, 1 in 6 school students (17%) reported having used an illicit drug at least once in their life, with levels varying considerably across the ESPAD countries (range: 4.2%–29%). Lifetime prevalence of illicit drug use in this group has been declining slightly since 2011, although has been generally stable over the past two decades.

ESPAD monitors the level of use of several illicit substances, including cannabis, ecstasy, amphetamine, methamphetamine, cocaine, crack, heroin, LSD or other hallucinogens, and GHB (gamma-hydroxybutyrate). For these substances information on the frequency of use in lifetime and during the last 12 months, the perceived availability, as well as the age of first use are collected.

Among illicit drugs, cannabis continues to generate significant policy and public interest in Europe, and the ESPAD results confirm that it is still the illicit drug most used by school students in participating countries (the prevalence of lifetime use of illicit drugs mainly relates to cannabis use, whose average lifetime prevalence is 16 %).

Cannabis is also perceived to be the easiest illicit substance to get hold of, with around one third of ESPAD students (32 %) rating cannabis as easily obtainable.

Long-term trends in ESPAD average cannabis use indicate an increase in both lifetime and last-month use between 1995 and 2019, from 11 % to 16 % and from 4.1 % to 7.4 %, respectively. However, lifetime use has slowly declined since 2011, while last-month use has stabilised since 2007.

The ESPAD data also indicate that cannabis use and its perceived availability vary widely among European adolescents, with the large differences in these indicators observed across ESPAD countries not showing any tendencies towards convergence.

High-risk cannabis use has been explored for the first time in all participating countries in the 2019 survey through the CAST (Cannabis Abuse Screening Test) tool. The results revealed that, on average, 4% of respondents fell into this category and are potentially at risk of developing cannabis-related problems.

As research shows, the links and causal relationships between policy, availability and cannabis use are still unclear. In recent years, new forms of cannabis have been developed and cannabis products tend to be much more potent than in the past. This means that, even in countries where the prevalence of use underwent limited changes, the potential health risks for adolescents may have changed.

The changing context depicted by the ESPAD results, as well as the need to consider the complicated interplay
between community-level and individual-level characteristics suggests that understanding and closely monitoring this phenomenon among adolescents is important for formulating effective prevention policies.