Combining Alcohol with Benzodiazepines or Psychostimulants. Metaphoric Meanings and the Concept of Control in the Online Talk of Polydrug Use.

The co-administration of different substances is a widespread practice in the context of hard drug use. Among others, alcohol combined with certain substances produces potentially dangerous interactions. This article explores how people who combine alcohol with benzodiazepines or psychostimulants perceive these practices and how they share their perceptions in Finnish and Swedish online discussions. This is carried out by analyzing discussants' use of metaphoric expressions. We found that the metaphors given to the use of these substance combinations reflect their pharmacological characteristics. Through that, the metaphors and meanings were different depending on the substance alcohol was combined with. Moreover, we found that, in the realities the metaphors create, the control of use was differently conceptualized. The different aspects of control could be divided into three categories that, however, were not related to any specific substances but overarched all metaphors: 1) controlling pharmacological risks, 2) controlling social appearance and 3) ignoring control. As our findings bring out, often the actual health dangers and risks of the studied substance combinations were bypassed, and the control was rather understood either as a form of socially appropriate behavior or wholly ignored.

A virtual academy of polydrug use: Masters, novices and the art of combinations.

AIMS: Information technology has become an essential part of drug culture, providing a platform for lay knowledge concerning drug use. Due to the co-effects of different substances, making substance "combos" requires advanced skills to enhance pleasures and manage risks. In this study, we focussed on Finnish and Swedish online discussions as a context for learning and sharing experiences of combining substances. METHODS: Taking influences from positioning theory, we used qualitative methods to map what kinds of mutual interactive positions related to the expertise in polydrug use online discussants take and how these positions are negotiated and reformulated in the online setting. We reflect these results through Howard S. Becker's theory of social learning, according to which becoming a drug user is a process that occurs in interaction with other users, as the beginners need a model and advice from experienced users in order to claim their place in the users' community. RESULTS: In online forums, users discuss the risks and pleasures of combining drugs - on the one hand, in relation to different situations and, on the other hand, in relation to different competence positions. This occurs by asking for advice, presenting one's knowledge, challenging others, repositioning oneself, defending one's position or proving one's competence. CONCLUSION: Online discussion forums constitute a kind of virtual academy where knowledge of the pleasures and risks of combining substances is produced and circulated, and where experienced masters mediate their expertise to less experienced novices.

Measuring Concurrent Polydrug Use in General Populations: A Critical Assessment.

BACKGROUND/AIMS: Polydrug use is a complicated phenomenon that is measured in a wide variety of different ways. Using Finland as an example, we aimed to demonstrate how the prevalence and prevalence trends of concurrent polydrug use (CPU) varied in the general population based on the different measurements used. METHODS: Population-based Drug Surveys conducted every 4 years during 1998-2014 were used. CPU was measured with different measurements: strict, medial and loose definition of CPU, which were based on different combinations of alcohol, illicit drugs, pharmaceutical drugs and cigarettes used during the last 12 months/30 days. Logistic regression was used to estimate the p values for assessing trends. RESULTS: Depending on the measurements used, the prevalence of CPU in 2014 varied between 2.0 and 18.7%. Different definitions also produced contradictory trends of CPU: there was a modest increase in prevalence if it was measured with a medial (p < 0.001) or strict (p = 0.054) definition, but when measured with the loose definition (only measure that included smoking), there was a decrease in prevalence (p < 0.001). CONCLUSIONS: The prevalence of CPU varies greatly depending on the measurement used, as does the course of the prevalence trends. The concept of simultaneous polydrug use may capture the phenomenon better compared to the concept of CPU.