Measuring substance use in the club setting: a feasibility study using biochemical markers

The setting was a 40 hour electronic music dance event (EMDE) on a cruise ship on the Baltic Sea, departing from Sweden, with 875 passengers. Groups of participants at the EMDE were randomly invited to participate. Data were collected with face-to-face and self-administered questionnaires. Further, oral fluid samples were collected to determine illicit drug use, and blood alcohol concentration (BAC) levels were measured using a breath analyzer.A total of 422 passengers were asked to participate in the study whereof 21 declined (5.0% refusal rate). Of the 401 study participants (accounting for 45.8% of all attendees), 5 declined oral fluid drug testing. Results show that there was a discrepancy between self-reported and actual drug use as 10.1% of the participants were positive on illicit drug use (amphetamines, ecstasy/MDMA, cannabis, cocaine), while only 3.7% of the participants reported drug use during the last 48 hours. The average BAC level was 0.10% and 23.7% had BAC levels ≥ 0.15%, while 5.9% had levels below the detection limit. The mean BAC levels for the illicit drug users were significantly higher (p = 0.004) than for non-drug users (0.13% vs. 0.10%). Self-reported AUDIT-C scores (using a threshold of ≥ 5 for men and ≥ 4 for women) revealed that 76.0% of the men and 80.7% of the women had risky alcohol consumption patterns.This study indicates that it is feasible to conduct breath alcohol and oral fluid drug testing in a Swedish club setting.The use of illicit drugs in the nightlife setting is a public health concern since it is associated with violence, drug driving, and risky sexual behavior [1-5]. In Sweden, problems related to club drug use have been attributed to an increased availability of club drugs and a reduction in drug prices [6,7], as well as an increase in the number of licensed premises with extended opening hours [8,9]. In 2002, STAD (Stockholm Prevents Alcohol and Drug Problems) initiated a multi-component community-based club drug prevent