INTRODUCTION: Amphetamine-type stimulants (ATS) including amphetamine, methylenedioxymethamphetamine/'ecstasy', methamphetamine, synthetic cathinones and 'Ritalin' are the second most commonly used illicit drugs globally. Yet, there is little evidence on which factors are associated with the development of different patterns of ATS use over the life course. This study aims to examine which individual, social and environmental factors shape different pathways and trajectories of ATS consumption. The study will be conducted in five European countries: Germany, the Netherlands, Poland, Czech Republic and the UK. METHODS AND ANALYSIS: We will use a sequential mixed-methods study design to investigate the multiple factors (familial, social and occupational situation, critical life events, general risk behaviour, mental and physical health, satisfaction with life) that shape individual ATS use pathways. A systematic literature review will be performed to provide an overview of the current academic literature on the topic. In module 1, qualitative semistructured interviews (n=ATS users and non-users) will be conducted to explore individual experiences of, and perspectives on, dynamics of change in stimulant consumption patterns. In module 2, structured questionnaires (n=2000 ATS users and non-users) will be administered via tablet computers to validate and enhance the generalisability of the interview findings. Data integration will take place at two key points. First, during the study, where the findings from the first qualitative interviews will inform the design of the structured questionnaire. Second, at the end of the study, where mixed methods data will be brought together to generate an in-depth, contextualised understanding of the research topic. ETHICS AND DISSEMINATION: The study has been approved by the respective responsible ethics committee in each participating country. Data will be treated confidentially to ensure participants' anonymity. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings for policy and practice.

Bonger Institute of Criminology University of Amsterdam Amsterdam The Netherlands

Centre of Interdisciplinary Addiction Research of Hamburg University Department of Psychiatry University Medical Centre Hamburg Eppendorf Hamburg Germany

Department of Addictology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Department of Social Sciences Northumbria University Newcastle upon Tyne UK

Institute of Health and Society Newcastle University Newcastle upon Tyne UK

Maria Grzegorzewska Academy of Special Education Institute of Applied Psychology Warsaw Poland

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UNODC United nations office on drugs and crime. world drug report 2018. Vienna United Nations, 2018.

EMCDDA European monitoring centre for drugs and drug addiction. European drug report 2018: trends and developments. publications office of the European Union. Luxembourg: European Monitoring Centre for Drugs and Drug Addiction, 2018.

EMCDDA EMCDDA –Europol joint publications: amphetamine. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2011.

EMCDDA European monitoring centre for drugs and drug addiction and Eurojust. New psychoactive substances in Europe: legislation and prosecution. Lisbon: EMCDDA & Eurojust, 2017.

UNODC United nations office on drugs and crime. world drug report 2017. Vienna United Nations, 2017.

EMCDDA European monitoring centre for drugs and drug addiction: wastewater analysis and drugs: a European multi-city study. Lisbon: Perspectives on Drugs, 2018.

Best D, Gross S, Vingoe L, et al. . Dangerousness of drugs: a guide to the risks and harms associated with substance use 2003.

Degenhardt L, Charlson F, Ferrari A, et al. . The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet Psychiatry 2018;5:987–1012. 10.1016/S2215-0366(18)30337-7 PubMed DOI PMC

Gonzales R, Mooney L, Rawson RA. The methamphetamine problem in the United States. Annu Rev Public Health 2010;31:385–98. 10.1146/annurev.publhealth.012809.103600 PubMed DOI PMC

Degenhardt L, Roxburgh A, Black E, et al. . The epidemiology of methamphetamine use and harm in Australia. Drug Alcohol Rev 2008;27:243–52. 10.1080/09595230801950572 PubMed DOI

Kelly BC. Mediating MDMA-related harm: preloading and post-loading among Ecstasy-using youth. J Psychoactive Drugs 2009;41:19–26. 10.1080/02791072.2009.10400671 PubMed DOI

Home Office Psychoactive substances ban 6 months on: almost 500 arrests and first convictions, 2016. Available: https://www.gov.uk/government/news/psychoactive-substances-ban-6-months-on-almost-500-arrests-and-first-convictions

Addison M, Stockdale K, McGovern R, et al. . Exploring the intersections between novel psychoactive substances (NPS) and other substance use in a police custody suite setting in the North East of England. Drugs: Education, Prevention and Policy 2017:1–7.

O'Donnell A, Addison M, Spencer L, et al. . Which individual, social and environmental influences shape key phases in the amphetamine type stimulant use trajectory? A systematic narrative review and thematic synthesis of the qualitative literature. Addiction 2018. PubMed PMC

Duff C, Moore D. Evading and embracing normality: estrangement and ambivalence in the accounts of methamphetamine consumers. Crit Public Health 2015;25:488–503. 10.1080/09581596.2014.913785 DOI

Levy KB, O'Grady KE, Wish ED, et al. . An in-depth qualitative examination of the ecstasy experience: results of a focus group with ecstasy-using college students. Subst Use Misuse 2005;40:1427–41. 10.1081/JA-200066810 PubMed DOI PMC

Van Hout MC, Brennan R. Plant food for thought: a qualitative study of mephedrone use in Ireland. Drugs: Education, Prevention and Policy 2011;18:371–81.

Ding Y, He N, Detels R. Circumstances of initiation into new-type drug use among adults in Shanghai: are there differences by types of first new-type drug used? Drug Alcohol Depend 2013;131:278–83. 10.1016/j.drugalcdep.2012.12.019 PubMed DOI PMC

Boeri MW, Harbry L, Gibson D. A qualitative exploration of trajectories among suburban users of methamphetamine. J Ethnogr Qual Res 2009;3:139–51. PubMed PMC

Fast D, Small W, Wood E, et al. . Coming 'down here': young people's reflections on becoming entrenched in a local drug scene. Soc Sci Med 2009;69:1204–10. 10.1016/j.socscimed.2009.07.024 PubMed DOI PMC

Sherman SG, German D, Sirirojn B, et al. . Initiation of methamphetamine use among young Thai drug users: a qualitative study. J Adolesc Health 2008;42:36–42. 10.1016/j.jadohealth.2007.07.002 PubMed DOI PMC

Cheney AM, Newkirk CN, Nekhavhambe VM, et al. . Effects of social and spatial contexts on young Latinas' methamphetamine use initiation. J Ethn Subst Abuse 2018;17:32–49. 10.1080/15332640.2017.1362721 PubMed DOI PMC

Smirnov A, Najman JM, Hayatbakhsh R, et al. . Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study. Addiction 2013;108:1809–17. 10.1111/add.12239 PubMed DOI

Cheng WS, Garfein RS, Semple SJ, et al. . Binge use and sex and drug use behaviors among HIV(-), heterosexual methamphetamine users in San Diego. Subst Use Misuse 2010;45:116–33. 10.3109/10826080902869620 PubMed DOI PMC

Boeri MW, Sterk CE, Elifson KW. Baby Boomer drug users: career phases, social control, and social learning Theory*. Sociol Inq 2006;76:264–91. 10.1111/j.1475-682X.2006.00154.x DOI

Ho HT, Le GM, Dinh TT, et al. . Female sex workers who use amphetamine-type stimulants (ats) in three cities of Vietnam: use and sexual risks related to HIV/AIDS. Glob Public Health 2013;8:552–69. 10.1080/17441692.2013.790459 PubMed DOI

von MC, Brecht M-L, Anglin MD. Use ecology and drug use motivations of methamphetamine users admitted to substance abuse treatment facilities in Los Angeles: an emerging profile. J Addict Dis 2002;21:45–60. 10.1300/J069v21n01_05 PubMed DOI

Bourne A, Reid D, Hickson F, et al. . "Chemsex" and harm reduction need among gay men in South London. Int J Drug Policy 2015;26:1171–6. 10.1016/j.drugpo.2015.07.013 PubMed DOI

Eiserman JM, Diamond S, Schensul JJ. "Rollin' on E": a qualitative analysis of ecstasy use among inner city adolescents and young adults. J Ethn Subst Abuse 2005;4:9–38. 10.1300/J233v04n02_02 PubMed DOI

Parsons JT, Kelly BC, Weiser JD. Initiation into methamphetamine use for young gay and bisexual men. Drug Alcohol Depend 2007;90:135–44. 10.1016/j.drugalcdep.2007.02.017 PubMed DOI PMC

Carbone-Lopez K, Owens JG, Miller J. Women’s “Storylines” of Methamphetamine Initiation in the Midwest. J Drug Issues 2012;42:226–46. 10.1177/0022042612456013 DOI

Kerley KR, Copes H, Griffin OH. Middle-Class motives for non-medical prescription stimulant use among college students. Deviant Behav 2015;36:589–603. 10.1080/01639625.2014.951573 DOI

Bavarian N, Flay BR, Ketcham PL, et al. . Illicit use of prescription stimulants in a college student sample: a theory-guided analysis. Drug Alcohol Depend 2013;132:665–73. 10.1016/j.drugalcdep.2013.04.024 PubMed DOI PMC

Sterk CE, Theall KP, Elifson KW. Getting into ecstasy: comparing moderate and heavy young adult users. J Psychoactive Drugs 2007;39:103–13. 10.1080/02791072.2007.10399869 PubMed DOI

Bungay V, Malchy L, Buxton JA, et al. . Life with jib: a snapshot of street youth's use of crystal methamphetamine. Addict Res Theory 2006;14:235–51. 10.1080/16066350500270901 DOI

German D, Sherman SG, Sirirojn B, et al. . Motivations for methamphetamine cessation among young people in northern Thailand. Addiction 2006;101:1143–52. 10.1111/j.1360-0443.2006.01490.x PubMed DOI

O'Brien AM, Brecht M-L, Casey C. Narratives of methamphetamine abuse: a qualitative exploration of social, psychological, and emotional experiences. J Soc Work Pract Addict 2008;8:343–66. 10.1080/15332560802224469 DOI

Sexton R, Carlson R, Leukefeld C, et al. . Trajectories of methamphetamine use in the rural South: a longitudinal qualitative study. Hum Organ 2008;67:181–93. 10.17730/humo.67.2.h457132482255391 DOI

Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196:129–36. 10.1126/science.847460 PubMed DOI

Cooke A, Smith D, Booth A. Beyond PICO: the spider tool for qualitative evidence synthesis. Qual Health Res 2012;22:1435–43. 10.1177/1049732312452938 PubMed DOI

Gossop M, Darke S, Griffiths P, et al. . The severity of dependence scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction 1995;90:607–14. PubMed

Bruno R, Matthews AJ, Topp L, et al. . Can the severity of dependence scale be usefully applied to 'ecstasy'? Neuropsychobiology 2009;60:137–47. 10.1159/000253550 PubMed DOI

Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qualitative health research 2015. PubMed

Palinkas LA, Horwitz SM, Green CA, et al. . Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health 2015;42:533–44. 10.1007/s10488-013-0528-y PubMed DOI PMC

Cohen J, Hillsdale NJ. Statistical power analysis for the behavioral sciences. England: Lawrence Erlbaum Accociates, 1988.

Etikan I, Sa M, Alkassim RS. Comparison of convenience sampling and Purposive sampling. Am J Appl Math Stat 2016;5:1–4. 10.11648/j.ajtas.20160501.11 DOI

Shaghaghi A, Bhopal RS, Sheikh A. Approaches to Recruiting 'Hard-To-Reach' Populations into Re-search: A Review of the Literature. Health Promot Perspect 2011;1:86–94. 10.5681/hpp.2011.009 PubMed DOI PMC

MAXQDA [program]. 18.1.1 version Berlin: VERBI Software GmbH; 2018.

NVivo [program] Victoria, Australia: QSR International; 2017.

SPSS 22 [program] New York: IBM; 2013.

Minozzi S, Saulle R, De Crescenzo F, et al. . Psychosocial interventions for psychostimulant misuse. Cochrane Database Syst Rev 2016;9 10.1002/14651858.CD011866.pub2 PubMed DOI PMC

UNESCO International standard classification of education (ISCED) 2011. Available: http://uis.unesco.org/en/topic/international-standard-classification-education-isced

Beste J, Bethmann A, Gundert S. Social Structure and Living Conditions: Material and Social Situation of Unemployment Benefit Recipients : IfE R, Iab summary reports. 8 Nuremberg, 2014.

Ewing JA, alcoholism D. The cage questionnaire. Jama 1984;252:1905–7. PubMed

Bush K, Kivlahan DR, McDonell MB, et al. . The audit alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. ambulatory care quality improvement project (ACQUIP). alcohol use disorders identification test. Arch Intern Med 1998;158:1789–95. PubMed

Derogatis LR. BSI 18, Brief Symptom Inventory 18 : administration, scoring and procedures manual. Minneapolis, MN: NCS Pearson, Inc, 2001.

Diener E, Emmons RA, Larsen RJ, et al. . The satisfaction with life scale. J Pers Assess 1985;49:71–5. 10.1207/s15327752jpa4901_13 PubMed DOI

Rammstedt B, John OP. Measuring personality in one minute or less: a 10-item short version of the big five inventory in English and German. J Res Pers 2007;41:203–12. 10.1016/j.jrp.2006.02.001 DOI

Stephenson MT, Hoyle RH, Palmgreen P, et al. . Brief measures of sensation seeking for screening and large-scale surveys. Drug and alcohol dependence 2003;72:279–86. PubMed

Schwarzer R, Jerusalem M. Generalized Self-Efficacy scale : Weinman J, Wright S, Johnston M, Measures in health psychology: A user’s portfolio Causal and control beliefs. Windsor, England: NFER-NELSON, 1995: 35–7.

Connor KM, Davidson JRT. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depress Anxiety 2003;18:76–82. 10.1002/da.10113 PubMed DOI

Different phases of ATS use call for different interventions: a large qualitative study in Europe