Annual report 2009: the state of the drugs problem in Europe International Conference: New trends in drug use: facts and solutions, Parliament of the Republic.

Annual report 2009: the state of the drugs problem in Europe

International Conference: New trends in drug use: facts and solutions, Parliament of the Republic of Vilnius - 5 November 2009

Dagmar Hedrich (EMCDDA)NB Embargo 5 November 2009 10:00 CET (Brussels time)

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Latest on the drugs problem across Europe

• Overview of the European drug phenomenon in 30 countries

• Data and analyses: across Europe and by country

• Latest trends and responses

• Selected issues 2009 • Polydrug use: patterns and responses• Drug offences: sentencing and other

outcomes

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Overview 2009

• Drug use levels still high in Europe - but no major increases for most forms of use

• Cocaine and heroin maintain firm hold on Europe’s drug scene, with little sign of any recent improvement

• Cannabis: evidence of a decline in use, particularly in young people

• Heroin: no longer declining

• Amphetamine and ecstasy use: overall steady

• Polydrug use: widespread and a growing issue for services

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Cocaine, still Europe’s most popular stimulant

• Some 13 million European adults (15–64 years) have tried cocaine in their lifetime (3.9%); some 4 million adults have used it in the last year

• Still concentrated in western EU countries, elsewhere in Europe consumption is low

• Most reporting countries show a stable or rising trend in last-year use among young adults

• In Denmark, Spain, Ireland, Italy and the UK, last-year prevalence (15–34 years) ranges from 3.1 % to 5.5 %

• Seizures and studies raise concerns about potential for further diffusion

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Trends in last year prevalence of cocaine among young adults (aged 15–34), measured by population surveys Countries with three or more surveys

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Heroin — trend no longer declining

• New data confirm last year’s analysis of ‘a stable, but no longer diminishing, problem’

• Concerns raised by three indicators of heroin use:• treatment demand• drug-induced deaths• seizures

• Not the epidemic spread of heroin problems seen in Europe in 1980s and 1990s

• But vigilance needed — heroin is still responsible for the largest share of drug-related health and social costs

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Drug-related infectious diseases

• HIV incidence among IDUs remains low at

4.7 cases per million population in EU;• Availability of treatment and harm reduction measures;• Decline in injecting.

• But neighbouring countries show increasing trends;

• HCV still widespread among drug users (national samples vary from 18 – 95%) in most countries > 40%.

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Warning signs (i): treatment demand

• Between 1.2 and 1.5 million problem opioid users (EU + Norway)

• New recruitment to heroin use is still occurring

• Number of new demands for treatment (heroin as the primary drug) was 6 % greater in 2007 than in 2002

• Eight countries reported that, between 2006 and 2007, users entering treatment for primary heroin use increased:

• in number and

• as a percentage of all clients

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Trend in estimated number of new clients entering treatment by primary drug used, from 2002 to 2007Numbers of clients by primary drug

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Warning signs (ii): drug-induced deaths

• In the period 1990–2006, between 6 400 and 8 500 drug-induced deaths were reported each year in Europe

• Most fatal overdoses are associated with opioids (typically over 85 %)

• Following an overall falling trend in drug-induced deaths between 2000 and 2003, subsequent data show an increase

• In 2007, 13 of the 18 reporting countries showed a rise

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Mortality rates among all adults (15–64 years) due to drug-induced deaths

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Risk factors for overdoses

• Opiate use / Injection • Polydrug drug use

• Being out of drug treatment • waiting list, dropped out

• Just after prison release

• History of previous overdoses• Old, long time user with cumulative health damage• Unemployed, living alone, psychiatric co-morbidity

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Warning signs (iii): seizures

• Number of reported heroin seizures (EU + Norway) rose on average by around 4 % per year between 2002 and 2007

• Estimated 56 000 seizures in 2007 (51 000 in 2006)

• Amount of heroin seized (EU + Norway) declined after 2002, but increased from 8.1 tonnes in 2006 to 8.8 tonnes in 2007

• Turkey, important transit country for heroin entering EU, reported a record 13.2 tonnes seized in 2007 (2.7 tonnes in 2002)

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Cannabis – declining use.. but not everywhere

• Around 74 million Europeans (15–64 years) have tried cannabis in their lifetime; 41.5 million are young adults (15–34 years)

• 17 million young adults (15-34) have used it in the last year

• Up to 2.5 % of all young Europeans could be using cannabis on a daily basis

• But new data confirm last year’s assessment of overall declining popularity, particularly among young people

• School survey data from the USA and Australia also point to a decreasing trend since the early 2000s

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Cannabis — school students

• Different patterns in cannabis use among school students (15–16 years) across Europe (ESPAD surveys 1995, 1999, 2003, 2007)

• West European countries, as well as Croatia and Slovenia — a fall or stabilisation in lifetime cannabis use in 2007

• Central and east European countries — the increasing trend to 2003 may be levelling out (only Slovakia and Lithuania report a rise of over 3 %)

• Northern and southern Europe — overall more stable and low lifetime prevalence estimates of cannabis use from the mid to late 1990s to 2007

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Different patterns in trends in lifetime prevalence of cannabis use among 15- to 16-year-old school students

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Cannabis prevalence rates. Comparison of trends in average (unweighted) lifetime prevalence of cannabis (%) among 15-16 year old school students in Europe, USA and Australia

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Methamphetamine edges into new territory

• Methamphetamine is yet to make significant inroads into the stimulant drug market in western Europe (cocaine or amphetamine still dominate)

• But some signs that methamphetamine is starting to edge into new territory (beyond Czech Republic)

• Methamphetamine problems have developed in Slovakia and the drug appears to be becoming more available in parts of northern Europe, such as Norway and Sweden

• Some new production sites appear to be located in Lithuania, whose geographical position may facilitate the importation of the methamphetamine precursor BMK from outside the EU

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Treatment From ‘one size fits all’ to targeted solutions

• Services for drug users are increasingly diversified and offered as part of an integrated package of care

• Harm-reduction and treatment interventions are often linked and offered by the same providers

• In 2007, some 650 000 opioid users were estimated to have received substitution treatment in Europe

• Treatment coverage is still uneven (e.g. limited access to treatment outside metropolitan areas, small proportion of substitution treatments are in eastern EU Member States)

• Integration of drug treatment into general health care can contribute to a broader provision of treatment

• More projects address needs of stimulant and cannabis users

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Trend in the number of clients receiving opioid substitution

treatment from 1993 to 2007 in the EU-27

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1993 1995 1997/1998 2001/2002 2003 2005 2007

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Provision of opioid substitution treatment by office-based general practitioners , 2007

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Provision of substitution/maintenance treatment (OST) in the community and availability of OST programmes in the prison system in 2007 (expert rating)

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Development of effective drug policies in Europe and beyond

• The European Union and the United Nations have both renewed their drug action plans

• Both highlight the importance of monitoring and evaluation to improve drug policies

• Almost all EU Member States have a national drug strategy or action plan – including plans to evaluate these

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A multilingual information package

Annual report 2009 in 23 languages• http://www.emcdda.europa.eu/events/2009/annual-report

• Additional online material• Statistical bulletin • Country overviews • Selected issues• Reitox national reports

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• Thank you for your attention.