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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)
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
2
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
3
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
4
Trends in last year prevalence of cocaine among young adults
(aged 15–34), measured by population surveys
Countries with three or more surveys
5
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
6
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%.
7
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
8
Trend in estimated number of new clients entering treatment by
primary drug used, from 2002 to 2007
Numbers of clients by primary drug
9
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
10
Luxembourg
Estonia
Norway
Denmark
Ireland
United Kingdom
Finland
Portugal
Croatia
Austria
Lithuania
Slovenia
Malta
Germany
Sweden
Greece
Romania
Cyprus
Spain
Belgium
Italy
Latvia
Bulgaria
Netherlands
Poland
France
Czech Republic
Slovakia
Hungary
Turkey
Rate per million
Mortality rates among all adults (15–64 years) due to
drug-induced deaths
90
80
70
60
50
40
30
20
10
0
11
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
12
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)
13
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
14
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
15
Different patterns in trends in lifetime prevalence of
cannabis use among 15- to 16-year-old school students
2
1
3
16
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
17
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
18
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
19
Trend in the number of clients receiving opioid substitution
treatment from 1993 to 2007 in the EU-27
Clients in substitution treatment
700000
600000
500000
400000
300000
200000
100000
0
1993
1995
1997/1998 2001/2002
2003
2005
2007
20
Provision of opioid substitution treatment by
office-based general practitioners , 2007
21
Provision of substitution/maintenance treatment (OST) in the community and
availability of OST programmes in the prison system in 2007 (expert rating)
22
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
23
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
24
• Thank you for your attention.
25