an overview of european trends and developments roland simon
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An overview of European trends and developments Roland Simon. ECAD Meeting 2011, Varna. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Community Agency Established: 1993 Staff: 102. Market Drug use Consequences Interventions Standards Prison Internet - PowerPoint PPT PresentationTRANSCRIPT
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An overview of European
trends and developments
Roland Simon
ECAD Meeting 2011, Varna
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European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
Community Agency
Established: 1993
Staff: 102
The drug information hub in Europe
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Participating Countries:
27 EU Member States, Croatia, Turkey and Norway
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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TrendsMarketDrug useConsequencesInterventions
DevelopmentsStandards and quality of interventionsDrugs in prisonDrugs and the internetDrugs and licit psychotropic substances
Data: Annual Report 2010 + more recent details
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Herbal:289 000 seizures (250% of 2003)90 tons: Turkey 31t, Germany 9t
Resin 369 000 seizures (increased)900 t (increased last years)More than half of seizures/amount: Spain
Proper balance?
CannabisMarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Number of seizures increasing for last 20 years: 96 000
Quantities seized decreased since 2006: 67 tonnes
New smuggling techniques
Cocaine seizuresMarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Heroin seizures and quantities seized
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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New Drugs – “Legal Highs”
• New groups & large number of new unregulated compounds
• Marketed in various combinations or as products laced with synthetic compounds
• Difficulties in analytical identification
• Little or no knowledge of pharmacology, toxicity, safety profile
• Increasing interaction between the “legal-highs” market & organised crime
MarketDrug use
ConsequencesInterventions
StandardsPrison
Internet Licit substances
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75.5 million Europeans have ever used cannabis (22.5 %)
23 million in the past year (6.8 %)
17 million are between 15 and 34 years old
Trends mostly downwards (not Easter Europe)
Cannabis
MarketDrug use
ConsequencesInterventions
StandardsPrison
Internet
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Cannabis use: last year prevalence
among young adultsMarket
Drug useConsequences
Interventions
StandardsPrison
InternetLicit substances
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14 million Europeans have ever used cocaine (4.1 %) 4 million during the past year (1.3 %)
3 million are between 15 and 34 years old
Cocaine
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Cocaine use: last year prevalence among young adults in Europe, Australia, Canada and the USA
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Cocaine use: last year prevalence among young adults
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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2.5 million young adults (1.7 %) have used ecstasy in the last year
1.5 million young adults (1.2 %) have used amphetamines in the last year
Ecstasy and amphetamines
MarketDrug use
ConsequencesInterventions
StandardsPrison
Internet
Licit substances
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About 1.35 million (EU & Norway): or 0.4 % of the adult population (0.1-0.8%)
Injectors estimates around half of this or less and appear to be still decreasing
Opioids
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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750 000 to one million in the EU and Norway —0.26 % of the adult population
Decrease in the proportion of injectors among opioid users entering treatment
Injecting drug users
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Reports of problem opioid use in Russia and Ukraine (UNODC): 2−4 times the EU average
High proportion of drug injectors and levels of HIV infections
Problem opioid use in neighbouring countries
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Trends in newly reported HIV infections in injecting drug users in four EU Member States reporting high rates of infection
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Drug-induced deaths: change 2004 to 2007/8
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Around 1 000 cocaine-related deaths were reported in 2008
Marked increases in Spain and the United Kingdom
Cocaine deaths
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Prevention
• Environmental strategies: School policies
• Universal prevention: Normative beliefs, social competence, parenting
• Selective prevention: Socially excluded groups, vulnerable families
• Indicated prevention Early childhood problems etc.
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Prevention: Provision of selective prevention
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Large investments in treatment
At least 1 million Europeans undergo drug treatment every year
Major increase over the last decades: new providers and new needs
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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SE
NL. UK
DKFI
IT
PT
MT, AT LU
SI, ES, HR
DE, IE
PL, GR
BEFR, HU
LV, LT, BG
SK
CZ, RO, NOEE
ES, FR
FI
DK, IT, NL, AT, PT, SK, SE, UK
CZ, DE
NO
IE, GR, LT, LU
BE, EE, LV
SI
MT, HR
CY, RO
0
5
10
15
20
25
30
1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
cu
mu
lati
ve
nu
mb
er
of
co
un
trie
s
MMT HDBT
Year or introduction of methadone maintenance treatment (MMT) and high dosage buprenorphine treatment (HDBT) in Europe
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Large investments in treatment: opioid substitution treatment
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Estimated proportion of problem opioid users in substitution treatmentMarket
Drug useConsequencesInterventions
StandardsPrison
InternetLicit substances
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Trends in treatment entries by primary drug
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Treatment entries by primary drug: New clients
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Older drug users in drug treatment
Treatment starters above 4010 year before: usually below 10%
Today: 19%Portugal: 28%
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Older drug users in drug treatment
Mainly heroin addicts
Infectious diseases, mental health problems, living conditions more difficult
Premature aging
Needed: special services/facilities or closer collaboration between general health care and drug care
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Reintegration
• 47% outpatient clients unemployed
• 40 % clients entering treatment: no secondary education
• paid employment important part in reintegration into society and long term treatment outcome
-----> Focus on employability
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Guidelines in Europe
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
Comulative number of EU countries introducing guidelines in drug addiction(by year of introduction)
CY, RO, TR, NO
LTSE
PT, DK, HR
LV, ESNL
FI, BG, HU
EE, GR, CZ, AT
BE, DEFR, LU
SI
UKIE
0
5
10
15
20
25
30
1980 1985 1990 1995 2000 2005 2010
Nb
of
co
un
trie
s
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Guidelines in Europe
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
Treatment (TOTAL)
0
10
20
30
40
50
60
Not specified Psychosocial MT Detox Social Reint. Harmreduction
Alc + drugproblems
Nb
of
gu
ide
line
s
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MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Foto portale linee guida
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Situation
600 000 people in penal institutions in the EU
EU: 120/ 100.000, Russia: 629/100.000, US: 756/100.000
Reports of 10−30 % incarcerated because of drug law offences
Drug use prevalence much higher than among the general population
Increased overdose risk after prison release
MarketDrug use
ConsequencesInterventions
StandardsPrisonInternet
Licit substances
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Situation
Drug use prevalence much higher than among the general population
Entitlement to equivalent services as in the community
Risk reduction
Allows to reach highly problematic group
Possible effect on public health
MarketDrug use
ConsequencesInterventions
StandardsPrisonInternet
Licit substances
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Treatment in prison
Some countries recognise the need to develop specific strategies and interventions
Transfer of prison health to Ministries of Health; integration of drugs or health services in prison
Development of specific standards
MarketDrug use
ConsequencesInterventions
StandardsPrisonInternet
Licit substances
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Internet – an additional risk
170 online shops
Substances sold as ‘legal highs’
Rapid adaptation to control measures
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Internet – an additional resource
Information provision: warnings
Contacts to drug users (Cannabis, cocaine)
Internet based treatment
Mixed approaches
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substances
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Drugs and licit substances
Prevention: broader than drugs
Tobacco ban and cannabis regulations
Drugs policy vs. alcohol policy vs. policy on psychotropic substances
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substanc
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Drugs and licit substances
Overlapping target groups: multiple problems, substances, gambling, social conduct
Overlapping substances: “legal highs”, pharmaceutics
Overlapping objectives:limit access, reduce risks, avoid secondary problems, treat addictions …
MarketDrug use
ConsequencesInterventions
StandardsPrison
InternetLicit substanc
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Conclusions
• Overall stable, partly decreasing• Concern: Cocaine, synthetic drugs, “legal highs”• Local hot spots: Crack cocaine, alcohol/cannabis, young opiate users• Interventions well developed, increased quality
• Challenges: new substances, new needs• Opportunities: new media, programmes,treatments
• Policy sets objectives• Carefull implementation needed• EMCDDA: monitoring and quality development
MarketDrug use
ConsequencesInterventions
StandardsPrison
Internet
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Thanks for your attention
More information under:
emcdda.europa.eu