2 emcdda.europa.eu European drug report package A comprehensive analysis on the drugs problem in Europe

3 emcdda.europa.eu Country overviews Prevalence barometers Health and social responses profiles

4 emcdda.europa.eu PODs – perspectives on drugs Mass media campaigns Hepatitis C treatment for IDUs Preventing overdose deaths Emergency health consequences of cocaine use Trends in heroin treatment Characteristics of high-risk cannabis users New EU drugs strategy Controlling new psychoactive substances Models for the legal supply of cannabis Synthetic cannabinoids Synthetic drug production

5 emcdda.europa.eu The European drug policy landscape in 2013 After 30+ years with heroin centre stage in Europe — there are now signs of a decline The use of other ‘old drugs’ is overall stable but with some new developments New psychoactive substances are on the increase

Cannabis use in Europe 77 million adults ever used cannabis 15.4 million young adults used last year

7 emcdda.europa.eu 3 million daily cannabis users Young males over represented

8 emcdda.europa.eu Cannabis – rising treatment demand Second most frequently reported drug – all treatment clients Cannabis

9 emcdda.europa.eu Cannabis treatment: range of approaches Internet-based, brief interventions, family therapy, etc. Evaluations on the increase

10 emcdda.europa.eu Cannabis market changes: from resin to herb Herb Resin

11 emcdda.europa.eu Cannabis supply Domestic production reported by almost all countries Increased violence, organised crime involvement

12 emcdda.europa.eu Drug supply reduction: shift away from drug squads …towards organised crime agencies with drug supply reduction mandate

Opioids Europe’s biggest drug problem 1.4 million problem opioid users

14 emcdda.europa.eu Opioids > Heroin use – signs of a decline Fewer new clients entering treatment Ageing treatment cohort Less heroin injecting Heroin users in treatment

15 emcdda.europa.eu Overdose deaths decreasing Overdose deaths: From (2009) to (2011)

16 emcdda.europa.eu Drop in drug law offences Heroin

17 emcdda.europa.eu Opioids > Heroin: signs of a decline Lowest quantities seized for a decade

18 emcdda.europa.eu Heroin replaced by… Stimulants New drugs Other opioids etc. Fentanyl

19 emcdda.europa.eu Disruption in decline in new HIV diagnoses 2011 HIV outbreaks in Greece and Romania continued into 2012

20 emcdda.europa.eu Hepatitis C – a hidden epidemic Prevalence between 18– 80% in IDUs

21 emcdda.europa.eu New Hepatitis C treatments New generation of medicines being developed

22 emcdda.europa.eu Preventing overdose deaths Take-home naloxone programmes

23 emcdda.europa.eu Opioids > 1.2 million in drug treatment in Europe Substitution treatment is first choice for opioid users Other forms of treatment available in all countries

24 emcdda.europa.eu Substitution treatment – increasing provision in opioid substitution treatment Coverage for around 50% of POUs

25 emcdda.europa.eu Substitution treatment in prisons Available in most countries, but restrictions exist

Stimulants 2.5 million young Europeans used cocaine in the last year 1.8 million used ecstasy 1.7 million used amphetamines

27 emcdda.europa.eu Stimulants: increasingly complex market Stimulants > Predominant stimulant drug by last year prevalence among year olds

28 emcdda.europa.eu Wastewater analysis Recent studies support this geographical distribution of stimulants

29 emcdda.europa.eu Cocaine decline (high-prevalence countries) Recent surveys Treatment presentations Hospital emergencies Deaths Stimulants >

30 emcdda.europa.eu Cocaine: changes in trafficking? Diversification in trafficking routes

31 emcdda.europa.eu Signs of more methamphetamine AmphetamineMethamphetamine

32 emcdda.europa.eu Synthetic drug production: precursors and pre-precursors As one chemical comes under scrutiny, producers will simply switch to an alternative

33 emcdda.europa.eu Ecstasy: making a comeback? MDMA rebound

New drugs Around 280 new drugs monitored by the EWS

35 emcdda.europa.eu 73 new substances in synthetic cannabinoids in 2012

36 emcdda.europa.eu Emergence of synthetic cannabinoids in EU Powders manufactured in and imported from China Mixed with, or sprayed onto, herbs Packaged for sale as ‘legal highs’

37 emcdda.europa.eu Synthetic cannabinoids: new developments Resinous products Tablets resembling ‘ecstasy’ Cannabis sprayed

38 emcdda.europa.eu Risk assessment of NPS 4-MA (2012) – 21 deaths 5-IT (2013) – 21 deaths Formalised guidelines Health risks, social risks, organised crime Diffusion potential

39 emcdda.europa.eu A challenge for drug control policies Controlling NPS

40 emcdda.europa.eu In summary Drug use remains high by historical standards, but some positive changes apparent: Record treatment levels, declines in new heroin use and erosion in injecting Stable or declining trends for most ‘old’ drugs BUT ‘New’ problems are emerging linked to ‘new’ psychoactive substances Concern unemployment and service cuts could lead to re-emergence of ‘old’ problems