Annual report 2009: the state of the drugs problem in Europe NB Embargo 5 November :00 CET (Brussels time)

2 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

3 A multilingual information package Annual report 2009 in 23 languages Additional online material Statistical bulletin Country overviews Selected issues Reitox national reports

4 Overview 2009 Drug use levels still high in Europe But no major increases for most forms of use Amphetamine and ecstasy use: overall steady Cannabis: evidence of a decline in use, particularly in young people Cocaine and heroin maintain firm hold on Europe’s drug scene, with little sign of any recent improvement Polydrug use: now widespread and a growing issue for services

5 Overview 2009 New drugs: market innovation and sophistication Increasingly complex and volatile synthetic drug market Synthetic cannabinoids: latest in ‘designer drugs’ Changes in the ecstasy market Signs of methamphetamine edging into new territory

6 Part I Cocaine Heroin Cannabis Polydrug use

7 Cocaine, still Europe’s most popular stimulant Some 13 million European adults (15–64 years) have tried cocaine in their lifetime; some 4 million adults have used it in the last year Still concentrated in western EU countries, but 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

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

9 Cocaine — more figures… Cocaine seizures rose to in 2007 ( in 2006) But the quantity seized dropped: to 77 tonnes in 2007 (121 tonnes in 2006) 22 % of those entering drug treatment for the first time cite cocaine as their primary drug Some 500 cocaine-related deaths were reported in 2007

10 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

11 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

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

13 Warning signs (ii): drug-induced deaths In the period 1990–2006, between and 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

14 Warning signs (iii): seizures Number of reported heroin seizures (EU + Norway) rose on average by around 4 % per year between 2002 and 2007 Estimated seizures in 2007 ( 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)

15 Cannabis — declining use 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 have used it in the last year But new data confirm last year’s assessment of overall declining popularity, particularly among young people The falling trend is particularly noticeable among schoolchildren School survey data from the USA and Australia also point to a decreasing trend since the early 2000s

16 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

17 Different patterns in trends in lifetime prevalence of cannabis use among 15- to 16-year-old school students 1 2 3

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

19 Cannabis — young adults Last year cannabis use among young adults (15–34 years): generally a stabilisation or decline between 2002 and 2007 But less encouraging is the number of regular and intensive cannabis users in Europe Up to 2.5 % of all young Europeans could be using cannabis on a daily basis A large population at risk and in potential need of treatment One example of innovative responses: Internet-based drug treatment interventions

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

21 Polydrug use — patterns and responses Polydrug use, widespread in Europe Combined use of different substances is ‘responsible for, or complicates, most of the problems we face’ Increases risks and complicates treatment delivery Alcohol present in almost all polydrug use repertoires ‘Selected issue’ — overview of this behaviour in: schoolchildren (15–16 years) young adults (15–34 years) problem drug users

22 Polydrug use — schoolchildren Of schoolchildren (15–16 years) surveyed in 22 countries: 20 % reported use in the last month of alcohol with cigarettes 6 % cannabis with alcohol and/or cigarettes 1 % cannabis with alcohol and/or cigarettes plus at least one other illicit drug (ecstasy, cocaine, amphetamines, LSD or heroin) Polydrug use can increase the risk of toxic effects and is associated with a greater risk of developing long-term problems

23 Polydrug use — young adults Among young adults (15–34 years), polydrug use can reflect established patterns of substance use, potentially carrying long-term health problems, but also acute risk- taking during leisure time Frequent or heavy alcohol users in this age group were between two and six times more likely to have used cannabis in the last year than the general population And between two and nine times more likely to have used cocaine during that period

24 Polydrug use — problem drug users Particularly prevalent among problem drug users Can aggravate their already difficult health conditions, leading to increased risk-taking and sometimes severe consequences In a recent analysis, over half (57 %) of those entering treatment reported problems with at least two different drugs Toxicology reports following fatal overdoses often show the presence of more than one substance Management of polydrug use among problem drug users is a complex task

25 Part II Difficulties of ‘hitting a moving target’ Detecting new drugs Monitoring the Internet ‘Spice’ Ecstasy Methamphetamine

26 Difficulties of ‘hitting a moving target’ Market innovation and sophistication challenge drug policies Increasingly complex and volatile synthetic drug market Suppliers now ‘highly innovative’ in their production processes, product ranges and marketing ‘Growing sophistication’ in marketing legal alternatives to illicit drugs (so-called ‘legal highs’) Wide range of substances and growing use of the Internet

27 Detecting new drugs Europe is making headway in detecting new drugs EU early-warning system (rapid-response mechanism set up in 1997), has tracked over 90 substances to date In 2008, 13 new psychoactive substances were reported by EU Member States to the EMCDDA and Europol For the first time, a synthetic cannabinoid, JWH-018, was among the reported drugs Synthetic cannabinoids — latest stage in the development of ‘designer drugs’

28 Monitoring the Internet Monitoring the Internet — an ‘increasingly important element in identifying new drug trends’ Now a major marketplace for psychoactive substances In 2009, the EMCDDA surveyed 115 online shops in 17 European countries Majority of the online retailers’ websites were registered in the UK (37 %), Germany (15 %), Netherlands (14 %) and Romania (7 %) Innovations of the online market include the creation of distinct brands and attractive packaging, a prime example being ‘Spice’

29 Is ‘Spice’ the taste of things to come? Products marketed under the ‘Spice’ brand have been monitored through the early-warning system since early 2008 Packaging information claims these are a blend of plant or herbal materials (often sold as incense), but some batches contain synthetic cannabinoids (e.g. JWH-018) These ingredients do not feature in the product information and may therefore be consumed unknowingly Some 48 % of the 115 online retailers surveyed were offering ‘Spice’

30 Changes in the ecstasy market Most ecstasy tablets analysed until 2007 typically contained MDMA or another ecstasy-like substance (e.g. MDA, MDEA) This may be changing in some EU countries: around half of the ‘ecstasy’ tablets recently seized or sold in Denmark and the Netherlands contained no MDMA (instead tablets contained mCPP) Changes in the ecstasy market may be the result of more successful efforts to prevent the diversion of precursors The shortage of PMK, a key precursor used to make MDMA, could be one explanation for the recent changes

31 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

32 Methamphetamine — Norway and Sweden In 2007, almost seizures of methamphetamine, amounting to approximately 340 kg, were reported in Europe Norway, by far the highest number of seizures (1 284) and the largest amount of methamphetamine recovered (167 kg) The second largest amount of methamphetamine seized in Europe (51 kg) was in Sweden Methamphetamine production in Europe has traditionally taken place in small-scale kitchen laboratories in the Czech Republic Europol now reports some larger sites in other parts of Europe (e.g. Germany, the Netherlands)

33 Seized meth- amphetamine production facilities in 2008 and main trafficking flows

34 Part III Treatment today Selected issue: Drug offences Development of effective drug policies in Europe and beyond

35 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 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

36 Trend in the number of clients receiving opioid substitution treatment from 1993 to 2007 in the EU-27

37 Drug offences: sentencing and other outcomes Little is known about the outcomes of drug offences Selected issue — a step towards filling this information gap Explores what happens to those who violate drug laws in 26 countries Examines national statistics (police, prosecutors, courts) according to: type of offence (personal use, supply) type of outcome (fine, custody, treatment, community work) Custodial sentences are rarely handed out for drug use or possession but are common for supply-related offences

38 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 Two thirds of them plan to evaluate these policy documents