An overview of European trends and developments Roland Simon ECAD Meeting 2011, Varna

2 European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Community Agency Established: 1993 Staff: 102 The drug information hub in Europe Market Drug use Consequences Interventions Standards Prison Internet Licit substances

3 Participating Countries: 27 EU Member States, Croatia, Turkey and Norway Market Drug use Consequences Interventions Standards Prison Internet Licit substances

4 Trends Market Drug use Consequences Interventions Developments Standards and quality of interventions Drugs in prison Drugs and the internet Drugs and licit psychotropic substances Data: Annual Report more recent details

5 Herbal: seizures (250% of 2003) 90 tons: Turkey 31t, Germany 9t Resin seizures (increased) 900 t (increased last years) More than half of seizures/amount: Spain Proper balance? Cannabis Market Drug use Consequences Interventions Standards Prison Internet Licit substances

6 Number of seizures increasing for last 20 years: Quantities seized decreased since 2006: 67 tonnes New smuggling techniques Cocaine seizures Market Drug use Consequences Interventions Standards Prison Internet Licit substances

7 Heroin seizures and quantities seized Market Drug use Consequences Interventions Standards Prison Internet Licit substances

8 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

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 Market Drug use Consequences Interventions Standards Prison Internet

10 Cannabis use: last year prevalence among young adults Market Drug use Consequences Interventions Standards Prison Internet Licit substances

11 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

12 Cocaine use: last year prevalence among young adults in Europe, Australia, Canada and the USA Market Drug use Consequences Interventions Standards Prison Internet Licit substances

13 Cocaine use: last year prevalence among young adults Market Drug use Consequences Interventions Standards Prison Internet Licit substances

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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

15 About 1.35 million (EU & Norway): or 0.4 % of the adult population ( %) Injectors estimates around half of this or less and appear to be still decreasing Opioids Market Drug use Consequences Interventions Standards Prison Internet Licit substances

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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

17 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

18 Trends in newly reported HIV infections in injecting drug users in four EU Member States reporting high rates of infection Market Drug use Consequences Interventions Standards Prison Internet Licit substances

19 Drug-induced deaths: change 2004 to 2007/8 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

20 Around cocaine-related deaths were reported in 2008 Marked increases in Spain and the United Kingdom Cocaine deaths Market Drug use Consequences Interventions Standards Prison Internet Licit substances

21 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. Market Drug use Consequences Interventions Standards Prison Internet Licit substances

22 Prevention: Provision of selective prevention Market Drug use Consequences Interventions Standards Prison Internet Licit substances

23 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

24 Year or introduction of methadone maintenance treatment (MMT) and high dosage buprenorphine treatment (HDBT) in Europe

25 Large investments in treatment: opioid substitution treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances

26 Estimated proportion of problem opioid users in substitution treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances

27 Trends in treatment entries by primary drug Market Drug use Consequences Interventions Standards Prison Internet Licit substances

28 Treatment entries by primary drug: New clients Market Drug use Consequences Interventions Standards Prison Internet Licit substances

29 Older drug users in drug treatment Treatment starters above year before: usually below 10% Today: 19% Portugal: 28% Market Drug use Consequences Interventions Standards Prison Internet Licit substances

30 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

31 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

32 Guidelines in Europe Market Drug use Consequences Interventions Standards Prison Internet Licit substances

33 Guidelines in Europe Market Drug use Consequences Interventions Standards Prison Internet Licit substances

34 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

35 Foto portale linee guida Market Drug use Consequences Interventions Standards Prison Internet Licit substances

36 Situation people in penal institutions in the EU EU: 120/ , Russia: 629/ , US: 756/ 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

37 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

38 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 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

39 Internet – an additional risk 170 online shops Substances sold as ‘legal highs’ Rapid adaptation to control measures Market Drug use Consequences Interventions Standards Prison Internet Licit substances

40 Internet – an additional resource Information provision: warnings Contacts to drug users (Cannabis, cocaine) Internet based treatment Mixed approaches Market Drug use Consequences Interventions Standards Prison Internet Licit substances

41 Drugs and licit substances Prevention: broader than drugs Tobacco ban and cannabis regulations Drugs policy vs. alcohol policy vs. policy on psychotropic substances Market Drug use Consequences Interventions Standards Prison Internet Licit substanc

42 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 … Market Drug use Consequences Interventions Standards Prison Internet Licit substanc

43 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 Market Drug use Consequences Interventions Standards Prison Internet

44 Thanks for your attention More information under: emcdda.europa.eu