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

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

4. 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. 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

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

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

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

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

10. 10 emcdda.europa.eu Cannabis market changes: from resin to herb 20012011 Herb Resin

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

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

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

14. 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. 15 emcdda.europa.eu Overdose deaths decreasing Overdose deaths: From 7 700 (2009) to 6 500 (2011)

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

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

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

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

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

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

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

23. 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. 24 emcdda.europa.eu Substitution treatment – increasing provision 730 000 in opioid substitution treatment Coverage for around 50% of POUs

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

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

27. 27 emcdda.europa.eu Stimulants: increasingly complex market Stimulants > Predominant stimulant drug by last year prevalence among 15- 34 year olds

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

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

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

31. 31 emcdda.europa.eu Signs of more methamphetamine AmphetamineMethamphetamine

32. 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. 33 emcdda.europa.eu Ecstasy: making a comeback? MDMA rebound

34. New drugs Around 280 new drugs monitored by the EWS

35. 35 emcdda.europa.eu 73 new substances in 2012 30 synthetic cannabinoids in 2012

36. 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. 37 emcdda.europa.eu Synthetic cannabinoids: new developments Resinous products Tablets resembling ‘ecstasy’ Cannabis sprayed

38. 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. 39 emcdda.europa.eu A challenge for drug control policies Controlling NPS

40. 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