1. Meth/amphetamines - trends in stimulant production and use in Europe Tomas Zabransky Identifying Europe’s information needs for effective drug policy Lisbon, 7 th May, 2009

2. Structure of the presentation History of meth/amphetamine type stimulants (ATS) Recent history of ATS in Europe Czech Republic Slovak Republic Some other EU countries Neighbouring countries / countries of Eastern partnership Risks and challenges How to understand better / respond in time? 3.5.2015page 2Meth/amph trends in Europe

3. Meth/amphetamines: fairly traditional drugs Amphetamine: 1887 (Lazăr Edeleanu) Methamphetamine: 1919 (Ogata) WW II use: amphetamine (Allies) vs. methamphetamine (Axis) 1940s post-war distribution of the huge war surplus in US, Europe, and Japan 1950s pharmaceutical wave: anorectics and stimulants („good wife drug“) 3.5.2015page 3Meth/amph trends in Europe

4. Housework on meth

5. Mods on purple hearts and MSM clubbers on meth

6. Recent global situation UNODC „guestimates“ production as high as 332 metric tons per year and 24 mil recent users 2.7 million Europe 4.3 million Americas 16.7 million Asia 1.8 million Africa 600 thousand in Oceania. Principal drugs for: Australia, New Zealand, China, the Czech Republic, Japan, the Philippines, Slovakia, Sweden, Thailand, and the U.S.

7. CZ situation Iron curtain after 1948 cut off people, and commodities – incl. psychotropic drugs Use of pharmaceuticals with/out alcohol 1970s: simple formula of production of meth (pervitin) reinvented, probably in Prague, and quickly widespread into the Czech part of the federation Self-supporting „squads“ of 3-6 people sharing supplying functions and production know-how as typical phenomenon of pervitin production and consumption 3.5.2015page 7Meth/amph trends in Europe

8. History (cont.) 1984: estimated 30,000 „non-alcohol addicts“ in Czechoslovakia; pervitin clearly prevailing 1986: 1890 people arrested because of „drug crimes,“ only 6 because of „drug sale“ 1990s and later: home-made opioids pushed out by heroin and its hierarchically organized suppliers quickly, but not so for meth… (so far) 3.5.2015page 8Meth/amph trends in Europe

9. Prevalences (for country of 10 mil.) 18-64 of age, 2004: Lifetime prevalence: 2.5% (22% THC) Last year prevalence: 0.9% (9.3% THC) ESPAD (16agers), 2007: LTP: 3.5% (45.1% cannabinoids) LYP: 3.1% (34.8% cannabinoids) Prevalence of problem use of pervitin, 2007: 21,000 meth PDUs out of all 31,000 PDUs (stable in last 10 years) Immigrant (Russian speaking) drug users in Prague (2007-8): 77% used meth in last month 3.5.2015page 9Meth/amph trends in Europe

10. Prevalences in night life / dance culture setting 3.5.2015page 10Meth/amph trends in Europe LTP in general population: 2,5% LTP in dance scene: 47,6% LMP between 2003 and 2007 increased only in stimulants (and far less by shrooms). Frequency of use increased in general (except alcohol), and in pervitin it increased most.

11. Market/s and law enforcement Estimated annual consumption (2005): 3,150 kg, of which 160 kg consumed in recreational settings, almost 3,000 kg by PDUs Price about 1000 CZK (37 €) per 1 g stable for last 15 years, as well as purity (but average income tripled) Seizures: 6,15 kg in 374 seizure cases (0,2 % of consumed) 281 cases < 5 g 168 cases < 1 g 1178 „meth arrests“ in 2007 (59% of all drug arrests) 593 (49% of all drug cases) sentenced in the same year 3.5.2015page 11Meth in Czech Republic

12. Recent trends in CZ The majority of the meth is produced in small scale kitchen settings – up to 5 grams per week Police provides isolated reports on export of Czech meth and/or „cooks“ to neighbouring countries persistent from mid 1990s (esp. Germany: „Czecho,“ Kristall“; less so Austria) In 2007 and 2008: the first cases of „manufacture“ meth production in 2000s; author of this ppt connects it directly to increase in meth recreational use New attempts for regulation of pharmaceutical pseudo/ephedrine: limited amount per month, connected with ID 3.5.2015page 12Meth in Czech Republic

13. Case of Slovakia: things can go really fast Slovakia never experienced real epidemic in meth use during the Czechoslovak federation and until early 2000s, but… 3.5.2015page 13Meth/amph trends in Europe Positive meth urine tests in patients entering methadone treatment in Bratislava (Source: CPLDZ 2008)

14. SK - FTD 3.5.2015page 14Meth/amph trends in Europe Source: Slovak National Centre for Health Information

15. Sweden Amphetamine traditional, but share of methamphetamine seems to increase (2005-9 MA doubled to 14% in specimen of minor offenders) Incidence: In the recent study, of newcomers to (alcohol / drugs / social care) outpatient centres 30% used meth/amphetamines, 25% XTC, 20% BZPs, 20% cocaine, 7% heroin TRT Prevalence: 34% among the reported drug clients in treatment outside prisons heroin 22% cannabis 20% Clients treated in prisons amphetamines 36% heroin 11% of the cases. 3.5.2015page 15Meth/amph trends in Europe

16. Other EU countries Poland: amphetamines have been a big issue traditionally (reported increased production in bigger amounts from 2006), and in 2008 first lab producing meth discovered in Szczecin In Lithuania, large-scale labs are detected and classical market sale is reported by IDUs Hungary: Number of stimulants patients doubled between 2000-6 (at 1500 patients) Increasing evidence from other Baltic countries Police in those countries connects it to Lithuanian and Polish labs 3.5.2015page 16Meth/amph trends in Europe

17. Central and Eastern European countries Skyrocketing of pseudo/ephedrine based drugs use in Ukraine from early 2000s – esp. young injectors (68% of IDUs in Kiev injected ATS within 1 month prior to 2008 interview ) An explosion of the same phenomena in Georgia: 2004 – 0 cases; 2008: most frequently injected drugs by PDUs in last month Patterns of production similar to Czech ones in terms of „squads,“ but using fairly primitive production patterns for meth (jeff), and Very easy „boiling“ of methcathinone (boltushka) with kalium and mangan injected, and Cathinone and ephedrine 3.5.2015page 17Meth/amph trends in Europe EXTREMELY RISKY IN TERMS OF COMMON JAR AND ADULTERANS

18. Risks and challenges The price makes meth/amphetamines very competitive in times of economic crisis The relative easiness of making the drug/s and wide spectre of possible procedures (and precursors – P/E, BMK, P2P, …) makes them fairly available Very quick changes at the market possible Injecting common for both meth/amphetamine – BBDs risk Production patterns may facilitate HIV transmission (common jar) Toxic waste as byproduct The whole phenomenon rather underestimated Unintended consequences of regulation measures high: see US example/s 3.5.2015page 18Meth/amph trends in Europe

19. Outlook for stimulant markets? Methamphetamine from north-east, cocaine from south-west? Price vs. reputation Economic crisis may favourise the cheaper product not dependent on plant precursor 3.5.2015page 19Meth/amph trends in Europe

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21. How to monitor a fast drug phenomena little dependent on plant precursors? Much of smoke, limited fire? Maybe, but the swiftness was demonstrated in SK (and HU, and GE) Typically, when the law enforcement and treatment agencies data catch the trend, it is in full run already The EMCDDA system is well developed and unique globally But relies on quantitative data, that, by definition come too late EWS…? But first of all, „qualitative monitoring“ is needed Ask those who know Make qualitative monitoring part of the system 3.5.2015page 21Meth/amph trends in Europe

22. Conclusions Meth/amphetamines are quite traditional in EU and quick in changing drug use situations and drug markets when entering it Easy production and cheapness may create strong potential for spread in the LARGE stimulant market of EU Technologies, and consumers are here…what is the trigger? We need a real-time monitoring, working in much shorter periodicity / time lags. 3.5.2015page 22Meth/amph trends in Europe

23. Thank you for your attention! copies of the presentation at tomas@zabransky.cz tomas@zabransky.cz 3.5.2015page 23Meth/amph trends in Europe