An overview of European
trends and developments
Roland Simon
ECAD Meeting 2011, Varna
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
European
Monitoring Centre
for Drugs and Drug
Addiction
(EMCDDA)
Community Agency
Established: 1993
Staff: 102
The drug information hub in Europe
2
Participating
Countries:
Market
Drug use
Consequences
Interventions
27 EU Member
States, Croatia,
Turkey and
Norway
Standards
Prison
Internet
Licit substances
3
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 2010 + more recent details
4
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
Cannabis
Herbal:
289 000 seizures (250% of 2003)
90 tons: Turkey 31t, Germany 9t
Resin
369 000 seizures (increased)
900 t (increased last years)
More than half of seizures/amount: Spain
Proper balance?
5
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
Cocaine seizures
Number of seizures increasing for last 20 years:
96 000
Quantities seized decreased since 2006:
67 tonnes
New smuggling techniques
6
Heroin seizures and quantities seized
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
7
New Drugs – “Legal Highs”
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
• 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
8
Cannabis
Market
Drug use
Consequences
Interventions
75.5 million Europeans have ever used cannabis
(22.5 %)
23 million in the past year (6.8 %)
Standards
Prison
Internet
17 million are between 15 and 34 years old
Trends mostly downwards (not Easter Europe)
9
Market
Drug use
Consequences
Interventions
Cannabis use:
last year
prevalence
among young
adults
Standards
Prison
Internet
Licit substances
10
Cocaine
Market
Drug use
Consequences
Interventions
14 million Europeans have ever used cocaine (4.1 %)
Standards
Prison
Internet
Licit substances
4 million during the past year (1.3 %)
3 million are between 15 and 34 years old
11
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
12
Cocaine use:
last year
prevalence
among
young adults
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
13
Ecstasy and amphetamines
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit
substances
2.5 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
14
Opioids
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
About 1.35 million (EU & Norway):
or 0.4 % of the adult population (0.1-0.8%)
Injectors estimates around half of this or less
and appear to be still decreasing
15
Injecting drug users
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
750 000 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
16
Problem opioid use in
neighbouring countries
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
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
17
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
18
Drug-induced deaths:
change 2004 to 2007/8
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
19
Cocaine deaths
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
Around 1 000 cocaine-related deaths
were reported in 2008
Marked increases in Spain
and the United Kingdom
20
Prevention
Market
Drug use
Consequences
Interventions
• Environmental strategies: School policies
Standards
Prison
Internet
Licit substances
• Universal prevention:
Normative beliefs, social competence, parenting
• Selective prevention:
Socially excluded groups, vulnerable families
• Indicated prevention
Early childhood problems etc.
21
Prevention: Provision of selective
prevention
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
22
Large investments
in treatment
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
At least 1 million Europeans undergo drug
treatment every year
Major increase over the last decades:
new providers and new needs
23
Year or introduction of methadone maintenance
treatment (MMT) and high dosage buprenorphine
treatment (HDBT) in Europe
30
EE
CZ, RO, NO
CY, RO
cumulative number of countries
25
SK
MT, HR
LV, LT, BG
FR, HU
20
SI
BE, EE, LV
BE
IE, GR, LT, LU
PL, GR
DE, IE
15
NO
CZ, DE
DK, IT, NL, AT, PT, SK, SE,
UK
SI, ES, HR
10
MT, AT
LU
IT
DK
5
PT
FI
FI
NL. UK
ES, FR
SE
0
1965
1970
1975
1980
1985
MMT
1990
1995
2000
2005
2010
HDBT
24
Large investments in treatment:
opioid substitution treatment
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
25
Market
Drug use
Consequences
Interventions
Estimated
proportion of
problem opioid
users in
substitution
treatment
Standards
Prison
Internet
Licit substances
26
Trends in treatment entries
by primary drug
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
27
Treatment entries by primary
drug: New clients
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
28
Older drug users in drug treatment
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
Treatment starters above 40
10 year before: usually below 10%
Today:
Portugal:
19%
28%
29
Older drug users in drug treatment
Mainly heroin addicts
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
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
30
Reintegration
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
• 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
31
Guidelines in Europe
Comulative number of EU countries introducing guidelines in drug addiction
(by year of introduction)
30
Standards
Prison
Internet
Licit substances
CY, RO, TR, NO
25
SE
20
Nb of countries
Market
Drug use
Consequences
Interventions
LT
PT, DK, HR
LV, ES
NL
15
FI, BG, HU
EE, GR, CZ, AT
10
BE, DE
FR, LU
5
UK
SI
IE
0
1980
1985
1990
1995
2000
2005
2010
32
Guidelines in Europe
Treatment (TOTAL)
60
Standards
Prison
Internet
Licit substances
50
Nb of guidelines
Market
Drug use
Consequences
Interventions
40
30
20
10
0
Not specified Psychosocial
MT
Detox
Social Reint.
Harm
reduction
Alc + drug
problems
33
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
34
Market
Drug use
Consequences
Interventions
Foto portale linee guida
Standards
Prison
Internet
Licit substances
35
Situation
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
600 000 people in penal institutions in the EU
EU: 120/ 100.000,
Russia: 629/100.000, US: 756/100.000
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
36
Situation
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
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
37
Treatment in prison
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substances
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
38
Internet – an additional risk
Market
Drug use
Consequences
Interventions
170 online shops
Substances sold as ‘legal highs’
Rapid adaptation to control measures
Standards
Prison
Internet
Licit substances
39
Internet – an additional resource
Market
Drug use
Consequences
Interventions
Information provision: warnings
Contacts to drug users (Cannabis, cocaine)
Internet based treatment
Standards
Prison
Internet
Licit substances
Mixed approaches
40
Drugs and licit substances
Market
Drug use
Consequences
Interventions
Prevention: broader than drugs
Tobacco ban and cannabis regulations
Standards
Prison
Internet
Licit substanc
Drugs policy vs. alcohol policy vs.
policy on psychotropic substances
41
Drugs and licit substances
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
Licit substanc
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 …
42
Conclusions
Market
Drug use
Consequences
Interventions
Standards
Prison
Internet
• 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
43
Thanks for your attention
More information under:
emcdda.europa.eu
44
Descargar

2006 Annual report on the state of the drugs problem in …