Transcript 2006 Annual report on the state of the drugs problem in Europe

2007 Annual report on the state
of the drugs problem in Europe
NB embargo 22 November 10:00 CET (Brussels time)
Latest on the drugs problem across Europe
• Overview of the European drug
phenomenon in 29 countries
• Data and analyses: across
Europe and by country
• Latest trends and responses
• Selected issues:
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Drugs and driving
Drug use among the under 15s
Cocaine and crack cocaine use:
a growing public health issue
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A multilingual information package
2007 Annual report:
In print and online in 23 languages
• http://www.emcdda.europa.eu/events/2007/annualreport.cfm
• Additional online material in English:
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Selected issues
Statistical bulletin
Country data profiles
Reitox national reports
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Part I: Annual report – 2007 overview
• After over a decade of rising drug use, Europe may now be
entering a more stable phase
• Heroin use and drug injecting generally less popular
• Cannabis use stabilising, signs of popularity waning among the
young in some countries
• Cocaine use rising again and record amount of cocaine seized
• HIV: overall positive assessment, but around 3 500 new
infections among IDUs in 2005
• High levels of drug-related deaths
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Cannabis use stabilising
• Some 70 million adults in the EU (15–64 years) have ever
tried cannabis. Some 23 million have used it in the last year
• After escalating cannabis use in the 1990s, data suggest
that use is stabilising overall and falling in some countries
• Among high-ranking countries, rates have stabilised or are
beginning to fall in Spain and have dropped by some 3–4
percentage points in the Czech Republic, France and the UK
• Data from mid-ranking countries show a stabilisation in
Denmark and the Netherlands
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Figure GPS-4: Trends in last-year prevalence of cannabis among young adults
(aged 15–34), measured by national surveys
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Signs of popularity waning among the young
• Among the UK’s younger cannabis users (16–24 years),
last-year use fell from 28.2% in 1998 to 21.4% in 2006
• Spanish School Survey (14–18 years): last-year use fell
from 36.6% in 2004 to 29.8% in 2006
• Cannabis use still rising among young adults (15–34 years)
in Hungary, Slovakia and Norway, but most rises are small
• The exception is Italy. Rates of last-year cannabis use in
young adults rose from 12.8% in 2003 to 16.5% in 2005.
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Figure GPS-10: Last-year prevalence of cannabis use by age group in the UK,
measured by national population surveys
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Attention turns to intensive cannabis use
• Only a relatively small proportion of cannabis users
report using the drug on a regular or intensive basis
• But still ‘a significant number of individuals’, says report
• 18% of the 70 million adults who have ever tried cannabis,
reported having used it in the last month, over 13 million
• Around 1% of European adults (around 3 million people)
may be using the drug on a daily, or almost daily, basis
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Treatment demands for cannabis problems
• Between 1999 and 2005, numbers of Europeans demanding
treatment for cannabis problems approximately trebled
• And new demands for treatment for cannabis problems rose
from 15 439 to 43 677 clients
• In 2005, 29% of all new demands were cannabis-related
• Innovative interventions are now developing in Europe to meet
the different needs of occasional, regular and intensive users
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Figure TDI-1, part ii: Trend in estimated number of new clients entering
treatment by primary drug used (1999–2005). Trend in numbers of clients by
primary drug.
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Chapter 3, Figure 4: Trends in pattern of use of treatment services (1999–2005).
Principal drug for which clients ask treatment as % of all requests.
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Cocaine use rising again
• 2007 report: some 4.5 million Europeans (all adults
aged 15–64 years) are likely to have used cocaine in
the last year
• 2006 report: estimate of 3.5 million adults
• Second most commonly used illicit drug after
cannabis
• Ahead of ecstasy and amphetamines
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Cocaine figures
• Some 12 million Europeans (4% of adults) have ever tried it
• Some 2 million have taken it in the last month, more than
double the estimate for ecstasy
• Among young adults (15–34 years), increases in last-year
cocaine use were registered in most reporting countries
• Some 7.5 million young adults have ever tried cocaine,
3.5 million in the last year, 1.5 million in the last month
• In highest prevalence countries (Spain, UK) recent increases
were small, suggesting that prevalence may be levelling off.
Clear rises were reported by Denmark and Italy.
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Chapter 5, Figure 7: Trends in last-year prevalence of cocaine use in young adults (15–34)
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Impact of cocaine on public health
• One indication of how cocaine is impacting on public health
is the rise in demand for treatment for cocaine problems
• In 2005, close to a quarter (22%) of all new demands for
treatment in Europe were cocaine-related: a total of 33 027
clients, compared with 12 633 in 1999
• Most treatment demands occur in a small number of
countries: Spain and the Netherlands are responsible for the
majority of reports of cocaine treatment in Europe
• Treatment services are faced with offering care to a broad
spectrum of clients (see Selected issues, Part II below)
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Record amount of cocaine seized
• Numbers of cocaine seizures and quantities intercepted
increased in Europe between 2000 and 2005
• 70 000 cocaine seizures amounting to a record 107 tonnes in
2005 (up over 45% on quantities seized in 2004)
• Around half the total number of seizures and the greatest
volume seized were in Spain (48.4 tonnes in 2005; 33.1 in 2004)
• Portugal was the country with the second largest quantities
intercepted (18.1 tonnes in 2005; 7.4 tonnes in 2004)
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Transit routes
• Iberian Peninsula, main point of entry of cocaine into Europe
• Most cocaine seized in Europe enters the continent from
South America or via Central America and the Caribbean
• West African countries increasingly used as transit routes
• EU responds to changes in trafficking routes via enhanced
coordination and cooperation between Member States
• Maritime Analysis and Operations Centre – Narcotics
(MAOC-N) established in September 2007
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HIV: overall positive assessment
• Rate of HIV transmission among injecting drug users (IDUs)
was low in most EU countries in 2005
• With the expansion of services, the HIV epidemics seen earlier
in Europe seem largely to have been avoided
• Baltic States, also relative decrease in new infections
• But some 3 500 new infections among IDUs in the EU in 2005
• Among EU MS reporting data, Portugal has highest HIV
transmission rate in IDUs (+/- 850 new infections in 2005)
• Up to 200 000 IDUs live with HIV, up to 1 million live with HCV
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High levels of drug-related deaths
• Overdose, a major cause of preventable death among young
Europeans
• Deaths historically high: 7 000–8 000 overdose deaths per year
and no downward trend detectable in most recent data
• Recent rises in deaths recorded in several countries, and clear
rises of over 30% in: Greece (2003–2005), Austria (2002–2005),
Portugal (2003–2005) and Finland (2002–2004)
• Europe lacks comprehensive approach to overdose prevention
• …and risks failing to meet targets to reduce drug-related deaths
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Drug-related deaths (continued)
• Risk factors possibly contributing to the problem: more
polydrug use by opioid users and rises in heroin availability
• The sustainability of the generally stable heroin situation in
Europe is called into question by rising Afghan opium
production
• 6 610 tonnes of opium produced in 2006 — 92% in Afghanistan
• Estimates of global heroin production increase again:
606 tonnes in 2006, up from 472 tonnes in 2005 (UNODC, 2007)
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Chapter 8, Figure 13: Overall trend in acute drug-related deaths, 1996–2005 for all
Member States with available data
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Part II: Selected issues – 2007 overview
Three in-depth reviews published alongside the
2007 Annual report
• Drugs and driving
• Drug use and related problems among very
young people (under 15s)
• Cocaine and crack cocaine use: a growing
public health issue
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Drugs and driving (1)
• After alcohol, cannabis and benzodiazepines are the psychoactive substances most prevalent among Europe’s drivers
• A consistent finding regardless of study type (e.g. roadside
tests at random/on suspicion, in hospitals, post-mortem)
• Studies are equally divided as to which of the two substances
is more prevalent
• Exceptions: in Finland, Sweden, Latvia and Norway,
amphetamines are more frequently found in drivers than
cannabis and benzodiazepines. In Slovenia, opioids are found
more often than benzodiazepines.
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Drugs and driving (2)
• Performance tests show that use of cannabis and
benzodiazepines results in impaired driving ability, varying
according to dose, tolerance and delay after intake
• Risk assessment studies show that combining these drugs
with alcohol significantly increases the risk of being involved
in, or responsible for, a traffic accident
• Cannabis-using drivers tend to be young males while
benzodiazepine-using drivers middle-aged and often female
• Alcohol: still no 1 substance endangering lives on our roads
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Drugs and driving (3)
• Many countries have tightened laws, increased penalties or
altered national strategies to address the problem
• Countries’ legal responses to drug driving vary greatly,
from ‘zero tolerance’ laws (sanctioning detection of the
substance per se) to impairment laws (sanctioning if the
person is deemed unfit to drive)
• ‘Zero tolerance’ laws for illicit drugs (e.g. cannabis) have
been introduced in Belgium, Portugal and Sweden (1999)
and France and Finland (2003)
• Several countries have passed laws to allow or define
roadside drug testing (e.g. by saliva, sweat testing), but
some draft laws await reliable test kits before enactment
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Drugs and driving (4)
• Most EU MS carry out mass media campaigns on health risks of
substance use and driving, but these focus mainly on alcohol
• Only around one-fifth of EU countries target cannabis and
benzodiazepines specifically
• Drug-specific prevention programmes are now a prominent
feature in driving schools
• ‘One-size-fits-all’ campaigns may be unsuitable (cannabis and
benzodiazepine users have quite different profiles)
• Many unaware of possible effects of medication on driving
ability (5 countries use pictograms on medicinal packaging)
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Drug use among the under-15s (1)
• Illicit drug use in very young people is rare and regular use rarer
• Largely found among specific groups of the population where
drug use occurs alongside other psychological/social disorders
• Cannabis is the illicit substance most commonly used, followed
by inhalants (e.g. glue, aerosols)
• Of 15–16 year-old school students reporting to have used
cannabis, first use by age 13 is uncommon (typically 1%–4%)
• School surveys showed that daily tobacco smoking by age 13
varied in EU countries (7%–18%). Between 5% and 36% of
school students reported having ever been drunk by that age
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Drug use among the under-15s (2)
• Few under-15s enter drug treatment (less than 1% of all clients)
• Referred by family, social services or by criminal justice system
• The large majority do so for primary cannabis use, and to a
lesser extent for use of inhalants
• Under-15s whose family members use psychoactive substances
are known to be at higher risk of early drug use (at least 28,000
clients in drug treatment live with their children)
• In 2005, 18 drug-related deaths among the under-15s were
reported in Europe (0.2% of the total number of such deaths)
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Drug use among the under-15s (3)
• Responses targeted at very young drug users range from
universal prevention approaches (e.g. schools, communities)
to early interventions (e.g. counselling) when use is suspected
• Mid-way between these are prevention responses tailored to
high-risk groups (e.g. families at risk)
• In most EU countries, measures to prevent the early use of licit
substances are viewed as prevention against use of illicit ones
later
• Promoting the use of illicit drugs among young people incurs
stiff penalties in several countries
• Sale of illicit drugs near schools or locations attended by
young people is also severely penalised
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Cocaine and crack cocaine use (1)
Considerable concern in recent years regarding:
• rises in cocaine use in recreational settings and among young
people in general in some countries
• concurrent use of cocaine and heroin becoming more
common among problem opioid users
• problem use of crack cocaine. This remains rare but causes
concern in some marginalised groups in some areas
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Cocaine and crack cocaine use (2)
• Adverse health effects of cocaine use include: cardiovascular,
cerebrovascular and neurological disorders
• Risk of cocaine toxicity may be influenced by concomitant use
of other substances (e.g. alcohol, heroin)
• Some 400 deaths recorded as cocaine-related in 2005 – deaths
from purely pharmacological overdose are relatively infrequent
• Possible under reporting of cocaine-related deaths
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Cocaine and crack cocaine use (3)
• Flexible treatment services are required that can attract and
respond to the specific needs of very different cocaine users
• No effective medication exists at present to help cocaine
users maintain abstinence or reduce use
• Cocaine users in treatment are generally prescribed
medications, such as anti-depressants or benzodiazepines,
to provide symptomatic relief (anxiety, depression)
• New developments: experimental therapeutic drugs to
reduce withdrawal symptoms/cravings have shown potential
in clinical trials. Immunotherapy for cocaine dependence
through a cocaine vaccine (TA-CD) is under investigation.
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Time to acknowledge progress
• Now faced with a more complex and heterogeneous drug
situation in Europe than a decade ago
• Important to show where intelligent investments are paying
dividends
• Drug use has stabilised in many important areas, albeit at
historically high levels – some cases merit cautious optimism
• Dramatic increase in countries’ investment in prevention,
treatment and harm-reduction activities and better cooperation
in supply reduction
• Assessing progress is crucial right now as we enter a period of
reflection on recent achievements. In 2008, the EMCDDA will
contribute to the evaluation of the EU drugs action plan and
UNGASS review process.
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