Transcript 1% of all adults - Annual report 2005

2005 Annual report on the state
of the drugs problem in Europe
Name, place, date and time
Latest on the drug 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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•
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drug-related public nuisance
alternatives to prison
buprenorphine
A multilingual, state-of-the art package
2005 Annual report:
In print and online in 22 languages
• http://annualreport.emcdda.eu.int
Additional online material in English:
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•
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Selected issues http://issues05.emcdda.eu.int
Statistical bulletin http://stats05.emcdda.eu.int
Reitox national reports http://www.emcdda.eu.int/?nnodeid=435
Headlines 2005
• Part I
Headlines 2005
• Cocaine becoming stimulant drug of choice for
many young Europeans in parts of Europe
• Upward trend in use of amphetamines + ecstasy
• Cannabis still Europe’s most popular drug –
more even picture as national differences narrow
• Up to 2m problem drug users in the EU
• Polydrug use, central to EU drug phenomenon
Headlines 2005 (continued)
• Heterosexual transmission overtakes injecting
drug use as route of new AIDS cases
• Overall low HIV prevalence among IDUs
• Hepatitis B and C still major causes of disease
among IDUs
• Overdose, main cause of death among opiate
users, but numbers of young fatalities falling
Cocaine – stimulant drug of choice for
many young Europeans in parts of Europe
• Cocaine: now major element in EU drug picture
• Indicators of trafficking and consumption point to
a rise in importation and use of the drug
• Still large differences between countries
• Between 2002 + 2003, amount of cocaine seized
in the EU nearly doubled (47 tonnes to over 90)
Cocaine facts and figures
• Around 9 million Europeans have tried cocaine in
their lifetime (3% of all adults)
• Between 3 and 3.5 million are likely to have tried
the drug in the last year (1% of all adults)
• Around 1.5 million are classified as current users
(last month) (0.5% of all adults)
• Between 1% and 11.6% of young adults have tried
cocaine. Use mainly among young, urban males
Cocaine facts and figures (continued)
• Highest levels of recent use among young adults
are in Spain + the UK (over 4%, similar to US)
• Around 10% of requests for treatment for drug
problems in the EU are linked to cocaine use
• ‘Determining role’ in around 10% of drug deaths;
but deaths by cocaine use alone are rare
• New concern: links to cardiovascular problems
• Crack cocaine limited to a few big cities (NL, UK)
Recent (last year) use of cocaine among
young adults (15–34 years)
Other stimulants – main trends
• Upward trend in amphetamine and ecstasy use in
most EU countries (young adults)
• Highest rates of recent amphetamine use (young
adults) in Denmark, Estonia and UK (+/-3%). UK
only EU country with significant fall in recent use
• Highest rates of recent ecstasy use (young
adults) in Estonia, Spain, Czech Republic and UK.
Stabilisation in Germany, Greece and UK
Other stimulants (continued)
• Europe still major centre for ecstasy production
but manufacture spreads to other parts of world
• Global amphetamine production and seizures still
concentrated in Europe
• Growing problems with methamphetamine use in
Africa, Asia, Australia, New Zealand and US. No
significant use in EU, except Czech Rep + SK
• Experimentation with ‘magic mushrooms’, now
relatively common phenomenon (15–16 years)
Trends in recent (last year) amphetamine +
ecstasy use in young adults (15–34 years)
Cannabis still EU’s most popular drug
• Over 62 million Europeans have tried cannabis
(or over 20% of all adults)
• Around 20 million have used it in the last year
(over 6% of all adults)
• Around 9.5 million are ‘current users’
(almost 4% of all adults)
• Roughly 3 million young adults, mostly males,
are estimated to be daily or almost daily, users
Cannabis – national differences narrow
• 1995 + 2003 ESPAD data from surveys of drug
use in European schoolchildren (15–16 years)
• 1995 (lifetime prevalence of cannabis use):
dramatic differences between countries (41% UK,
37% Ireland, but most countries’ rates below 10%)
• 2003: nine EU Member States reported estimates
of lifetime use in excess of 20%
• ESPAD and other survey data show some signs
of convergence. Rises most pronounced in new
Central and Eastern EU Member States
Trends in recent use (last year) of cannabis
among young adults (aged 15–34)
Up to 2m problem drug users in the EU
• Between 1.2 and 2.1 million problem drug users
and between 850,000 and 1.3 million injectors
• Prevalence estimates since mid to late 90s show
some rise in number of problem drug users in
Denmark, Austria, Finland, Sweden and Norway
• Stabilisation or decline in the Czech Republic,
Germany, Greece and Ireland
• Elsewhere, no clear conclusions on trends
Problem drug use (continued)
• Numbers of new heroin users may have fallen
across Europe (peak in most countries early 90s)
• Rates of injecting among heroin users in
treatment have declined in several countries
• In Denmark, Greece, Spain, France, Italy and the
UK, less than 50% of new opiate users entering
drug treatment say they inject
Polydrug use
• Now central feature of EU drug phenomenon
• Substance-specific analysis no longer realistic
• Analysis of public health impact of drug use
today must take into account the complex picture
of the inter-related consumption of psychoactive
substances, including alcohol and tobacco
Heterosexual transmission overtakes injecting
drug use as route of new AIDS cases
• Most new AIDS cases in EU to 2001 attributed to
IDU; heterosexual transmission now overtaking
• Why? Better access for HIV-positive IDUs to
highly active antiretroviral therapy (HAART).
Over 75% of those needing HAART now have
access to it in most of Western Europe
• Better access for IDUs to treatment/harmreduction services; some decline in injecting
AIDS cases by transmission group and year of
diagnosis (1987–2003) adjusted for reporting delays, EU
Overall, low HIV prevalence among IDUs
• Prevalence of HIV infection among IDUs – low in
most EU Member States and candidate countries
• Infection rates around, or below, 1% of IDUs in
the Czech Republic, Greece, Hungary, Slovenia,
Slovakia, Finland, the UK, Bulgaria and Romania
• Higher rates (+/- 10%) in Estonia, Spain, France,
Italy, Latvia, Netherlands, Poland and Portugal
• Hepatitis B and C, still major causes of disease
among IDUs in Europe
Overdose main cause of death among opiate
users, but numbers of young fatalities falling
• Lower proportion of overdose deaths under the age of 25
than a decade ago in most EU-15, suggesting fall in new
young addicts and number of young injectors
• Different picture in new EU Member States and candidates,
where deaths under 25 increased from mid-1990s–2002
• Total number of reported drug-related deaths from the EU15 countries and Norway fell from 8 394 in 2001 to 7 122
cases in 2002, representing a 15% decrease
• Across the EU, drug-related deaths remain at historically
high levels, but there are signs that these may have peaked
Long-term trend in acute drug-related
deaths in the EU, 1985–2003
Indexed: 1985 = 100%
300
Index % (1985=100%)
250
200
150
100
50
INDEX
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003*
100,0
104,5
118,7
136,9
153,7
181,0
216,4
223,5
201,8
212,2
225,4
252,4
230,1
235,6
241,1
255,4
240,1
205,8
194,9
Headlines 2005
• Part II
Headlines 2005
• Over half a million Europeans now receive
substitution treatment. Use of buprenorphine now
more common
• Treatment for other drug problems more limited
• Concern over impact of drug use on communities
• Rise in drug law offences in most of EU
• Countries opt for treatment over prison
Over half a million Europeans now receive
substitution treatment
• Major increase in services for opiate dependence
(seven-fold over last decade)
• +/- 530,000 clients receive substitution treatment
across 28 countries (EU-25, NO, BG, RO)
• Availability still differs markedly across Europe,
particularly between the EU-15 and the new and
prospective Member States
• 10 new MS, BG + RO account for only just over
1% of substitution treatment clients in Europe
Buprenorphine, an increasingly common
therapeutic choice
• Around 80% of those in substitution therapy
receive a methadone prescription
• Greater range of therapeutic options now
available. Almost 20% of clients in substitution
treatment now receive buprenorphine
• By late 2004, all former EU-15 countries reported
some/limited use of buprenorphine treatment
• Among the 10 new EU Member States, it is only
common in the Czech Republic
Treatment for drug problems still limited
• Despite expansion in substitution treatment for
opiate dependence, treatment for other types of
drug use remains limited
• Overall treatment options for those with cocaine
problems are poorly developed
• Few countries offer services tailored to problem
cannabis users, despite rising treatment demand
• More investment needed to ensure that treatment
options are available to all those who need them,
no matter where they live or what drug they use
Impact of drug use on our communities
• New tendency for drug control policies to focus
on targeting drug-related behaviours which have
a negative impact on the community as a whole
• Public nuisance, new umbrella concept covering
anti-social behaviours, disturbances and
activities (e.g. public drug taking; street dealing)
• Reducing drug-related public nuisance, now a
key goal of national drug policy in five countries.
Others address the acts covered by the term
under broader title of security or public order
• Other responses: laws against drug-specific
public nuisance; local policing, etc.
Rise in drug law offences in most of EU
• Violations of drug law (‘drug law offences’) –
upward trend in 20 countries (1998–2003)
• Drug use or possession (personal use) account
for largest proportion of drug law offences
• Proportion of drug law offences involving cocaine
generally increased (98–2003). Cannabis still drug
most often cited in drug law offences in most EU
• Heroin-related offences fell in all reporting
countries (1998–2003), except Austria and the UK
Countries opt for treatment over prison
• For many problem drug users, prison can be a
particularly detrimental environment
• Broad political consensus to divert drug using
offenders from imprisonment to treatment
• Prisons are overcrowded – treatment option can
be a more cost-efficient way of sentencing
• The new EU drugs action plan 2005–2008 asks
Member States to ‘make effective use of, and
develop further alternatives to, prison for drug
abusers who commit drug-related offences’
Policy-makers support data collection
• EMCDDA working for over a decade with Member
States to develop comprehensive picture of the
European drug phenomenon
• Quantity and quality of data in 2005 Annual report
reflect commitment of policy-makers across EU
to invest in, and support, data-collection process
• Strong consensus on need to base actions on a
sound understanding of the drug situation and to
share experience on what works to respond to it
• These aspirations are found in the new EU
strategy and action plan on drugs