An overview of European trends and developments Roland Simon ECAD Meeting 2011, Varna.

An overview of European

trends and developments

Roland Simon

ECAD Meeting 2011, Varna

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European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)

Community Agency

Established: 1993

Staff: 102

The drug information hub in Europe

MarketDrug use

ConsequencesInterventions

StandardsPrison

InternetLicit substances

3

Participating Countries:

27 EU Member States, Croatia, Turkey and Norway

MarketDrug use


StandardsPrison


4

TrendsMarketDrug useConsequencesInterventions

DevelopmentsStandards and quality of interventionsDrugs in prisonDrugs and the internetDrugs and licit psychotropic substances

Data: Annual Report 2010 + more recent details

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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?

CannabisMarketDrug use


StandardsPrison


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Number of seizures increasing for last 20 years: 96 000

Quantities seized decreased since 2006: 67 tonnes

New smuggling techniques

Cocaine seizuresMarketDrug use


StandardsPrison


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Heroin seizures and quantities seized

MarketDrug use


StandardsPrison


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New Drugs – “Legal Highs”

• 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

MarketDrug use


StandardsPrison

Internet Licit substances

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75.5 million Europeans have ever used cannabis (22.5 %)

23 million in the past year (6.8 %)

17 million are between 15 and 34 years old

Trends mostly downwards (not Easter Europe)

Cannabis

MarketDrug use


StandardsPrison

Internet

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Cannabis use: last year prevalence

among young adultsMarket

Drug useConsequences

Interventions

StandardsPrison


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14 million Europeans have ever used cocaine (4.1 %) 4 million during the past year (1.3 %)

3 million are between 15 and 34 years old

Cocaine

MarketDrug use


StandardsPrison


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Cocaine use: last year prevalence among young adults in Europe, Australia, Canada and the USA

MarketDrug use


StandardsPrison


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Cocaine use: last year prevalence among young adults

MarketDrug use


StandardsPrison


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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

Ecstasy and amphetamines

MarketDrug use


StandardsPrison

Internet

Licit substances

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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

Opioids

MarketDrug use


StandardsPrison


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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

Injecting drug users

MarketDrug use


StandardsPrison


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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

Problem opioid use in neighbouring countries

MarketDrug use


StandardsPrison


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Trends in newly reported HIV infections in injecting drug users in four EU Member States reporting high rates of infection

MarketDrug use


StandardsPrison


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Drug-induced deaths: change 2004 to 2007/8

MarketDrug use


StandardsPrison


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Around 1 000 cocaine-related deaths were reported in 2008

Marked increases in Spain and the United Kingdom

Cocaine deaths

MarketDrug use


StandardsPrison


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Prevention

• Environmental strategies: School policies

• Universal prevention: Normative beliefs, social competence, parenting

• Selective prevention: Socially excluded groups, vulnerable families

• Indicated prevention Early childhood problems etc.

MarketDrug use


StandardsPrison


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Prevention: Provision of selective prevention

MarketDrug use


StandardsPrison


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Large investments in treatment

At least 1 million Europeans undergo drug treatment every year

Major increase over the last decades: new providers and new needs

MarketDrug use


StandardsPrison


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SE

NL. UK

DKFI

IT

PT

MT, AT LU

SI, ES, HR

DE, IE

PL, GR

BEFR, HU

LV, LT, BG

SK

CZ, RO, NOEE

ES, FR

FI

DK, IT, NL, AT, PT, SK, SE, UK

CZ, DE

NO

IE, GR, LT, LU

BE, EE, LV

SI

MT, HR

CY, RO

0

5

10

15

20

25

30

1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

cu

mu

lati

ve

nu

mb

er

of

co

un

trie

s

MMT HDBT

Year or introduction of methadone maintenance treatment (MMT) and high dosage buprenorphine treatment (HDBT) in Europe

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Large investments in treatment: opioid substitution treatment

MarketDrug use


StandardsPrison


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Estimated proportion of problem opioid users in substitution treatmentMarket

Drug useConsequencesInterventions

StandardsPrison


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Trends in treatment entries by primary drug

MarketDrug use


StandardsPrison


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Treatment entries by primary drug: New clients

MarketDrug use


StandardsPrison


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Older drug users in drug treatment

Treatment starters above 4010 year before: usually below 10%

Today: 19%Portugal: 28%

MarketDrug use


StandardsPrison


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Older drug users in drug treatment

Mainly heroin addicts

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

MarketDrug use


StandardsPrison


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Reintegration

• 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

MarketDrug use


StandardsPrison


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Guidelines in Europe

MarketDrug use


StandardsPrison


Comulative number of EU countries introducing guidelines in drug addiction(by year of introduction)

CY, RO, TR, NO

LTSE

PT, DK, HR

LV, ESNL

FI, BG, HU

EE, GR, CZ, AT

BE, DEFR, LU

SI

UKIE

0

5

10

15

20

25

30

1980 1985 1990 1995 2000 2005 2010

Nb

of

co

un

trie

s

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Guidelines in Europe

MarketDrug use


StandardsPrison


Treatment (TOTAL)

0

10

20

30

40

50

60

Not specified Psychosocial MT Detox Social Reint. Harmreduction

Alc + drugproblems

Nb

of

gu

ide

line

s

34

MarketDrug use


StandardsPrison


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Foto portale linee guida

MarketDrug use


StandardsPrison


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Situation

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

MarketDrug use


StandardsPrisonInternet

Licit substances

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Situation

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

MarketDrug use



Licit substances

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Treatment in prison

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

MarketDrug use



Licit substances

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Internet – an additional risk

170 online shops

Substances sold as ‘legal highs’

Rapid adaptation to control measures

MarketDrug use


StandardsPrison


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Internet – an additional resource

Information provision: warnings

Contacts to drug users (Cannabis, cocaine)

Internet based treatment

Mixed approaches

MarketDrug use


StandardsPrison


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Drugs and licit substances

Prevention: broader than drugs

Tobacco ban and cannabis regulations

Drugs policy vs. alcohol policy vs. policy on psychotropic substances

MarketDrug use


StandardsPrison

InternetLicit substanc

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Drugs and licit substances

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 …

MarketDrug use


StandardsPrison

InternetLicit substanc

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Conclusions

• 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

MarketDrug use


StandardsPrison

Internet

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Thanks for your attention

More information under:

emcdda.europa.eu

An overview of European trends and developments Roland Simon ECAD Meeting 2011, Varna.

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Transcript of An overview of European trends and developments Roland Simon ECAD Meeting 2011, Varna.