Annual report 2009: the state

of the drugs problem in Europe

NB Embargo 5 November 2009 10:00 CET (Brussels time)

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Latest on the drugs problem across Europe

• Overview of the European drug phenomenon in 30 countries

• Data and analyses: across Europe and by country

• Latest trends and responses

• Selected issues 2009 • Polydrug use: patterns and responses• Drug offences: sentencing and other

outcomes

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A multilingual information package

Annual report 2009 in 23 languages• http://www.emcdda.europa.eu/events/2009/annual-report

• Additional online material• Statistical bulletin • Country overviews • Selected issues• Reitox national reports

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Overview 2009

• Drug use levels still high in Europe

• But no major increases for most forms of use

• Amphetamine and ecstasy use: overall steady

• Cannabis: evidence of a decline in use, particularly in young people

• Cocaine and heroin maintain firm hold on Europe’s drug scene, with little sign of any recent improvement

• Polydrug use: now widespread and a growing issue for services

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Overview 2009

• New drugs: market innovation and sophistication

• Increasingly complex and volatile synthetic drug market

• Synthetic cannabinoids: latest in ‘designer drugs’

• Changes in the ecstasy market

• Signs of methamphetamine edging into new territory

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Part I

• Cocaine• Heroin• Cannabis• Polydrug use

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Cocaine, still Europe’s most popular stimulant

• Some 13 million European adults (15–64 years) have tried cocaine in their lifetime; some 4 million adults have used it in the last year

• Still concentrated in western EU countries, but elsewhere in Europe consumption is low

• Most reporting countries show a stable or rising trend in last-year use among young adults

• In Denmark, Spain, Ireland, Italy and the UK, last-year prevalence (15–34 years) ranges from 3.1 % to 5.5 %

• Seizures and studies raise concerns about potential for further diffusion

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Trends in last year prevalence of cocaine among young adults (aged 15–34), measured by population surveys Countries with three or more surveys

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Cocaine — more figures…

• Cocaine seizures rose to 92 000 in 2007 (84 000 in 2006)

• But the quantity seized dropped: to 77 tonnes in 2007 (121 tonnes in 2006)

• 22 % of those entering drug treatment for the first time cite cocaine as their primary drug

• Some 500 cocaine-related deaths were reported in 2007

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Heroin — trend no longer declining

• New data confirm last year’s analysis of ‘a stable, but no longer diminishing, problem’

• Concerns raised by three indicators of heroin use:• treatment demand• drug-induced deaths• seizures

• Not the epidemic spread of heroin problems seen in Europe in 1980s and 1990s

• But vigilance needed — heroin is still responsible for the largest share of drug-related health and social costs

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Warning signs (i): treatment demand

• Between 1.2 and 1.5 million problem opioid users (EU + Norway)

• New recruitment to heroin use is still occurring

• Number of new demands for treatment (heroin as the primary drug) was 6 % greater in 2007 than in 2002

• Eight countries reported that, between 2006 and 2007, users entering treatment for primary heroin use increased:

• in number and

• as a percentage of all clients

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Trend in estimated number of new clients entering treatment by primary drug used, from 2002 to 2007Numbers of clients by primary drug

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Warning signs (ii): drug-induced deaths

• In the period 1990–2006, between 6 400 and 8 500 drug-induced deaths were reported each year in Europe

• Most fatal overdoses are associated with opioids (typically over 85 %)

• Following an overall falling trend in drug-induced deaths between 2000 and 2003, subsequent data show an increase

• In 2007, 13 of the 18 reporting countries showed a rise

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Warning signs (iii): seizures

• Number of reported heroin seizures (EU + Norway) rose on average by around 4 % per year between 2002 and 2007

• Estimated 56 000 seizures in 2007 (51 000 in 2006)

• Amount of heroin seized (EU + Norway) declined after 2002, but increased from 8.1 tonnes in 2006 to 8.8 tonnes in 2007

• Turkey, important transit country for heroin entering EU, reported a record 13.2 tonnes seized in 2007 (2.7 tonnes in 2002)

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Cannabis — declining use

• Around 74 million Europeans (15–64 years) have tried cannabis in their lifetime; 41.5 million are young adults (15–34 years)

• 17 million young adults have used it in the last year

• But new data confirm last year’s assessment of overall declining popularity, particularly among young people

• The falling trend is particularly noticeable among schoolchildren

• School survey data from the USA and Australia also point to a decreasing trend since the early 2000s

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Cannabis — school students

• Different patterns in cannabis use among school students (15–16 years) across Europe (ESPAD surveys 1995, 1999, 2003, 2007)

• West European countries, as well as Croatia and Slovenia — a fall or stabilisation in lifetime cannabis use in 2007

• Central and east European countries — the increasing trend to 2003 may be levelling out (only Slovakia and Lithuania report a rise of over 3 %)

• Northern and southern Europe — overall more stable and low lifetime prevalence estimates of cannabis use from the mid to late 1990s to 2007

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Different patterns in trends in lifetime prevalence of cannabis use among 15- to 16-year-old school students

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Cannabis prevalence rates. Comparison of trends in average (unweighted) lifetime prevalence of cannabis (%) among 15-16 year old school students in Europe, USA and Australia

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Cannabis — young adults

• Last year cannabis use among young adults (15–34 years): generally a stabilisation or decline between 2002 and 2007

• But less encouraging is the number of regular and intensive cannabis users in Europe

• Up to 2.5 % of all young Europeans could be using cannabis on a daily basis

• A large population at risk and in potential need of treatment

• One example of innovative responses: Internet-based drug treatment interventions

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Trends in last year prevalence of cannabis among young adults

(aged 15–34), measured by national surveys

Countries with three or more surveys

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Polydrug use — patterns and responses

• Polydrug use, widespread in Europe

• Combined use of different substances is ‘responsible for, or complicates, most of the problems we face’

• Increases risks and complicates treatment delivery

• Alcohol present in almost all polydrug use repertoires

• ‘Selected issue’ — overview of this behaviour in: • schoolchildren (15–16 years)• young adults (15–34 years) • problem drug users

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Polydrug use — schoolchildren

• Of schoolchildren (15–16 years) surveyed in 22 countries:• 20 % reported use in the last month of alcohol with cigarettes• 6 % cannabis with alcohol and/or cigarettes• 1 % cannabis with alcohol and/or cigarettes plus at least one

other illicit drug (ecstasy, cocaine, amphetamines, LSD or heroin)

• Polydrug use can increase the risk of toxic effects and is associated with a greater risk of developing long-term problems

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Polydrug use — young adults

• Among young adults (15–34 years), polydrug use can reflect established patterns of substance use, potentially carrying long-term health problems, but also acute risk-taking during leisure time

• Frequent or heavy alcohol users in this age group were between two and six times more likely to have used cannabis in the last year than the general population

• And between two and nine times more likely to have used cocaine during that period

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Polydrug use — problem drug users

• Particularly prevalent among problem drug users

• Can aggravate their already difficult health conditions, leading to increased risk-taking and sometimes severe consequences

• In a recent analysis, over half (57 %) of those entering treatment reported problems with at least two different drugs

• Toxicology reports following fatal overdoses often show the presence of more than one substance

• Management of polydrug use among problem drug users is a complex task

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Part II

• Difficulties of ‘hitting a moving target’ • Detecting new drugs• Monitoring the Internet• ‘Spice’• Ecstasy• Methamphetamine

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Difficulties of ‘hitting a moving target’

• Market innovation and sophistication challenge drug policies

• Increasingly complex and volatile synthetic drug market

• Suppliers now ‘highly innovative’ in their production processes, product ranges and marketing

• ‘Growing sophistication’ in marketing legal alternatives to illicit drugs (so-called ‘legal highs’)

• Wide range of substances and growing use of the Internet

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Detecting new drugs

• Europe is making headway in detecting new drugs

• EU early-warning system (rapid-response mechanism set up in 1997), has tracked over 90 substances to date

• In 2008, 13 new psychoactive substances were reported by EU Member States to the EMCDDA and Europol

• For the first time, a synthetic cannabinoid, JWH-018, was among the reported drugs

• Synthetic cannabinoids — latest stage in the development of ‘designer drugs’

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Monitoring the Internet

• Monitoring the Internet — an ‘increasingly important element in identifying new drug trends’

• Now a major marketplace for psychoactive substances

• In 2009, the EMCDDA surveyed 115 online shops in 17 European countries

• Majority of the online retailers’ websites were registered in the UK (37 %), Germany (15 %), Netherlands (14 %) and Romania (7 %)

• Innovations of the online market include the creation of distinct brands and attractive packaging, a prime example being ‘Spice’

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Is ‘Spice’ the taste of things to come?

• Products marketed under the ‘Spice’ brand have been monitored through the early-warning system since early 2008

• Packaging information claims these are a blend of plant or herbal materials (often sold as incense), but some batches contain synthetic cannabinoids (e.g. JWH-018)

• These ingredients do not feature in the product information and may therefore be consumed unknowingly

• Some 48 % of the 115 online retailers surveyed were offering ‘Spice’

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Changes in the ecstasy market

• Most ecstasy tablets analysed until 2007 typically contained MDMA or another ecstasy-like substance (e.g. MDA, MDEA)

• This may be changing in some EU countries: around half of the ‘ecstasy’ tablets recently seized or sold in Denmark and the Netherlands contained no MDMA (instead tablets contained mCPP)

• Changes in the ecstasy market may be the result of more successful efforts to prevent the diversion of precursors

• The shortage of PMK, a key precursor used to make MDMA, could be one explanation for the recent changes

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Methamphetamine edges into new territory

• Methamphetamine is yet to make significant inroads into the stimulant drug market in western Europe (cocaine or amphetamine still dominate)

• But some signs that methamphetamine is starting to edge into new territory (beyond Czech Republic)

• Methamphetamine problems have developed in Slovakia and the drug appears to be becoming more available in parts of northern Europe, such as Norway and Sweden

• Some new production sites appear to be located in Lithuania, whose geographical position may facilitate the importation of the methamphetamine precursor BMK from outside the EU

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Methamphetamine — Norway and Sweden

• In 2007, almost 4 500 seizures of methamphetamine, amounting to approximately 340 kg, were reported in Europe

• Norway, by far the highest number of seizures (1 284) and the largest amount of methamphetamine recovered (167 kg)

• The second largest amount of methamphetamine seized in Europe (51 kg) was in Sweden

• Methamphetamine production in Europe has traditionally taken place in small-scale kitchen laboratories in the Czech Republic

• Europol now reports some larger sites in other parts of Europe (e.g. Germany, the Netherlands)

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Seized meth-

amphetamine

production

facilities in

2008 and

main

trafficking

flows

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Part III

• Treatment today• Selected issue: Drug offences• Development of effective drug policies in

Europe and beyond

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Treatment From ‘one size fits all’ to targeted solutions

• Services for drug users are increasingly diversified and offered as part of an integrated package of care

• Harm-reduction and treatment interventions are often linked and offered by the same providers

• In 2007, some 650 000 opioid users were estimated to have received substitution treatment in Europe

• Treatment coverage is still uneven (e.g. limited access to treatment outside metropolitan areas, small proportion of substitution treatments are in eastern EU Member States)

• Integration of drug treatment into general health care can contribute to a broader provision of treatment

• More projects address needs of stimulant and cannabis users

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Trend in the number of clients receiving opioid substitution

treatment from 1993 to 2007 in the EU-27

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Drug offences: sentencing and other outcomes

• Little is known about the outcomes of drug offences

• Selected issue — a step towards filling this information gap

• Explores what happens to those who violate drug laws in 26 countries

• Examines national statistics (police, prosecutors, courts) according to: • type of offence (personal use, supply) • type of outcome (fine, custody, treatment, community work)

• Custodial sentences are rarely handed out for drug use or possession but are common for supply-related offences

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Development of effective drug policies in Europe and beyond

• The European Union and the United Nations have both renewed their drug action plans

• Both highlight the importance of monitoring and evaluation to improve drug policies

• Almost all EU Member States have a national drug strategy

or action plan

• Two thirds of them plan to evaluate these policy documents