Annual report 2008: the state

of the drugs problem in Europe

NB Embargo 6 November 2008 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 issue: Drugs and vulnerable groups of young people

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A multilingual information package

Annual report 2008 in print and online in 23 languages• http://www.emcdda.europa.eu/events/2008/annual-report

• Additional online materialo Statistical bulletin

o Country overviews

o Selected issue

o Reitox national reports

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Overview 2008: progress

• Drug use in Europe entering a more stable phase

• Amphetamine and ecstasy use: overall steady or declining

• Cannabis: ‘stronger signals’ of declining popularity

• Treatment availability growing (although still insufficient)

• Common approach: 26 EU Member States, Croatia, Turkey and Norway, have a national drug policy document

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Overview 2008: challenges

• Warning signs over heroin

• Problems with synthetic opioids (e.g. fentanyl)

• High rates of drug-related death

• Continued increases in cocaine use

• Innovations on the illicit drug market

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Part I. Opioids, still at heart of our drug problem

• Estimated 1.3 to 1.7 million problem opioid users (EU + Norway)

• Heroin: largest drug-related health and social costs

• In most EU countries, opioid use accounts for between 50 % and 80 % of all treatment demands

• 80 % of fatal overdoses are associated with opioid use

• 7 000 to 8 000 drug-induced deaths in Europe annually

• 600 000 in substitution treatment for opioid use per year

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Warning signs over Europe’s biggest drug problem

• Signs of change in heroin and synthetic opioid problem • Countries need to be vigilant and prepared to respond

• Data call into question ‘slowly improving heroin situation’ reported last year

• Now ‘a stable, but no longer diminishing, problem’

• But not an epidemic growth in heroin problems as seen in Europe in 1990s

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We cannot ignore…

• Threat posed by glut of heroin on world market (record Afghan opium production in 2007: 8 200 tonnes, UNODC)

• Concerns raised by indicators of heroin useo seizureso treatment demando drug-related deaths

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Warning signs (i)

i. Seizures

• Number of heroin seizures increased by over 10 % in most reporting countries (2003–06)

• Quantity of heroin seized in Turkey, an important transit country, more than doubled in this period

• Overall, heroin seizures reached an estimated 19.4 tonnes (48 200 seizures) in Europe in 2006

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Warning signs (ii)

ii. New demands for treatment • Increased in around half of the countries reporting

data in 2006 (primary drug: heroin)

• New recruitment to heroin use is still occurring

• New injectors: large proportions (20 %) in some countries

• Young injectors: large proportions (40 %) of injectors under 25 in some studies

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Proportion of young and new injectors in samples of injecting drug users

(Chapter 6, Figure 9)

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Warning signs (iii)

iii. Drug-induced deaths

• Heroin is the drug most associated with drug-related deaths, but other opioids are also reported

• After falling deaths (2000–03), now a static or growing problem: most countries report rises since 2003

• Average age of those dying from overdose = mid-30s, but some countries report a high proportion of overdose deaths among the under-25s

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Indexed long-term trend in drug-induced deaths in the EU 15 Member

States and Norway, 1985 = 100 (Figure DRD-8)

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Proportion of drug-induced deaths occurring under the age of 25 (Figure DRD-2)

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One death per hour

• One of our young citizens dies every hour from an overdose that could have been avoided

• Need to prioritise overdose prevention measures and target high-risk groups (e.g. those leaving prison or relapsing after treatment)

• Reducing drug-related deaths is an explicit goal of most national drug strategies

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Problems related to synthetic opioids

• Indications of growing problems caused by availability of 3-methylfentanyl

• Fentanyl is considerably more potent than heroin

• Over 70 fentanyl-related deaths in Estonia (2006)

• Methadone is identified in the toxicological reports of some deaths in Europe

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Part II. Stimulants

• Stimulant drugs — such as amphetamines, ecstasy and cocaine — 2nd most commonly consumed drug type in Europe today, after cannabis

• But within this group, data reveal a very mixed picture in terms of prevalence, trends and market developments

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Lifetime prevalence

• Some 12 million Europeans (15–64 years) have tried cocaine in their lifetime

• 11 million for amphetamines

• 9.5 million for ecstasy

• Stabilising or even declining trend in the use of amphetamines and ecstasy

• But continued rise in cocaine use, albeit in a limited number of countries

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Amphetamines and ecstasy: situation stable

• Around 2 million young Europeans (15–34 years) have tried amphetamines in the last year and 2.5 million have tried ecstasy

• Stable/falling trends in last-year amphetamine use in this group since 2003; on average 1.3 % of young adults report annual use

• Last-year ecstasy use also largely steady over the last five years; on average 1.8 % of young adults report annual use

• School surveys (Czech Republic, Spain, Sweden, UK) show stable situation or decline in the use of both drugs among 15–16-year-olds

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Trends in last-year use of amphetamines among young adults

(15–34 years), measured by population surveys (Figure GPS-8, i)

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Trends in last-year prevalence of amphetamines, ecstasy and cocaine among

young adults (15–34 years) in the United Kingdom (E&W) (Figure GPS-23, i)

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Trends in last-year prevalence of amphetamines, ecstasy and cocaine among

young adults (15–34 years) in Denmark (Figure GPS-23, ii)

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Cocaine use continues to rise

• Around 3.5 million young Europeans (15–34 years) have used cocaine in the last year

• Around 1.5 million in the last month

• Seven countries report a rising trend in last-year use in recent surveys (2005–07)

• In high-prevalence countries (Denmark, Spain, Ireland, Italy, UK) last-year prevalence figures (15–34 years) ranged from around 3 % to 5.5 %

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Trends in last-year prevalence of cocaine among young adults (15–34 years)

measured by population surveys (Figure GPS-14, i)

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Cocaine treatment and deaths

• Upward trend in treatment demand for cocaine problems continues

• 2002–06: number of new clients in Europe demanding such treatment rose from around 13 000 to almost 30 000

• Some 500 deaths associated with cocaine use were registered in 2006

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Europe’s divided stimulant market

• Cocaine dominates the illicit stimulant market in the west and south of Europe, but elsewhere use and availability are low

• In most northern, central and eastern Member States, amphetamines are the prevailing stimulant

• Use of methamphetamine still limited in the EU to the Czech Republic and Slovakia

• Cocaine and amphetamines: ‘competing products’ on the European illicit drug market?

• A holistic approach to stimulants is needed (rather than focusing on individual substances)

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Chapter 4: The European stimulant market

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Part III. Cannabis

• Around 71 million Europeans (15–64 years) have tried cannabis in their lifetime and around 7 % (23 million) in the last year

• Around 17.5 million young Europeans (15–34 years) are estimated to have used cannabis in the last year, on average 13 % of young adults

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Stronger signals of declining popularity

• ‘Stronger signals’ that popularity may be waning, reinforcing analysis in last year’s report

• Latest national survey data on last-year cannabis use among young adults reveal a stabilisation or decline

• Lifetime and heavy cannabis use among 15-year-old school students in most EU countries also stable or declining (HBSC surveys)

• Downward trend is visible in population surveys in some high-prevalence countries

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Trends in last-year prevalence of cannabis use among young adults (15–34

years), measured by population surveys. (Figure GPS-4, i)

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Changes between 2001/02 and 2005/06 in prevalence of ever-in-lifetime

cannabis use among school students 15–16 years (HBSC) (Figure EYE-5)

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Changes between 2001/02 and 2005/06 in prevalence of heavy cannabis use

among school students 15–16 years (HBSC) (Figure EYE-4)

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Regular and intensive cannabis use

• Trends in this type of use may move independently of prevalence among the general population

• Some 4 million European adults (15–64 years) use cannabis on a daily or almost daily basis

• Among the estimated 160 000 new demands for treatment for drug problems reported in 2006, cannabis clients formed 2nd largest group (28 %)

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Proportion of new clients entering treatment by primary drug in

2006 in 24 EU Member States (Figure TDI-2, i)

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Part IV. Dynamic markets: cocaine trafficking

• Drug supply into and inside Europe is evolving

• West Africa, a major hub: almost a quarter of the cocaine entering Europe in 2007 came via this route (UNODC estimate)

• This route is thought to have contributed to bolstering the role of the Iberian peninsula as key entry point into the EU

• Of the 121 tonnes of cocaine seized in Europe in 2006, 41 % was intercepted in Spain, 28 % in Portugal

• Recent reports of cocaine importation via east European countries could herald development of new trafficking routes

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Dynamic markets: domestic cannabis production

• Domestic production: ‘May no longer be considered as marginal’ in some countries

• Cannabis resin, mostly from Morocco, historically the dominant product in the EU

• In some countries, a switch from resin to locally-grown herbal cannabis is now reported

• Some 2.3 million cannabis plants seized in Europe (2006)

• Local production, raises new challenges for law-enforcement

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Dynamic markets: online shops

• Over 200 psychoactive substances are advertised by online shops, often as ‘legal highs’ (e.g. salvia divinorum)

• But in some countries contents are covered by the same laws as controlled drugs, and may incur penalties

• Most of the shops identified were in the UK and the Netherlands (+ to a lesser extent, Germany and Austria)

• The number of these online retailers appears to be growing and they adapt quickly to new controls

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Part V: Drugs and vulnerable groups of young people

• EU countries increasingly prioritise 'vulnerable groups' in their drug and social policies to reduce risks of drug use problems where they are most likely to occur

• Knowing the profiles of these groups and where they are found can be a key entry-point for drug prevention strategies and interventions

• Examples: young people in government care, in disadvantaged families or neighbourhoods, early school leavers

• A visible gap between political will and practical implementation

• Preference for office-based ('come') services over outreach work

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Providing an evidence base

• Europe now stands out as one of the parts of the world where drug monitoring capacities are most developed

• Evidence-based information on today’s drug situation is essential for an informed, productive and reasoned debate on this complex issue

• It ensures that opinions are enlightened by facts, and that policy-makers have a clear understanding of the options available

• This is rationale behind the work of the EMCDDA and its Annual report