Annual report 2009: the state of the drugs problem in Europe International Conference: New trends in drug use: facts and solutions, Parliament of the Republic of Vilnius - 5 November 2009 Dagmar Hedrich (EMCDDA) NB Embargo 5 November :00 CET (Brussels time)

2 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

3 Overview 2009 Drug use levels still high in Europe - but no major increases for most forms of use Cocaine and heroin maintain firm hold on Europe’s drug scene, with little sign of any recent improvement Cannabis: evidence of a decline in use, particularly in young people Heroin: no longer declining Amphetamine and ecstasy use: overall steady Polydrug use: widespread and a growing issue for services

4 Cocaine, still Europe’s most popular stimulant Some 13 million European adults (15–64 years) have tried cocaine in their lifetime (3.9%); some 4 million adults have used it in the last year Still concentrated in western EU countries, 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

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

6 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

7 Drug-related infectious diseases HIV incidence among IDUs remains low at 4.7 cases per million population in EU; Availability of treatment and harm reduction measures; Decline in injecting. But neighbouring countries show increasing trends; HCV still widespread among drug users (national samples vary from 18 – 95%) in most countries > 40%.

8 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

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

10 Warning signs (ii): drug-induced deaths In the period 1990–2006, between and 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

11 Mortality rates among all adults (15–64 years) due to drug-induced deaths

12 Risk factors for overdoses Opiate use / Injection Polydrug drug use Being out of drug treatment waiting list, dropped out Just after prison release History of previous overdoses Old, long time user with cumulative health damage Unemployed, living alone, psychiatric co-morbidity

13 Warning signs (iii): seizures Number of reported heroin seizures (EU + Norway) rose on average by around 4 % per year between 2002 and 2007 Estimated seizures in 2007 ( 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)

14 Cannabis – declining use.. but not everywhere 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 (15-34) have used it in the last year Up to 2.5 % of all young Europeans could be using cannabis on a daily basis But new data confirm last year’s assessment of overall declining popularity, particularly among young people School survey data from the USA and Australia also point to a decreasing trend since the early 2000s

15 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

16 Different patterns in trends in lifetime prevalence of cannabis use among 15- to 16-year-old school students 1 2 3

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

18 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

19 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 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

20 Trend in the number of clients receiving opioid substitution treatment from 1993 to 2007 in the EU-27

21 Provision of opioid substitution treatment by office-based general practitioners, 2007

22 Provision of substitution/maintenance treatment (OST) in the community and availability of OST programmes in the prison system in 2007 (expert rating)

23 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 – including plans to evaluate these

24 A multilingual information package Annual report 2009 in 23 languages Additional online material Statistical bulletin Country overviews Selected issues Reitox national reports

25 Thank you for your attention.