Linda Montanari, Buenos Aires, October 2003 CICAD/OAS, Demand Reduction Experts Group Meeting The Information System on Treatment Demand in EU EMCDDA

To provide the Community and the EU Member States with objective, reliable and comparable information concerning drugs and drug addiction and their consequences Further information: Mission of the EMCDDA

Collecting and analysing existing data Improving data- comparison methods Disseminating data and information Tasks SituationResponsesImpact Areas

Map of EU Member States, Norway, acceding and candidate countries

Situation analysis: Working methods Key indicators Core data and developing areas Expert groups Reporting guidelines Analytical project groups

Extent and patterns of drug use in the general population Prevalence of problem drug use Drug-related deaths and mortality among drug users Treatment demand Drug-related infectious diseases Key indicators A common language for describing the drug situation

Crime Arrest Data Drug Related Crime Drug Markets & Availability Perceived availability Seizures Price & Purity Social Exclusion Youth and vulnerability New Trends Core data and developing areas

Treatment Demand Indicator TDI One of the 5 key Indicators at the EMCDDA Provide information on the people demanding treatment in the specialised drug services in Europe Further information:

What is the objective? To provide comparable, reliable and anonymous information on: Number of people treated for their drug use Characteristics and Profile of clients Patterns of use Trends over time

What is the purpose? Indirect indicator of trends in problem drug use Identification of patterns of drug use Basis for other methodologies on problem drug use prevalence estimation Identify patterns of use of services and plan and evaluation of services

Which questions the TDI answer to? Treatment contact details centre type, time of treatment, source of referral Socio-demographic information gender, age, living and labour status, education, nationality Drug related information primary and secondary drug, substitution treatment, route of administration, frequency of use, age at first use Information in TDI: 20 items What drug treatment? Which substances / Patterns of use? What characteristics of clients?

Guidelines A joint EMCDDA/Pompidou Group protocol (TDI protocol), with definitions and guidelines for data collection TDI Protocol /situation/treatment_indicator_report.pdf

How data are collected? 23 excel sheets (cross tabulations) inserted in a central EMCDDA database (EISDD) By centre type: outpatient, inpatient, low threshold, GPs, prison, others By each country (29): 15 Member States + Norway + 10 acceding countries + 3 candidate countries

What are the main resources? Network: one expert identified in each country by the NFP Working group in most of the countries involving professionals from the treatment centres at national level European annual expert meeting: the state of progress and future perspectives Small thematic working group (e.g. data coverage and cannabis data in 2003)

Some Results Clients admitted to drug treatment in 2001: trends and patterns of use

Percent of new clients admitted to treatment by main drug in 2001 Source: 2002 Reitox National Reports; Standard Table 3; 2001 data All Centre Types; N.cases: (new clients) Countries included: Dk, Ge, Gr, Sp, IR (2000 data), Nl, FI, Sw Weighted average on the total numbers of new clients by country

Percent of new clients by main drug Source: REITOX National Reports - Standard Table 3 –2001 data (*) 2000 data – All centre types

% of new clients admitted to treatment for opiates, cocaine, cannnabis in some EU countries to Source: Reitox National Reports; Standard Table 4; All Centre Types Countries included: Dk, Ge, Gr, Sp, Nl, Sw Average weighted on the number of clients by country

Percent of new outpatient clients in some country by source of referral Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres – Valid per cent, n = cases, new clients - * Ireland: 2000 data (n. 689) (n. 488) (n. 4700) (n. 1258) (n. 831) (n. 5970) *

Mean age of clients in treatment in 2001 New clients All clients (n = 83571)(n ) Denmark Germany Greece Spain Italy Luxembourg The Netherlands Finland Sweden United Kingdomn.a.28.3 Source: REITOX National Reports - Standard Table 3 – 2001 data All centre types Opiates and Cocaine between and Stimulants and cannabis between and 20-29

Gender distribution among new clients in 2001 Source: Reitox National Reports - Outpatient Treatment Centres N. Cases: n Countries: Dk, Ge, Gr, Sp, Nl, Fi, Sw Mainly males: 79.2 males / 20.8 females Differences between drugs: Opiates:81.2 males / 18.8 females Cocaine:85.0 males / 15.0 females Stimulants:67.5 males / 32.5 females Cannabis: 85.8 males / 14.2 females Highest proportion of males in Spain (84.9), lowest in Sweden (69.1)

Percent of new outpatient clients by level of education in 2001 Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres Valid per cent, n = cases, new clients Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw

Percent of new outpatient clients by labour status among in 2001 Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres Valid per cent, n = cases, new clients Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw 8.2% in general population

Age at first use of main drug among new clients in some countries Source: 2002 Reitox National Reports – Outpatient Treatment Centres Year covered: 2001 Countries covered: Dk, Ge, Gr, Sp, Fin, Sw

Frequency of use of main drug: % new clients in 2001 (last 30 days before starting treatment) Source: 2002 Reitox National Reports – TDI data – Outpatient Treatment Centres Year covered: 2001 Countries covered: 2001: Dk, Ge, Gr, Nl, Fin, Sw %

Route of administration among all and new clients in some country in 2001 Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres Countries: Dk, Ge, Gr, Ir (2000 data), Nl, Sp, Fin, Sw, Uk (all clients)

Most used secondary drugs among new clients in 2001 in some countries Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres Valid per cent, n using a secondar drug (n = total new clients) Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw % 85.1% use more than one drug

Opiates main substance, followed by cannabis and cocaine Decrease of opiates users, increase cannabis and cocaine Clients are males in their 20s or 30s Clients demand treatment spontaneously or through family Social conditions are worsening than general population Clients start to use in the adolescence: earlier for cannabis Conclusions (1)

Polarization of frequency of use for opiates and cocaine graduation for stimulants and especially cannabis Clients tend to inject opiates, sniff cocaine, eat stimulants: less injection among new clients Polydrug use is apparent, with cannabis as main secondary drug, followed by cocaine Relevant differences between countries Conclusions (2)

Further information on the 2003 EU drug situation: