1. Drug issues across Europe Christine Goodair, Head of Website and Information Services, DrugScope "Information without Borders" 28th Annual SALIS and 18th Annual Elisad Joint Conference: Boston, September 26- 30, 2006.

2. Outline of Presentation Geography of Europe Overview of European issues relating to alcohol, drugs, and tobacco Key information resources Facts from Elisad members

5. Alcohol The European Union is the heaviest drinking region of the world. Most Europeans drink alcohol 55 million adults abstain (15%) Average consumption per drinker reaches 15 litres per year In northern and central Europe beer is the main drink. In southern Europe wine is the main drink

6. Alcohol Drinking to drunkenness varies across Europe with it being less prevalent in southern Europe. Estimated that 23 million Europeans are dependent on alcohol. Alcohol is responsible for about 195,000 deaths each year Alcohol is the third highest of 26 risk factors for ill health in the EU. Source: Alcohol in Europe a public health perspective, a report for the European Commission, Peter Anderson and Ben Baumberg: Institute of Alcohol Studies, London UK June 2006 http://ec.europa.eu/health-eu/doc/alcoholineu_summary_en.pdf http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm

7. Alcohol Many people suffer due to someone else’s’ drinking – including 5-9 million children living in families damaged by alcohol and the 10,000 ‘innocent’ deaths that occur to bystanders or passengers from drink-drivers. Alcohol is also estimated to cost Europe €125 billion – equivalent to over €650 for every household each year. UK adolescents are also the third-worst binge- drinkers in the EU, with more than a quarter 15-16 olds binge-drinking 3-or-more times in the last month.

8. Alcohol UK adolescents are also the third-worst binge-drinkers in the EU, with more than a quarter 15-16 olds binge- drinking 3-or-more times in the last month. Source: Alcohol in Europe a public health perspective, a report for the European Commission, Peter Anderson and Ben Baumberg: Institute of Alcohol Studies, London UK June 2006 http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm

9. Alcohol Youth drunkenness is on the rise in many Member States Overall, 20% to 30% of young people drink at least once a week in most countries. Binge drinking occurs fairly frequently,involving as many as 30% of young people in the UK, Ireland and Poland. Alcohol use inflicts more acute and social harm in the UK and Ireland than in the other countries Source: http://www.rand.org/pubs/technical_reports/TR412/ http://www.rand.org/pubs/technical_reports/TR412/

10. Key Information Resources:Alcohol Institute of Alcohol Studies http://www.ias.org.uk/index.html Adolescents and Alcohol http://www.ias.org.uk/resources/factsheets/adolescents. pdf http://www.ias.org.uk/resources/factsheets/comparisons.pdf http://www.ias.org.uk/resources/factsheets/adolescents. pdf http://www.ias.org.uk/resources/factsheets/comparisons.pdf Alcohol - Binge Drinking http://www.ias.org.uk/resources/factsheets/binge_drinking. pdf http://www.ias.org.uk/resources/factsheets/binge_drinking. pdf European alcohol information system http://euro.who.int/alcoholdrugs/20020611_1

11. Key Information Resources:Alcohol European Council for Alcohol Research Rehabilitation and Education (Eurocare) http://www.eurocare.org/ http://www.eurocare.org/eu/health/workinggp.html RAND Europe an independent think tank http://www.rand.org/pubs/technical_reports/TR412/ European Commission: Public Health http://ec.europa.eu/health/ph_determinants/life_style/alcoh ol/documents/ev_20050307_rd01_en.pdf World Health Organisation http://euro.who.int/alcoholdrugs

12. Drugs Cocaine becoming stimulant drug of choice for many young Europeans in parts of Europe Upward trend in use of amphetamines + ecstasy Cannabis still Europe’s most popular drug – more even picture as national differences narrow Up to 2m problem drug users in the EU Polydrug use, central to EU drug phenomenon Source: 2005 Annual report on the state of the drugs problem in Europe http://www.emcdda.europa.eu and powerpoint presentation of key trends http://ar2005.emcdda.europa.eu/download/ar2005-en.ppt http://www.emcdda.europa.euhttp://ar2005.emcdda.europa.eu/download/ar2005-en.ppt

13. Drugs Other Stimulants: Upward trend in amphetamine and ecstasy use in most EU countries (young adults) Highest rates of recent amphetamine use (young adults) in Denmark, Estonia and UK (+/-3%). UK only EU country with significant fall in recent use Source www.emcdda.eu.intwww.emcdda.eu.int

14. Drugs Heterosexual transmission overtakes injecting drug use as route of new AIDS cases Overall low HIV prevalence among injecting drug users Hepatitis B and C still major causes of disease among injecting drug users Overdose, main cause of death among opiate users, but numbers of young fatalities falling Highest rates of recent ecstasy use (young adults) in Estonia, Spain, Czech Republic and UK. Stabilisation in Germany, Greece and UK source www.emcdda.eu.intwww.emcdda.eu.int

15. Drugs Europe still major centre for ecstasy production but manufacture spreads to other parts of world Global amphetamine production and seizures still concentrated in Europe Growing problems with methamphetamine use in Africa, Asia, Australia, New Zealand and US. No significant use in EU, except Czech Rep + SK Experimentation with ‘magic mushrooms’, now relatively common phenomenon (15–16 years) source www.emcdda.eu.intwww.emcdda.eu.int

16. Drugs Over 62 million Europeans have tried cannabis (or over 20% of all adults) Around 20 million have used it in the last year (over 6% of all adults) Around 9.5 million are ‘current users’ (almost 4% of all adults) Roughly 3 million young adults, mostly males, are estimated to be daily or almost daily, users Between 1.2 and 2.1 million problem drug users and between 850,000 and 1.3 million injectors source www.emcdda.eu.intwww.emcdda.eu.int

17. Drugs Prevalence estimates since mid to late 90s show some rise in number of problem drug users in Denmark, Austria, Finland, Sweden and Norway Stabilisation or decline in the Czech Republic, Germany, Greece and Ireland Elsewhere, no clear conclusions on trends Numbers of new heroin users may have fallen across Europe (peak in most countries early 90s) Rates of injecting among heroin users in treatment have declined in several countries source www.emcdda.eu.intwww.emcdda.eu.int

18. Drugs In Denmark, Greece, Spain, France, Italy and the UK, less than 50% of new opiate users entering drug treatment say they inject Poly drug use is now a central feature of EU drug phenomenon Substance-specific analysis no longer realistic Analysis of public health impact of drug use today must take into account the complex picture of the inter-related consumption of psychoactive substances, including alcohol and tobacco Source: 2005 Annual report on the state of the drugs problem in Europe http://www.emcdda.europa.eu and powerpoint presentation of key trends http://ar2005.emcdda.europa.eu/download/ar2005-en.ppthttp://www.emcdda.europa.euhttp://ar2005.emcdda.europa.eu/download/ar2005-en.ppt source www.emcdda.eu.intwww.emcdda.eu.int

19. Key Information Resources: Drugs European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) http://www.emcdda.europa.eu/http://www.emcdda.europa.eu/ Overview of the European drug phenomenon in 29 countries Data and analyses: across Europe and by country Latest trends and responses Selected issues : drug-related public nuisance;alternatives to prison;buprenorphine In print and online in 22 languages http://annualreport.emcdda.eu.int

20. Key Information Resources: Drugs European Commission http://ec.europa.eu/justice_home/fsj/drugs/strategy /fsj_drugs_strategy_en.htm http://ec.europa.eu/justice_home/fsj/drugs/strategy /fsj_drugs_strategy_en.htm DrugScope website European links page http://www.drugscope.org.uk/links.asp?area=eu World Health Organisation http://euro.who.int/alcoholdrugs European Legal database on drugs http://eldd.emcdda.europa.eu/index.cfm?fuseactio n=public.Content&nNodeID=5l69&sLanguageIS O=EN http://eldd.emcdda.europa.eu/index.cfm?fuseactio n=public.Content&nNodeID=5l69&sLanguageIS O=EN

21. Tobacco Tobacco is the single largest cause of avoidable death in the EU Tobacco accounts for over a million deaths in Europe as whole. Estimated that 25% of all deaths in the Union could be attributed to smoking The EU is actively developing a tobacco control policy. Source: http://ec.europa.eu/health/ph_determinants/life_style/Tobacc o/tobacco_en.htm http://ec.europa.eu/health/ph_determinants/life_style/Tobacc o/tobacco_en.htm

22. Key Information Resources:Tobacco Tobacco or health in the European Union: past present and future. Aspect Consortium,2004 http://ec.europa.eu/health/ph_determinants/life_style/Tobacc o/Documents/tobacco_fr_en.pdf http://ec.europa.eu/health/ph_determinants/life_style/Tobacc o/Documents/tobacco_fr_en.pdf Action on Smoking and Health (ASH) fact sheets such as Tobacco policy in the European Union May 2006 http://www.ash.org.uk/html/factsheets/html/fact20.html http://www.ash.org.uk/html/factsheets/html/fact20.html World Health Organisation Tobacco Control Country Profiles http://www.globalink.org/tccp/EURO_Summary.pdf http://euro.who.int/healthtopics/HT2ndLvlPage?HTCode =tobacco http://www.globalink.org/tccp/EURO_Summary.pdf http://euro.who.int/healthtopics/HT2ndLvlPage?HTCode =tobacco Tobacco Factfile British Medical Association http://www.tobaccofactfile.org/ http://www.tobaccofactfile.org/

23. Key Information Resources:Tobacco World Health Organisation Tobacco Control Country Profiles http://www.globalink.org/tccp/EURO_Summary.pdf http://euro.who.int/healthtopics/HT2ndLvlPage?HTCo de=tobacco http://www.globalink.org/tccp/EURO_Summary.pdf http://euro.who.int/healthtopics/HT2ndLvlPage?HTCo de=tobacco Tobacco Factfile British Medical Association http://www.tobaccofactfile.org/ http://www.tobaccofactfile.org/ European Network for Smoking Preventionhttp://www.ensp.org/http://www.ensp.org/

24. Round up of other interesting facts from Elisad members Belgium - new drug law passed in 2003 stating that possession of small amounts for cannabis for personal use by adults would not attract prosecution, except in cases of "public disorder" or "aggravating circumstances". This created much confusion so the law has had to be clarified. Oslo, Norway – heroin drought this summer

25. Round up of other interesting facts from Elisad members Netherlands – smoking is still the main reason for premature deaths; young cannabis users are exhibiting greater behavioural problems. UK – Research conducted by the Advisory Council on the Misuse of Drugs (ACMD)and published Sept 2006, found that alcohol causes more problems in young people than all other drugs and has shown the most recent growth in use

26. Round up of other interesting facts from Elisad members Germany- decreasing trend in cigarette smoking in teenagers (16-18 years) has been observed over the last 1-2 years. Since summer 2006, the law on smoke-free schools covers all federal states Problematic drinking is a topic which is shifted to the focus of attention in the professional debate. An increasing amount of teenagers are seeking treatment for alcohol problems.

27. Round up of other interesting facts from Elisad members Serbia - drug prevention is mostly based on fear principle, embedded in state school programmes The school survey using ESPAD method with 3000 students aged 16 years in Belgrade, Nis and Novi Sad found high prevalence of alcohol consumption (93%), use of non –prescription medicines is popular.

28. Round up of other interesting facts from Elisad members Poland- on 6 September the Ministry of Health accepted the National programme for prevention of alcohol problems 2006-2010. Targets of the Programme for 2006-2010 are: Assist more alcoholics to become sober and healthy by effective treatment Reduction in alcohol consumption up to 20%

29. Round up of other interesting facts from Elisad members Reduction of harm caused by people dependent on alcohol to their families Reduction of youth drinking Action against drunk driving and violent behaviour in public places Foster awareness among society on alcohol problems, its social and economic costs

30. Round up of other interesting facts from Elisad members France - government study has found that youngsters are smoking and drinking less but are increasingly indulging in the sort of weekend drinking binges usually associated with their British counterparts. A ban on smoking similar to that in Eire and elsewhere is being considered. 150-180 000 problematic drug users in France, with opiates being the main substance Campaign to retain free subutex treatment has been won

31. Round up of other interesting facts from Elisad members Italy – dramatic increase in illegal drug use, with poly-drug use increasing also. The new government are proposing to move away from repressive approach to a encouraging prevention and a harm reduction approach Ireland’s 1st national longitudinal study on drug misuse treatment shows significant reductions in drug use and involvement in crime by participants after one year of treatment. http://www.ndc.hrb.ie/directory/news_detail.php?cat_id=& news_id=3148&pointer=0 http://www.ndc.hrb.ie/directory/news_detail.php?cat_id=& news_id=3148&pointer=0

32. Round up of other interesting facts from Elisad members Greece -new proposal for alcohol policy With an emphasis on prevention ; the proposed preventive interventions should Address young people who have not started using alcohol, special groups (e.g. pregnant women), industrial and farming machine operators and drivers. The interventions vary from integrated school programmes to media campaigns and information leaflets. Specific measures are proposed for the reduction of excessive consumption, and the reduction of abuse or misuse.

33. Thanks to Marc Wauters ( Belguim) Angita Peterse (Netherlands), Brian Galvin (Eire) Jorunn Moen (Norway) Grazyna Herczynska (Poland) Federica Ugaglia (Italy) Thomas Roualt & Isabelle Michot (France) Susanna Prepeliczay (Germany & Serbia) Penelope Vasiou (Greece)