An overview of European trends and developments Roland Simon

1. An overview of European trends and developments Roland Simon ECAD Meeting 2011, Varna

2. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Community Agency Established: 1993Staff: 102 Market Drug use Consequences Interventions Standards Prison Internet Licit substances The drug information hub in Europe

3. Participating Countries:27 EU Member States, Croatia, Turkey and Norway Market Drug use Consequences Interventions Standards Prison Internet Licit substances

4. Trends MarketDrug use ConsequencesInterventions Developments Standards and quality of interventions Drugs in prison Drugs and the internet Drugs and licit psychotropic substances Data: Annual Report 2010 + more recent details

5. Market Drug use Consequences Interventions Standards Prison Internet Licit substances Cannabis Herbal: 289 000 seizures (250% of 2003) 90 tons: Turkey 31t, Germany 9t Resin 369 000 seizures (increased) 900 t (increased last years) More than half of seizures/amount: Spain Proper balance?

6. Market Drug use Consequences Interventions Standards Prison Internet Licit substances Cocaine seizures Number of seizures increasing for last 20 years: 96 000 Quantities seized decreased since 2006: 67 tonnes New smuggling techniques

7. Heroin seizures and quantities seized Market Drug use Consequences Interventions Standards Prison Internet Licit substances

8. New Drugs – “Legal Highs” Market Drug use Consequences Interventions Standards Prison Internet Licit substances • New groups & large number of new unregulated compounds • Marketed in various combinations or as products laced with synthetic compounds • Difficulties in analytical identification • Little or noknowledge of pharmacology, toxicity, safety profile • Increasing interaction between the “legal-highs” market & organised crime

9. Cannabis Market Drug use Consequences Interventions Standards Prison Internet 75.5 million Europeans have ever used cannabis (22.5 %) 23 million in the past year (6.8 %) 17 million are between 15 and 34 years old Trends mostly downwards (not Easter Europe)

10. Cannabis use: last year prevalence among young adults Market Drug use Consequences Interventions Standards Prison Internet Licit substances

11. Cocaine Market Drug use Consequences Interventions Standards Prison Internet Licit substances 14 million Europeans have ever used cocaine (4.1 %) 4 million during the past year (1.3 %) 3 million are between 15 and 34 years old

12. Cocaine use: last year prevalence among young adults in Europe, Australia, Canada and the USA Market Drug use Consequences Interventions Standards Prison Internet Licit substances

13. Cocaine use: last year prevalence among young adults Market Drug use Consequences Interventions Standards Prison Internet Licit substances

14. Ecstasy and amphetamines Market Drug use Consequences Interventions Standards Prison Internet Licit substances 1.5 million young adults (1.2 %) have used amphetamines in the last year 2.5 million young adults (1.7 %) have used ecstasy in the last year

15. Opioids Market Drug use Consequences Interventions Standards Prison Internet Licit substances About 1.35 million (EU & Norway): or 0.4 % of the adult population (0.1-0.8%) Injectors estimates around half of this or less and appear to be still decreasing

16. Injecting drug users Market Drug use Consequences Interventions Standards Prison Internet Licit substances 750 000 to one million in the EU and Norway —0.26 % of the adult population Decrease in the proportion of injectors among opioid users entering treatment

17. Problem opioid use in neighbouring countries Market Drug use Consequences Interventions Standards Prison Internet Licit substances Reports of problem opioid use in Russia and Ukraine (UNODC): 2−4 times the EU average High proportion of drug injectors and levels of HIV infections

18. Trends in newly reported HIV infections in injecting drug users in four EU Member States reporting high rates of infection Market Drug use Consequences Interventions Standards Prison Internet Licit substances

19. Drug-induced deaths: change 2004 to 2007/8 Market Drug use Consequences Interventions Standards Prison Internet Licit substances

20. Cocaine deaths Market Drug use Consequences Interventions Standards Prison Internet Licit substances Around 1 000 cocaine-related deaths were reported in 2008 Marked increases in Spain and the United Kingdom

21. Prevention Market Drug use Consequences Interventions Standards Prison Internet Licit substances • Environmental strategies: School policies • Universal prevention: Normative beliefs, social competence, parenting • Selective prevention: • Socially excluded groups, vulnerable families • Indicated prevention • Early childhood problems etc.

22. Prevention: Provision of selective prevention Market Drug use Consequences Interventions Standards Prison Internet Licit substances

23. Large investments in treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances At least 1 million Europeans undergo drug treatment every year Major increase over the last decades: new providers and new needs

24. Year or introduction of methadone maintenance treatment (MMT) and high dosage buprenorphine treatment (HDBT) in Europe

25. Large investments in treatment: opioid substitution treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances

26. Estimated proportion of problem opioid users in substitution treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances

27. Trends in treatment entries by primary drug Market Drug use Consequences Interventions Standards Prison Internet Licit substances

28. Treatment entries by primary drug: New clients Market Drug use Consequences Interventions Standards Prison Internet Licit substances

29. Older drug users in drug treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances Treatment starters above 40 10 year before: usually below 10% Today: 19% Portugal: 28%

30. Older drug users in drug treatment Market Drug use Consequences Interventions Standards Prison Internet Licit substances Mainly heroin addicts Infectious diseases, mental health problems, living conditions more difficult Premature aging Needed: special services/facilities or closer collaboration between general health care and drug care

31. Reintegration Market Drug use Consequences Interventions Standards Prison Internet Licit substances • 47% outpatient clients unemployed • 40 % clients entering treatment: no secondary education • paid employment important part in reintegration into society and long term treatment outcome -----> Focus on employability

32. Guidelines in Europe Market Drug use Consequences Interventions Standards Prison Internet Licit substances

33. Guidelines in Europe Market Drug use Consequences Interventions Standards Prison Internet Licit substances

34. Market Drug use Consequences Interventions Standards Prison Internet Licit substances

35. Market Drug use Consequences Interventions Standards Prison Internet Licit substances Foto portale linee guida

36. Situation Market Drug use Consequences Interventions Standards Prison Internet Licit substances 600 000 people in penal institutions in the EU EU: 120/ 100.000, Russia: 629/100.000, US: 756/100.000 Reports of 10−30 % incarcerated because of drug law offences Drug use prevalence much higher than among the general population Increased overdose risk after prison release

37. Situation Market Drug use Consequences Interventions Standards Prison Internet Licit substances Drug use prevalence much higher than among the general population Entitlement to equivalent services as in the community Risk reduction Allows to reach highly problematic group Possible effect on public health

38. Treatment in prison Market Drug use Consequences Interventions Standards Prison Internet Licit substances Some countries recognise the need to develop specific strategies and interventions Transfer of prison health to Ministries of Health; integration of drugs or health services in prison Development of specific standards

39. Internet – an additional risk Market Drug use Consequences Interventions Standards Prison Internet Licit substances 170 online shops Substances sold as ‘legal highs’ Rapid adaptation to control measures

40. Internet – an additional resource Market Drug use Consequences Interventions Standards Prison Internet Licit substances Information provision: warnings Contacts to drug users (Cannabis, cocaine) Internet based treatment Mixed approaches

41. Drugs and licit substances Market Drug use Consequences Interventions Standards Prison Internet Licit substanc Prevention: broader than drugs Tobacco ban and cannabis regulations Drugs policy vs. alcohol policy vs. policy on psychotropic substances

42. Drugs and licit substances Market Drug use Consequences Interventions Standards Prison Internet Licit substanc Overlapping target groups: multiple problems, substances, gambling, social conduct Overlapping substances: “legal highs”, pharmaceutics Overlapping objectives:limit access, reduce risks, avoid secondary problems, treat addictions …

43. Conclusions • Overall stable, partly decreasing • Concern: Cocaine, synthetic drugs, “legal highs” • Local hot spots: Crack cocaine, alcohol/cannabis, young opiate users • Interventions well developed, increased quality • Challenges: new substances, new needs • Opportunities: new media, programmes,treatments • Policy sets objectives • Carefull implementation needed • EMCDDA: monitoring and quality development Market Drug use Consequences Interventions Standards Prison Internet

44. Thanks for your attention More information under: emcdda.europa.eu