Home > Monitoring centre report reveals latest drug trends in Europe.

Galvin, Brian (2013) Monitoring centre report reveals latest drug trends in Europe. Drugnet Ireland, Issue 44, Winter 2012 . pp. 4-5.

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 The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published its annual report 2012 on the drugs situation in Europe in November.1 According to the report, we may be entering a new era in which heroin will no longer play such a central role in Europe’s drugs problems. The number of new heroin users is declining in several countries, while access to substitution treatment for opioid (mostly heroin) users has risen.  

There is a wide range of new psychoactive substances available and the drugs market is changing rapidly. The stimulant market is particularly complex. Cocaine, amphetamines and ecstasy are still the most important stimulants but a number of new synthetic drugs, such as cathinones, are becoming more significant. The EMCDDA says: ‘It is critical that we better understand the health and social impact of these emerging trends and develop measures to reduce demand. To do this better forensic and toxicological analysis is essential, as is the need to proactively engage with those most at risk.’
 
The drugs situation described in the report is presented below under a series of headings.
 
Cannabis
· Cannabis is still Europe’s most commonly consumed illicit drug. One in five adults aged 15–64 have tried cannabis at some point in their lives. Most countries report that cannabis use is stabilising or decreasing. Of the countries which have recorded the highest level of last-year prevalence among young people (aged 15–34) over the past decade, only Italy recorded an increase.

·  Around 1% of adults, three-quarters of whom are aged 15–34 use cannabis daily or almost daily. There is increasing awareness that dependency is a possible consequence of cannabis use and the number of individuals seeking help because of their cannabis use is growing in some European countries.

· Cannabis resin seizures declined in 2010 after a steady increase in the previous decade.   The amount of cannabis seized continued to decline and the 560 tonnes recorded in 2010 was a new low.

· Europe is now an important producer of cannabis. The overall trend is toward ‘import substitution’, that is, imported cannabis products being replaced by herbal cannabis grown inside Europe’s borders.

 
Opiates (mainly heroin)
· More than 200,000 (48%) clients who entered drug treatment in 2010 reported opioids, mainly heroin, as their primary problem drug.  

· In some countries clients cited other opioids as their primary drug more often than heroin. These include fentanyl in Estonia, buprenorphine in Finland, and other opioids in Denmark, Latvia and Austria.

·  Analysis of data in 24 countries on opioid users entering treatment for the first time in their lives showed a decrease from 61,000 in 2007 to 46,000 in 2010. The average time lag between first opioid use and first treatment entry is about nine years, so recent decreases in the number of heroin users entering treatment for the first time should at least partly reflect a reduction in heroin incidence that occurred some time ago.

· Most EU countries reported an upward trend in drug-induced deaths between 2003 and 2008, followed by stable numbers in 2009, with provisional data for 2010 pointing to an overall decrease in such deaths.

· Around 36% of those entering treatment for opioid use in 2010 reported injecting. The rate varies greatly between countries, from 7% in the Netherlands to 94% in Latvia, while data from most countries show a steady decrease from 2000. In eastern European countries injection is still the main route of administration. 

· While the rate of HIV transmission among drug users continues to decrease, Greece and Romania have reported outbreaks of HIV infection, with a local epidemic among injectors in Athens.

· The EMCDDA estimates that about 1,830 people died of HIV/AIDS attributable to drug use in the EU in 2009, with almost 90% of these deaths occurring in Spain, France, Italy and Portugal.

· An estimated 696,000 opioid users were in receipt of substitution treatment in 2011, the most common type of treatment for opioid dependence in Europe, with medium term trends showing a continuous increase since 2003. About half of all problem opioid users in Europe have access to substitution treatment, but some countries have considerably lower coverage levels: Greece (28%), Lithuania (17%), Slovakia (12%), Poland (8%) and Latvia (2%).

· Latest figures for seizures and drug-law offences point to an overall decrease in heroin supply. Around 55, 000 seizures resulted in the interception of 19 tonnes of heroin in 2010, compared with 56,000 seizures and 24 tonnes in 2009.

Cocaine
·  Cocaine remains the second most commonly used illicit drug in Europe, although high levels of cocaine use are observed only in a small number of mostly western European countries
 
·  Around 15% of drug users entering treatment report cocaine as their main problem drug.

· With the exception of Ireland, where the situation has stabilised, the countries most affected by cocaine use among young adults (aged 15–34) reported a decline in last-year use of this drug by this age group in the last country survey.

· The countries reporting the highest last-month prevalence among young people were Spain, the UK, Cyprus and Italy.

· Some countries reported that the number of cocaine-related hospital emergencies was three times higher in recent years than it had been at the end of the 1990s. 

·  The number of cocaine seizures fell slightly to around 88,000 in 2010 from 100,000 in 2008.
 
 ·  The most recent snapshot study (January 2012) identified 693 online shops purportedly selling psychoactive products, with three natural products – kratom, salvia and hallucinogenic mushrooms – the most frequently sold ‘legal highs’. There were 170 of these shops in January 2010. The snapshot identified a marked rise in the availability of synthetic cathinones, suggesting that online operators are seeking a replacement for mephedrone, now banned in the EU. 
 
Other stimulants and new psychoactive substanc
 · The European Early Warning System (EWS) identified 24 new psychoactive substances in 2009, 41 in 2010 and 49 in 2011. The EWS has already identified over 50 new substances in 2012, the largest number ever reported in a single year. The two largest drug groups monitored by the EWS are synthetic cannabinoids (such as found in ‘Spice’) and synthetic cathinones (e.g. mephedrone, MDPV) which mimic the effects of other stimulants (including cocaine).
 
·  While overall last year use of amphetamines among young adults is stable or declining, crystal meth use appears to be increasing. Germany, Estonia, Latvia and Austriaare among the countries that have seen significant increases in seizures of the drug between 2009 and 2010
 
·  Deaths linked to use of the stimulant drug 4-methylamphetamine (4-MA) and reports of seizures in 14 European countries have prompted a risk-assessment exercise by experts from a number of European agencies. 4-MA belongs to the group of synthetic phenethylamine drugs and is sold on the illicit market, usually mixed with amphetamine.
 
 ·  Use of ecstasy (MDMA) is concentrated among young adults. Of 2.0 million adults who reported using the drug in the past year, 1.5 million were in the 15–34-year age group. The proportion of MDMA in tablets sold as ecstasy had been declining in recent years owing to the success of measures to prevent diversion of precursor chemicals, but MDMA has reappeared and is increasing as manufacturers identify new precursor chemicals.
 
Responding to drug use in European prisons
It is estimated that around 635,000 people were held in penal institutions in the EU as at September 2010, compared with around 582,000 in 2001. A new EMCDDA report2 published alongside the annual report examines the provision of drug-related services in European prisons, including counselling, treatment of dependence and the prevention of infectious diseases. Lifetime prevalence levels for heroin use among prisoners in 13 of the 17 countries surveyed were between 15% and 30%; the rate is less than 1% for the general population. Some prisoners initiate drug use or begin to engage in more harmful practices (e.g. sharing injecting equipment) while in prison. Overcrowding, poor hygiene and a lack of healthcare provision affect many prisons, and contribute to the overall poor health status found in inmates.
 
The report notes that many countries have scaled up the provision of interventions within prisons, particularly of substitution treatment for those who are opioid dependent. However, prisons rarely offer a standard of care equivalent and comparable to that provided to the wider community. ‘Penitentiary healthcare has in the past decade increasingly been recognised as part of public health care’, says the report. There is a need to improve continuity of care for prisoners on their release when the risk of overdose death is extremely high because of reduced tolerance. The report highlights the need for pre-release counselling and overdose prevention training.
 
1. European Monitoring Centre for Drugs and Drug Addiction (2012) Annual report 2012: the state of the drugs problem in Europe. Luxembourg: Publications Office of the European Union. www.emcdda.europa.eu/publications/annual-report/2012
2. European Monitoring Centre for Drugs and Drug Addiction (2012) Prisons and drugs in Europe: the problem and responses. Luxembourg: Publications Office of the European Union. www.emcdda.europa.eu/publications/selected-issues/prison
Item Type:Article
Issue Title:Issue 44, Winter 2012
Date:January 2013
Page Range:pp. 4-5
Publisher:Health Research Board
Volume:Issue 44, Winter 2012
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:MM-MO Crime and law > Justice system > Correctional system and facility > Prison
J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service
B Drugs and alcohol substances > Cocaine
B Drugs and alcohol substances > Cannabis / Marijuana
VA Geographic area > Europe
B Drugs and alcohol substances > CNS stimulants
A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use

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