Heroin use and drug injecting have become ‘generally less common’, and cannabis use may be stabilising, according to the Annual Report 2007: the state of the drugs problem in Europe, published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in November.1 However, the level of drug-related deaths remains high and the use of cocaine is increasing.  Irish data for the report are provided by the Alcohol and Drugs Research Unit of the HRB.

Cocaine

Cocaine remains Europe’s second most commonly used illicit drug, after cannabis.  The EMCDDA estimates that 12 million European adults (aged 15–64) have tried cocaine, and 4.5 million have used it in the last year.  Most countries reported increases in last-year usage among young adults (aged 15–34).  However, slight increases in countries with the highest prevalence — Spain and the UK — suggest that prevalence may be levelling off. Cocaine accounts for 13% of cases entering treatment across the EU and is the most common reason for entering treatment, after opiates (mainly heroin), and cannabis. A total of 22% of new cases entering treatment in 2005 were cocaine related.  The number of new clients rose from 12,633 in 1999 to 33,027 in 2005, an indication of the impact on public health.  In 2005 a record 107 tonnes of cocaine were seized, up over 45% on quantities seized in 2004. 

In Ireland cocaine is the third most commonly used illicit drug, after cannabis and ecstasy  and was the third most common reason for entering treatment, after opiates and cannabis. According to the most recent general population survey, 3% of Irish adults (aged 15–64) had used cocaine at some point in their lives; just over 1% had used it in the year before the survey.  Just under 3% of young adults (aged 15–34) had used cocaine in the last year, while the European average was almost 2.5%.

Cannabis

Cannabis remains the most commonly consumed illicit drug in Europe. Nearly a quarter of all Europeans have used it at some point in their lives and 7% have used it in the past year.  Almost a quarter of young adults had used cannabis in their lifetime, and 9% had used it in the past year.  Latest data suggest that cannabis use is now stabilising or falling, particularly in high-prevalence countries.  An estimated 1% of European adults — around 3 million people — may be using the drug on a daily, or almost daily, basis and the EMCDDA intends to focus on improving monitoring of  this pattern of intensive consumption.

There is no available evidence to determine trends in cannabis use among the general population in Ireland.  The 2003 survey reported that one in five adults had used cannabis at some point in their lives and one in twenty had used it in the year before the survey. A quarter of young adults had used cannabis in their lifetime, and 9% had used it in the past year.  One in five cases entering treatment in 2006 reported cannabis as their main problem drug.

Injecting drug use and blood-borne infections

Although injecting drug use has become less important as a route of HIV infection, the EMCDDA estimates that it accounted for 3,500 new cases of HIV in the EU during 2005. Hepatitis C Virus (HCV) is more prevalent than HIV among injecting drug users and it is more evenly distributed. In contrast to their success in preventing HIV infection, prevention and harm reduction services seem to be having a weaker impact on preventing HCV. Seven in every ten injecting drug users in Ireland test positive for the hepatitis C virus. Ireland is currently defined as a high-prevalence country for this disease. One in ten injecting drug users in treatment is HIV positive. 

Drug-related deaths

The EMMCDA reports historically high levels of drug-related deaths.  Between 7,000 and 8,000 people died as a result of drug use in 2005.  The downward trend in drug-related deaths between 1999 and 2002 began to reverse in 2003 and has accelerated since then.  ‘There is an urgent need to research why drug-related deaths remain so high’, said EMCDDA Director Wolfgang Götz.

Drug use and related problems among very young people

Illicit drug use among under-15s is rare in Europe, and children account for less than 1% of all treatment clients. Regular drug use among this group is extremely rare and is associated with specific groups in the population where there is a combination of psychological and social problems. Cannabis is the most common illicit substance used among this age group, followed by inhalants (glue and aerosols). Between 5% and 36% of school students have been drunk at least once by the age of 13, and between 7% and 18% have smoked tobacco.

The situation in Ireland closely reflects findings reported across Europe, in prevalence, treatment figures and the most common drugs used.  The National Health Behaviour in School-aged Children survey indicates that the proportion of boys aged 12–14 who reported using cannabis in the 12 months prior to the survey decreased from 11% in 1998 to 7% in 2006. Almost one-quarter (24%) of Irish children reporting having been drunk by the age of 13.

Drugs and driving

After alcohol, cannabis and benzodiazepines are the psychoactive substances most prevalent among the European driving population. Many countries have responded by tightening laws, increasing penalties or altering national strategies to address drugs and driving problems. Responses vary greatly, from zero tolerance (sanctioning detection of the substance per se) to impairment laws (sanctioning if a person is deemed fit to drive). 

The main evidence in relation to drugs and driving in Ireland comes from a nationwide survey conducted by the Medical Bureau of Road Safety in 2000–2001. The survey found that 68% of drivers tested who had zero levels of alcohol were positive for more than one drug. Legislation allowing random breath testing for alcohol was introduced in Ireland in July 2006. Since then there has been a decrease of 19% in road accidents and a total of 17,788 drink-driving arrests.  (Brian Galvin)

1. EMCDDA (2007)  Annual Report 2007: the state of the drugs problem in Europe. Luxembourg: Office for Official Publications of the European Communities.www.emcdda.europa.eu/