The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) will publish their European Drug Report 2013: Trends and developments today. This year the agency’s annual overview of the European drug situation is presented in a new information package designed to be ‘more timely, interactive and interlinked’ and which replaces the former annual report. The shorter, graphic-rich report summarises the latest trends across the 27 EU Member States, Norway, Croatia and Turkey. Accompanying the European Drug Report 2013 are a series online interactive Perspectives on Drugs (PODs) providing deeper insights into important issues.

The Health Research Board (HRB) provides the Irish figures for the EMCDDA report. This media briefing compares the situation in Ireland with that in Europe.

The EMCDDA reports that the numbers initiating heroin use are falling, there is less injecting and the use of cocaine and cannabis is declining in some countries. While these are positive developments the use of new and synthetic drugs presents new challenges. Today’s drug market is less structured around the long distance movement of plant-based substances into Europe. Globalisation and new technologies have driven significant changes in the manufacturing, supply and distribution of drugs.

Commenting today, European Commissioner for Home Affairs Cecilia Malmström says:
‘I am heartened by the fact that, thanks to robust drug policies and record levels of treatment, use of heroin, cocaine and cannabis appears to be waning in some countries and drug-related HIV continues to decline.’
Despite these advances the fact that drug use in Europe remains high is a cause of continuing concern. Commissioner Malmström continues:
‘Emerging challenges add to my concerns — we are faced with an ever more complex stimulant market and a relentless supply of new drugs which are increasingly diverse. The fact that over 70 new drugs have been detected in the last year is proof in itself that drug policies need to stay on target’.

The EMCDDA estimates that at least 1.2 million Europeans received treatment for illicit drug use in 2011. Opioid users represent the largest group undergoing treatment, followed by cannabis and cocaine users. Substitution treatment remains the ‘first choice’ for treating opioid dependence. Some 730 000 Europeans now receive substitution treatment for opioid dependence— up from 650 000 in 2008 — representing around half of the estimated 1.4 million problem opioid users in Europe today.

The number of heroin users entering treatment for the first time continues to fall while there has been a steady increase in the number of those beginning treatment for problem cannabis use. Opioid users still represent the largest group in treatment. Despite the fall in the numbers entering treatment the long-term nature of opioid use means that many of those in treatment are likely to require services for many years to come.

The situation with respect Europe and Ireland is presented below under a series of headings.

Cannabis

European situation
• Cannabis is still Europe’s most commonly consumed illicit drug. However, most countries report stable or decreasing trends among young people. Around 15.4 million (11.7%) adults aged 15-34 years used cannabis in the last year, 9.2 million of whom (14.9% of this age group) are aged 15-24 years.
• The use of cannabis by school students aged 15-16 years increased between 1995 and 2003, decreased slightly in 2007 and has remained stable since then.
• Around 1% of adults, over two-thirds of whom are aged 15-34, use cannabis daily or almost daily.
• For all clients entering treatment cannabis is the second most frequently reported main problem drug, after heroin.
• Cannabis is now the most frequently reported main problem drug among those entering treatment for the first time. Between 2006 and 2011 the numbers of such clients increased from 45000 to 60000.
• Herbal cannabis is becoming more common in Europe with almost all countries reporting some domestic cultivation of cannabis plants.
• In 2011 herbal cannabis accounted for 41% of all drug seizures, while cannabis resin accounted for 36%.

Irish comparison
• The NACD 2010/11 general population survey reported that 6.0% of the general population (15-64) used cannabis in the year prior to the survey, and 3% in the last month. Ireland is placed in the mid-range for cannabis use.
• The 2010/11 European School Survey Project on Alcohol and Other Drugs (ESPAD) reported that 14% of 15–16-year-old students had used cannabis in the year prior to the survey. The number of students who had tried cannabis at some point in their lives decreased marginally from 20% in 2007 to 18% in 2011. These figures are broadly in line with the Health Behaviour in School-aged Children (HBSC) survey of 2010 which reported that 17% of 15–17-year-olds had used cannabis in the previous twelve months.
• The number of cannabis users attending treatment increased from 991 in 2003 to 1,893 in 2010, which respresents 25% of clients in treatment in 2010.
• A 2012 NACD bulletin presented drug prevalence data by regional drugs task force (RDTF) area based on findings from the 2010/11 general population survey. It reported that cannabis was the most commonly reported illegal drug used in each of the RDTF areas, with rates of last year use ranging between 2.8% in the North West and 9.4% in North Dublin. Rates have stabilised or fallen in six RDTF areas and increased significantly in one area, the Western RDTF.

Opiates (mainly heroin)

European situation
• Around 197,000 (48%) clients who entered drug treatment in 2011 reported opioids, mainly heroin, as their primary problem drug.
• Eleven European countries reported that 11% or more of new opioid clients entering treatment were using opioids such as fentanyl, methadone and buprenorphine without a prescription.
• Analysis of European data on opioid users entering treatment for the first time in their lives showed a decrease from a peak of 59,000 in 2007 to 41,000 in 2011.
• Treatment data provides evidence of a long-term decline in injecting opioids. The proportion of first time entrants to drug treatment who are opioid injectors fell from around 58% in 2001 to 38% in 2011.
• The trend in opiate-induced deaths showed an increase from 2003 up to 2008, stabilised in 2009 and began a decline in 2010. The downward trend continued in 2011 when 6,500 overdose deaths were reported compared to 7,000 cases in 2010 and 7,600 in 2009.
• The EMCDDA warns that ‘a large burden of advanced liver disease can be expected over the next decade’ among injecting drug users (IDUs) infected with hepatitis C. Injecting drug use accounts for an average of 58% of all hepatitis C virus cases and 41% of the acute cases notified across the countries that provided data in this area. Three (Italy, Portugal and Norway) of the countries with national trend data for 2006–2011 reported declining HCV prevalence while Greece and Cyprus reported an increase during this period.
• There were 1,507 newly report cases of HIV/AIDS attributable to drug use in the European Union in 2011, a slight increase on the 2010 figures. There are significant differences in prevalence between different countries with Greece and Romania between them accounting for 23% of the total. Other countries showed slight increases while in Ireland, Spain and Portugal infection rates have declined continually since 2004.
• Latest figures for seizures and drug-law offences point to an overall decrease in heroin supply. There were 40,500 seizures of the drug in 2011, down from around 55, 000 seizures in 2010. The 6.1 tonnes of heroin seized was the lowest reported in a decade and was equivalent to about half that seized in 2011.

Irish comparison
• In Ireland 4,930 (58%) of those who entered treatment in 2010 reported opioids, mainly heroin, as their primary problem drug.
• In Ireland around 2% of those entering treatment for drug problems in 2010 reported opiates other than heroin as their primary drug.
• In Ireland there were 16 newly diagnosed HIV cases among injecting drug users in 2011, down from 22 in 2010. These are considered to be very low numbers.
• The number of deaths where heroin was implicated in the cause of death (alone or with another drug or substance) decreased sharply from 115 in 2009 to 70 in 2010. This is the first time since 2005 there has been a decrease in the number of deaths due to heroin poisoning.

Stimulants and new psychoactive substances

Cocaine
European situation
• Cocaine remains the most commonly used illicit stimulant drug in Europe, although high levels of cocaine use are observed only in a small number of mostly western European countries. It is estimated that about 2.5 million young adults (15–34 years) used cocaine in the last year.
• Recent surveys have shown that there has been a fall in the use of cocaine by young adults (15–34 year) in those countries where use among this age group has been highest over the past few years. Fewer young adults are using cocaine in Denmark, Ireland (2.8%), Spain, Italy and the UK and fewer people are entering treatment for the first time with cocaine as their main problem drug.
• Since 2010, Poland is the only country to report a national survey showing an increase in cocaine use. At least 475 deaths related to cocaine were recorded in 2011.
• The number of cocaine seizures has fallen steadily in recent years. In 2011, 62 tonnes were seized, down from 120 tonnes in 2006. There have been some signs recently of diversification of cocaine trafficking routes with falls in interceptions of the drug in the Iberian Peninsula and increases in Bulgaria, Greece, Romania and the Baltic

Irish comparison
• The 2010/11 general population survey reported 1.5% of adults and 2.8% of young adults (15-34) used cocaine in the year prior to the survey, compared to 1.7 and 3.1 respectively in 2006/7.
• In Ireland in 2009, 11% of those who entered treatment reported cocaine as their primary drug and this fell to 9% in 2010.
• In Ireland the number of cocaine deaths increased from 10 in 2003, to 66 in 2007 then decreased to 52 in 2009.

Other stimulants and new psychoactive substances

European situation
• The European Early Warning System (EWS) identified 24 new psychoactive substances in 2009, 41 in 2010 and 49 in 2011. In 2012, 73 new psychoactive substances were officially notified for the first time, 30 of which were synthetic cannabinoids and 14 new substituted phenethylamines.
• An estimated 1.7 million (1.3%) of young adults (15–34 year) used amphetamines during the past year. Recent data show use of the drug to be stable or declining among this age group.
• Ecstasy refers to the synthetic substance MDMA. It is estimated that 1.8 million young adults used ecstasy in the last year. Most countries report stable or decline ecstasy used between 2006 and 2011. Ecstasy was the primary drug for less than 1% of those entering treatment for the first time in Europe.
• Since 2006 and 2011 the number of drugs supply offences related to ecstasy in Europe fell by about two-thirds and these now represent about 1% of all reported supply offences. There is, however, some recent evidence of increased availability of MDMA including high purity MDMA powders.

• Irish comparison
• Ireland has had notable success in limiting the sale of new psychoactive substances through legislation in 2010 and 2011. This was achieved through the combined efforts of a number of government departments and statutory agencies.
• The 2010/11 general population survey reported 3.5% of adults and 6.7% of young adults (15-34) used new psychoactive substances, such as herbal smoking mixtures, party pills or herbal highs, or powders such as cathinones during the year prior to the survey.
• Findings based on NACD 2010/11 general population survey show that ecstasy use decreased somewhat in all RDTF areas (significantly so in the East Coast area only), with proportions ranging between 0% in the North West and 1.3% in North Dublin.
• Recent use of new psychoactive substances was reported in all RDTF areas. The rate of use was highest in the East Coast (7.7%) and lowest in the North West (1.5%). Anecdotally, the use of new psychoactive substances appears to have decreased, which is evidenced by a reduction in the number of adverse events reported since the introduction of legislation in 2010 and 2011.

Drug policy during Ireland’s EU Presidency
Ireland is near the completion of its seventh Presidency of the Council of the European Union. During the Presidency a draft EU Action Plan on Drugs 2013–2016 was presented to the other 26 Member States and the EU Institutions. It is anticipated that the June meeting of the Council of Justice and Home Affairs Ministers will consider the adoption of the Action Plan.

The Drug Policy Unit (Department of Health), has led the Irish Presidency Steering Group on Drugs Issues, which comprises a small number of officials drawn from the Department of Health, the Department of Justice & Equality and the Department of Foreign Affairs & Trade. Work on drugs policy at EU level proceeds via the Horizontal Working Party on Drugs (HDG), a working party of the European Council, comprising representatives from each of the 27 Member States and based in Brussels. The Presidency chairs the monthly meetings of the HDG.