The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) will publish the European drug report 2017: trends and developments today. The European report provides a snapshot on the latest trends across the 28 EU member states, Norway and Turkey. The HRB provides the Irish figures for the EMCDDA report.

Dr Mairead O’Driscoll, Interim Chief Executive of the Health Research Board (HRB) says, ‘If we monitor what drugs people are taking, what treatment services are in demand and what is driving drug-related deaths, we can provide clear evidence to drive service planning at a local level. However cooperating across Europe also allows us to identify emerging trends and understand drug markets better, which is essential for informed decision-making and developing appropriate responses’.

This year the EMCDDA reports highlights the findings a major school survey in 2016 that showed that last-month cannabis use among European school students was around half the level reported in a similar study from the US. Cannabis use among school students in Europe appears to be stable while smoking and drinking is declining. The percentage of European students reporting last-month alcohol use was more than double (49%) that reported by their American peers (21%).

An estimated 8,440 people died from drug overdose, mainly related to heroin and other opioids in 2015. This is the third year in a row that overdose deaths in Europe have increased. Methadone-related deaths exceed heroin-related deaths in four European countries, including Ireland. Supervised drug consumption facilities are available in seven European countries and ten countries are running take-home naloxone programmes. Naloxone is an opioid overdose-reversal drug.

While the number of new substances being introduced to drug market has declined, the overall number of substances now available continues to grow. In 2016 the EMCDDA monitoring more than 620 new psychoactive substances (NPS), compared with around 300 monitored in 2013. The slower rate of detection of new substances may be due a more restrictive legal environment in some Member States and operations against NPS laboratories in China.

Dimitris Avramopoulos, European Commissioner for Migration, Home Affairs and Citizenship, says, ‘The impact of the drugs problem continues to be a significant challenge for European societies. Over 93 million Europeans have tried an illicit drug in their lives and overdose deaths continue to rise for the third year in a row. I am especially concerned that young people are exposed to many new and dangerous drugs. Already 25 highly potent synthetic opioids have been detected in Europe between 2009 and 2016, of which only small volumes are needed to produce many thousands of doses, thus posing a growing health threat’.

The content below outlines the drug situation in Europe and where the data is available, provides comparisons with the situation in Ireland.

Cannabis

European situation

• The EMCDDA estimates that around 17.1 million (13.9%) of young Europeans (15–34) used cannabis in the last year, 10 million of whom (17.7% of this age group) are aged 15-24 years.

• The most recent survey results show that countries continue to follow divergent paths in last year cannabis use. Of the countries that have produced surveys since 2014, 9 reported higher estimates, 6 were stable and 2 reported lower estimates than in the previous comparable survey.
• Levels of lifetime cannabis use in 2014 among school-aged children was, on average, 18%, with the highest levels reported by the Czech Republic (37%) and France (31%).
• The number of first-time treatment entrants for cannabis as their main problem drug increased from 43,000 in 2006 to 76,000 in 2015. It is estimated that around 1% of European adults are daily or almost daily cannabis users.
• In 2015, 703,000 seizures of cannabis were reported in the European Union (416,000 of herbal cannabis, 287,000 of cannabis resin). There were a further 21,000 seizures of cannabis plants. The quantity of cannabis resin, transported in large quantities and over long distances, seized in the European Union is much higher than that of herbal cannabis (537 tonnes versus 73 tonnes).

Irish comparison

• The National Advisory Committee on Drugs and Alcohol (NACDA) 2014/15 general population survey reported that 14% of young adults (15-34) used cannabis in the year prior to the survey (recent use).
• The NACDA 2010/11 survey used two instruments to determine cannabis abuse and dependence. Of recent users 9% were classified as cannabis dependent.
• Since 2004 cannabis has consistently been reported as the second most common problem drug for those entering treatment. The number of cases entering treatment with cannabis as their main problem drug in 2015 was 2,786 (28.2%).

• In 2015, 1,693 (45.2%) cases entering treatment for the first time identified cannabis as their main problem drug compared to 1,107 cases in 2009.
• The 2014/15 European School Survey Project on Alcohol and Other Drugs (ESPAD) survey reported that 16.8% of 15‒16-year-old students had used cannabis in the past 12 months.

• Just less than 10% of 13-17 year olds report having used cannabis in the last 12 months. The Health Behaviour in School-aged Children (HBSC) survey of 2014 also reported that cannabis use increased with each year of age and was more common among boys.
• There was a decline in the number of herbal cannabis seizures between 2014 and 2015, from 1,628 to 1,049. The number of herbal cannabis seizures was nearly three times higher than seizures for cannabis resin and plants.
• Similar to all drug seizures, a 36% reduction in cannabis-type substances seizures occurred between 2014 (2226) and 2015 (1423).

Opioids (mainly heroin)

European situation

• There was an estimated 1.3 million high-risk opioid users in Europe in 2015.
• Of the 191,000 clients entering specialised treatment and reporting opioids as their primary drug in 2015, 29,000 were first-time entrants. The numbers of new entrants to treatment had declined from 56,000 in 2007, when they accounted for 36 % of all new clients, to 23,000 in 2013.
• In 2015, 17 European countries reported that more than 10 % of all opioid clients entering specialised services presented for problems primarily related to opioids other than heroin including methadone, buprenorphine, fentanyl, codeine, morphine, tramadol and oxycodone.
• Among first-time clients entering drug treatment in 2015 with heroin as their primary drug, 29 % reported injecting as their main route of administration, down from 43 % in 2006.
• The EMCDDA estimates that at least 7,584 overdose deaths occurred in the European Union in 2015, an increase from the 6,800 figure recorded in 2014. The reported number of overdose deaths increased among older age groups between 2007 and 2015, while those among younger age groups decreased.
• Viral hepatitis, particularly infection caused by the hepatitis C virus (HCV), is highly prevalent among injecting drug users across Europe with 5 of the 13 countries with national data reporting a prevalence rate in excess of 50 % in 2014-15. Drug injection is a risk factor for other infectious diseases including hepatitis B, tetanus and botulism.
• The quantity of heroin seized within the EU had been declining steadily between 2002 and 2013 when 5.6 tonnes were seized. A total of 8.9 tonnes were seized in 2014, but in 2015, 4.8 tonnes were seized, a return to the levels registered in the early 2010s. The reversal in trends in 2015 was largely due to an increase in large seizures (above 100 kg) in several countries.

Irish comparison

• Opiates (mainly heroin) were the most common main problem drug reported by cases entering treatment in 2015. There were 4,732 cases (47.8%) in 2015, a continuation of the steady decrease in the proportion of the total number entering treatment in recent years.
• The number of those entering treatment for the first time in 2015 for whom heroin was the main problem was 971, a quarter of new cases in treatment.
• Methadone (alone or with another drug) was implicated in more than a quarter of poisoning deaths and continues to be the opiate most commonly implicated in poisoning deaths. In 2014, there were 98 deaths where methadone was implicated, compared to 93 deaths in 2013. This is compared to a peak in 2011 when there were 119 deaths where methadone was implicated.
• In 2014 there were 90 deaths where heroin was implicated, compared to 86 in 2013.       This is the first increase in heroin-related deaths since 2009.
• There were 169 notifications for hepatitis C virus (HCV) in 2015 where injecting was the predominant risk factor. In 2014 the equivalent number was 277 and the number of cases reported has been declining for several years.
• In 2014 there were 45 newly-diagnosed HIV cases, 9% of the total number of new cases, among intravenous drug users, the highest number since 2008. There was an outbreak of HIV in Dublin among people who inject drugs in 2014-2015. A detailed review of the region of origin, mode of transmission, duration of drug use and co-infection is also being conducted.

• The quantity of heroin seizures increased from 690 in 2013, to 954 in 2014 but dropped again in 2015 to 758 seizures.

Cocaine

European situation

• Cocaine is the most commonly used illicit stimulant drug in Europe. Its use is more prevalent in the south and west of Europe. It is estimated that about 2.3 million young adults aged 15 to 34 (1.9% of this age group) used cocaine in the last year. Only Ireland, Spain, the Netherlands and the United Kingdom report last year prevalence of cocaine use among young adults of 2.5 % or more.
• The decreases in cocaine use reported since 2008 had not been observed in the most recent surveys; of the countries that have produced surveys since 2014, three reported higher estimates, 12 reported a stable trend and one reported lower estimates than in the previous comparable survey.
• Overall, cocaine was cited as the primary drug by 63,000 clients entering specialised drug treatment in 2015, with the UK accounting for almost three quarters of all reported treatment entries for cocaine. After a period of decline, the overall number of cocaine first-time treatment entrants has been stable since 2012 and there were 28,000 first-time clients in 2015.
• In 2014, almost 7,400 clients entering treatment in Europe reported crack cocaine as their primary problem drug, with the United Kingdom accounting for more than half of these (4,800), and Spain, France and the Netherlands most of the remainder (1,900).
• In the United Kingdom, deaths involving cocaine increased from 169 in 2013 to 320 in 2015. In Spain, where cocaine-related deaths have been stable for some years, the drug continued to be the second most often cited drug in overdose deaths in 2014 (269 cases).
• In 2015, around 88,000 seizures of cocaine, amounting to 68.7 tonnes, were reported in the European Union. The situation has remained relatively stable since 2007, although both the number of seizures and the quantity seized increased between 2014 and 2015.

Irish comparison

• The 2014/15 general population survey reported last-year prevalence of cocaine use among 15–34-year-olds at 2.9%, which has not changed since the 2010/11 survey. Although the lifetime rate of cocaine use among persons aged 15‒64 years and young adults aged 15‒34 years has more than doubled since 2002/3, the percentage of respondents reporting current use of cocaine (last month) has remained relatively unchanged across surveys.
• A total of 513 (13.7%) new cases entering treatment in 2015 reported cocaine as their main problem drug, increased from 425 (11.3%) in 2014..
• During 2014 there were 40 deaths where cocaine was implicated (alone or with another drug), an increase on the 32 reported in 2013.
• In 2015, 364 seizures of cocaine were reported in Ireland, down from 405 seizures in 2014.

Other stimulants and new psychoactive substances

European situation

• Data on new psychoactive substances (NPS) are based on notifications by Member States to the EU Early Warning System (EWS). In 2016, 66 new substances were reported for the first time (98 in 2015). By the end of 2016, the EMCDDA was monitoring more than 620 NPS, compared with around 300 monitored in 2013.
• In 2015, almost 80 000 seizures of NPS were made across Europe, more than double the number reported in 2014. Together, synthetic cannabinoids and cathinones accounted for almost 60 % of the total number of all seizures of NPS.
• In 2015, synthetic cannabinoids accounted for just over 24 000 seizures. This represents an increase of almost 7 000 seizures compared to 2014 figures. Since 2008, 169 synthetic cannabinoids have been detected in a range of different products — including 11 new cannabinoids reported in 2016, and these continue to be the largest group of new drugs monitored by the EMCDDA.
• Synthetic cathinones are the second largest group of new drugs monitored by the EMCDDA. In total, 118 synthetic cathinones have been identified since 2005, with 14 reported for the first time in 2016, a decrease from the 31 reported in 2014.
• Numbers of detections of new opioids and benzodiazepines rose markedly in 2016. Nine new opioids were detected for the first time in 2016. Over 60 % of the 600 seizures of new synthetic opioids reported in 2015 were fentanyl derivatives. Over 300 000 tablets containing benzodiazepines, such as clonazolam, diclazepam, etizolam and flubromazolam were seized in 2015. This figure was almost twice the number reported in 2014.
• The EMCDDA estimates that 2.3 million young adults (15–34) used MDMA/ecstasy in the last year (1.8% of this age group), with national estimates ranging from 0.3% to 6.6%. These figures suggest an increase in use following a number of years of decline.
• Around two thirds of European countries (19) reported some level of use of new psychoactive substances among their populations of high-risk opioid and stimulant users. The injection of synthetic cathinones among these groups was reported, with the substance used often varying by country.

Irish comparison

• The 2014/15 NACDA survey reported last-year prevalence of Ecstasy of 4% for young adults (15-34), a significant increase from 0.9% recorded in the 2010/11 survey.
• Last year prevalence of new psychoactive substances (NPS), such as herbal smoking mixtures, party pills or herbal highs, or powders such as cathinones, was included as a drug category for the first time in the 2010/11 NACDA drug prevalence survey. In contrast to trends observed with other illicit substances, data from the 2014/15 study demonstrate a reduction in the use of NPS by young adults, from 6.7% to 1.6%. Last month prevalence was less than 1% for respondents aged 15‒64 years.
• In 2014, MDMA (alone or with other drugs) was implicated in 15 deaths. There were less than 5 deaths related to MDMA in 2010.
• There were 85 entrants to treatment in 2015 for whom an NSP was the main problem drug. The proportion of cases treated for this type of drug peaked in 2010 at 2.5 % of all treatment episodes, but dropped to 0. 2% in 2012 and has increased to represent and 0.9% in 2015.
• There was an increase in notifications of recently acquired HIV among people who inject drugs in Dublin during 2014 and 2015. This increase has been linked to injection of a synthetic cathinone PVP, with the street name ‘Snow Blow’.

ENDS

If you have any queries in relation to the Irish figures, you should contact

Gillian Markey, Communications Manager, Health Research Board

m +353 87 2288514         e gmarkey@hrb.ie