2006 Annual report on the state of the drugs problem in Europe

1. 2006 Annual report on the state of the drugs problem in Europe Name, place, date and time

2. Latest on the drug problem across Europe • Overview of the European drug phenomenon in 29 countries • Data and analyses: across Europe and by country • Latest trends and responses • Selected issues: • European drug policies • gender differences • drugs in recreational settings

3. A multilingual information package 2006 Annual report: In print and online in 23 languages • http://annualreport.emcdda.europa.eu • Additional online material in English: • Selected issues http://issues06.emcdda.europa.eu • Statistical bulletin http://stats06.emcdda.europa.eu • Country data profiles http://dataprofiles06.emcdda.europa.eu • Reitox national reports http://www.emcdda.europa.eu/?nnodeid=435

4. Headlines 2006 • Part I: Annual report

5. Headlines 2006 • Drugs in Europe cheaper than ever before • Heroin — seizures and production ‘up’ • Continuing transmission of drug-related infectious diseases • Deaths — downward trend may be faltering

6. Headlines 2006 (continued) • Cocaine — upward trend continues, but some signs of stabilisation • Cocaine — global production ‘up’, importation routes diversifying • Cocaine-related problems becoming visible in some countries

7. Drugs in Europe cheaper than ever before • Much variation in drug prices between countries • Analysis based on only a limited set of countries • Price of illicit drugs on Europe’s streets fell from 1999–2004 in many countries and for most drugs • In Europe as a whole, correcting for inflation, prices fell for cannabis resin (19%), herbal cannabis (12%), cocaine (22%) heroin (45%), amphetamine (20%), ecstasy (47%)

8. Drug prices (continued) • Drug prices influenced by many factors: supply, level of purity, type of product, volume purchased, etc. • Analyses difficult: hidden nature of illicit market, national variations in data quality and data collection • No simple link found between price and trends in other indicators (seizures, prevalence, purity, etc.) • Need to develop better understanding of factors influencing drug prices and how price impacts on levels of drug consumption

9. Trends in retail prices of drugs in Europe 1999–2004

10. Heroin — seizures and production ‘up’ • Afghanistan, world leader in supply of illicit opium: estimated 89% of global production (4,100 tonnes) in 2005 • Recent rises in production mean that global supply could be exceeding global demand (UNODC) • Asia (50%) and Europe (40%) still account for the greatest volume of heroin seized worldwide • Total quantities seized in Europe have been increasing steadily since 1999

11. Heroin (continued) • Record seizures in 2004: an estimated 46,000 European seizures resulted in the recovery of 19 tonnes of heroin. An increase of over 10% on the volume seized in 2003 • Cannot ignore dangers posed by surplus of illicit heroin • Heroin no longer a fashionable drug, but a new generation of young people could become vulnerable • Heroin and injecting — major public health issues in Europe for the foreseeable future

12. Continuing transmission of drug-related infectious diseases • HIV — prevalence of infection among IDUs still low in most European countries. Infection rates around, or below, 1% of IDUs in around 10 countries, under 5% in most of Europe • But new HIV infections attributed to drug injecting are still reported and may be increasing in some areas and groups • HCV — highly prevalent among IDUs in Europe: over 60% in some samples of IDUs tested • Syringe-exchange programmes now mainstream. Part of broader approach (information, education, communication)

13. Deaths – downward trend may be faltering • 7,000 to 8,000 drug-related deaths per year in Europe • Latest data show they account for 3% of all deaths among adults under 40 • Estimates are directly related to drug use, mainly opioid use, but do not include deaths related to accidents, violence or chronic diseases • Typical overdose victim in Europe: male, mid-30s. Across Europe, age of overdose victims is rising

14. Drug-related deaths (continued) • Decline in acute drug-related deaths from 2000–2003 • This decline followed a 14% increase from 1995–2000 • In the available data for 2003–2004, the number of deaths reported rose by 3%, suggesting the downward trend may be faltering • May not herald a long-term shift, but 13 out of 19 reporting countries recorded an increase of some degree

15. Ch. 7, Fig. 13 Long-term trend in acute drug-related deaths, 1985–2004

16. Cocaine — upward trend continues, but some signs of stabilisation • Around 10 m Europeans (over 3% of adults 15–64 years) have ever used cocaine • Around 3.5 m are likely to have used it in the last year (1%) • Around 1.5 m (0.5% of adults) report use in the last month • Cocaine use historically high by European standards, but still lower than in US where adult lifetime use is 14% • Much variation: prevalence rates still low in many countries • In the two countries most affected (Spain, UK), some signs of a more stable situation after dramatic rises in late 90s

17. Ch. 5, Fig. 6 Last year prevalence of cocaine use among all adults (aged 15-64) and young adults (aged 15-34 and 15-24)

18. Ch. 5, Fig. 7 Trends in last year prevalence of cocaine use among young adults (aged 15-34)

19. Cocaine — global production ‘up’, importation routes diversifying • Global cocaine production: around 687 tonnes in 2004 (UNODC) • Most cocaine seized in Europe enters from South America. With Latin American, Caribbean and now increasingly African countries used as transit routes • Around 74 tonnes of cocaine were seized in Europe in 2004 — a 20% decrease on the 2003 figure • The estimated number of cocaine seizures increased by 36% in 2004 to 60,890 • Iberian Peninsula a main gateway for cocaine entering Europe accounting for over half the volume seized

20. Cocaine-related problems becoming visible in some countries • Problems becoming visible, but still relatively low • Around 12% of all new treatment demands are related to cocaine but much variation exists between countries • In Spain and the Netherlands, where cocaine use is relatively well-established, at least one in four requests for drug treatment is now cocaine-related • Need to develop a better understanding of what constitutes appropriate treatment for cocaine and crack cocaine problems • Around 400 cocaine-related deaths reported

21. Drugs in Europe — Facts and figures • 65 m adults have ever used cannabis (lifetime use) – 20% of adults • 10 m adults have ever used amphetamine – 3% of adults • 8.5 m adults have ever used ecstasy – 2.6% of adults • Estimated 1.7 m problem drug users (mainly heroin users) in the EU today • See ‘Drugs in Europe – Facts and figures’ summary for more on individual drugs

22. Headlines 2006 • Part II: Selected issues

23. Headlines 2006 • Drug strategies broadening in scope • Drug treatment services for women still limited in Europe • Different patterns of drug-related harm among women • Is the gender gap narrowing?

24. Headlines 2006 (continued) • Surveys find club-goers over 10 times more likely (than young people in general population) to have tried stimulant drugs • Club tourism and holiday drug use • Long-term risks of alcohol often ignored • Challenges for monitoring

25. Drug strategies broadening in scope • Nearly all European countries now frame policy initiatives within an overall national drugs strategy/action plan • Signs of a broadening of the scope of strategies to encompass licit addictive substances (alcohol, tobacco, medicines) as well as illicit drugs • Over two-thirds of the countries surveyed now make some link or reference to licit substances in their policy documents

26. Drug treatment services for women still limited in Europe • Growing awareness of the needs of women drug users, who currently represent around 20% of those entering treatment • Nearly all EU countries and Norway have at least one drug treatment unit exclusively for women, or for women with children, but access to this sort of service is often limited • Most women are still treated through generic services • Nearly one in four (23%) women accessing drug outpatient treatment services is currently living with children • Childcare concerns can discourage women from seeking help. Women-friendly services have been shown to retain women in care

27. Different patterns of drug-related harm among women • Depending on the country, women represent between 7% and 35% of drug-related deaths • Differences between the genders in death trends • Between 2000 and 2003, overdose deaths among men fell by around 30%, whereas deaths among women fell by around 15% (EU-15) • Recent data from studies of IDUs in nine EU countries showed HIV prevalence to be on average 13.6% among male IDUs and 21.5% among females • Are harm-reduction measures targeted at high-risk drug users impacting less on women than on men?

28. Is the gender gap narrowing? • Marked differences between the genders in almost all aspects of the drug phenomenon • Males still outnumber females among drug users in all European countries, particularly when use is frequent, intensive and problematic • No strong evidence that the gap is narrowing between levels of male and female drug use • But data on drug use among school students (15–16 years) reveal worrying trends. In some countries, girls appear to be catching up with boys in lifetime use of drugs and alcohol

29. Surveys find club-goers over 10 times more likely to have tried stimulant drugs • In some cases around two thirds of club-goers reported ever using stimulants • Over 60% of club-goers surveyed in some settings in France, Italy and the UK said they had ever tried cocaine • Over half the club-goers surveyed in the Czech Republic, France, Hungary, the Netherlands and the UK reported to have ever used ecstasy

30. Fig. 2 Prevalence of ever in lifetime use of ecstasy in surveys carried out in club setting and among the general population

31. Recreational drug use (continued) • Some surveys report lifetime use of ketamine ranging from 7% (Czech Republic) to 21% (Hungary)… • …and lifetime use of GHB ranging from 6% (UK) to 17% (Netherlands) • For hallucinogenic drugs, high figures were recorded in club surveys in the Czech Republic (45% of those surveyed had ever tried LSD), and France (55% had ever tried ‘magic mushrooms’)

32. Club tourism and holiday drug use • Research shows young people are more likely to try drugs, or use them more often, when holidaying abroad • In Spain, recreational drug use is highest near tourist resorts • One Swedish study found that, of young people who had tried illegal drugs, 23% did so for the first time while outside the country • Interviews conducted with young holiday-makers returning from Ibiza, as part of a UK study, found that the frequency of all drug use was higher on holiday than at home

33. Long-term risks of alcohol often ignored • For the majority of young people across the EU, drug use is still not an integral element of dance music settings • For most, it is the music, social aspects and use of alcohol that are the most central experiences in this environment • Drinks manufacturers now tap into the lucrative dance music market, targeting new drinks at younger age groups • Concerns about the health risks of club-goers’ often excessive drinking, sometimes combined with illegal drugs • Club-goers generally aware of the health and legal risks associated with drug use, but less aware about alcohol-related problems and long-term risks

34. Challenges for monitoring • The EMCDDA currently faces the challenge of monitoring a much broader spectrum of substances than a decade ago • Polydrug use presents big challenges to drug monitoring systems that traditionally have focused on use of individual substances • Developing new methodologies to understand this type of drug use must be high on future agenda • As well as monitoring today’s situation, the EMCDDA keeps a watch out for new drugs and new trends that may threaten public health