TD-AC-12-001-EN-C ISSN 1609-6150 ANNUAL REPORT 2012: THE STATE OF THE THE STATE DRUGSANNUAL PROBLEM REPORT IN 2012: EUROPE About the EMCDDA The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is one of the European Union’s decentralised agencies. Established in 1993 and based in Lisbon, it is the central source of comprehensive information on drugs and drug addiction in Europe. The EMCDDA collects, analyses and disseminates factual, objective, reliable and comparable information on drugs and drug addiction; in doing so, it provides its audience with an evidence-based picture of the drug phenomenon at European level. The Centre’s publications are a prime source of information for a wide audience including policymakers and their advisers; professionals and researchers working in the field of drugs; and, more broadly, the media and general public. 12 The annual report presents the EMCDDA’s yearly overview of the drug phenomenon in the EU and is an essential reference for those seeking the latest findings on drugs in Europe. 20 THE STATE OF THE DRUGS PROBLEM IN EUROPE REPORT ANNUAL EN HOW TO OBTAIN EU PUBLICATIONS Free publications: • via EU Bookshop (http://bookshop.europa.eu); • at the European Union’s representations or delegations. You can obtain their contact details on the Internet (http://ec.europa.eu) or by sending a fax to +352 2929-42758. Priced publications: • via EU Bookshop (http://bookshop.europa.eu). Priced subscriptions (e.g. annual series of the Official Journal of the European Union and reports of cases before the Court of Justice of the European Union): • via one of the sales agents of the Publications Office of the European Union (http://publications.europa.eu/others/agents/index_en.htm). THE STATE OF THE DRUGS PROBLEM IN EUROPE IN PROBLEM DRUGS OF THE STATE THE ANNUAL REPORT 2012 Legal notice This publication of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is protected by copyright. The EMCDDA accepts no responsibility or liability for any consequences arising from the use of the data contained in this document. The contents of this publication do not necessarily reflect the official opinions of the EMCDDA’s partners, the EU Member States or any institution or agency of the European Union. A great deal of additional information on the European Union is available on the Internet. It can be accessed through the EUROPA server (http://europa.eu). Europe Direct is a service to help you find answers to your questions about the European Union. Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers or these calls may be billed. This report is available in Bulgarian, Spanish, Czech, Danish, German, Estonian, Greek, English, French, Italian, Latvian, Lithuanian, Hungarian, Dutch, Polish, Portuguese, Romanian, Slovak, Slovenian, Finnish, Swedish and Norwegian. All translations were made by the Translation Centre for the Bodies of the European Union. Cataloguing data can be found at the end of this publication. Luxembourg: Publications Office of the European Union, 2012 ISBN 978-92-9168-538-7 doi:10.2810/64775 © European Monitoring Centre for Drugs and Drug Addiction, 2012 Reproduction is authorised provided the source is acknowledged. Printed in Luxembourg PRINTED ON WHITE CHLORINE-FREE PAPER Cais do Sodré, 1249-289 Lisbon, Portugal Tel. +351 211210200 • Fax +351 218131711 [email protected] • www.emcdda.europa.eu Contents Foreword 5 Acknowledgements 7 Introductory note 9 Commentary: Building on achievements, maintaining momentum and responding to change — the challenge for drug policy in Europe today 13 Chapter 1: Policies and laws EU and international policy developments • National strategies • Public expenditure • National legislation • Research 20 Chapter 2: Responding to drug problems in Europe — an overview Prevention • Treatment • Social reintegration • Harm reduction • Quality standards • Drug law enforcement and offences 28 Chapter 3: Cannabis Supply and availability • Prevalence and patterns of use • Adverse health effects • Treatment 39 Chapter 4: Amphetamines, ecstasy, hallucinogens, GHB and ketamine Supply and availability • Prevalence and patterns of use • Health consequences • Prevention in recreational settings • Treatment 49 Chapter 5: Cocaine and crack cocaine Supply and availability • Prevalence and patterns of use • Health consequences • Problem use • Treatment and harm reduction 60 Chapter 6: Opioid use and drug injection Supply and availability • Problem use • Injecting drug use • Treatment 70 Chapter 7: Drug-related infectious diseases and drug-related deaths Infectious diseases • Responding to infectious diseases • Deaths and mortality • Reducing deaths 79 Chapter 8: New drugs and emerging trends Action on new drugs • Production and supply • Prevalence • Responses 89 References 95 3 Foreword This is the EMCDDA’s 17th annual report on the state of from drug markets and interdiction efforts, to drug use, the drugs problem in Europe, and it is gratifying when demand reduction responses and policy and legal looking back over the years to note how much progress developments. This allows us to provide a holistic analysis has been made in developing a sound understanding which is greater than the sum of its parts. You cannot of the European drug phenomenon. This is not an fully understand supply issues if you do not understand achievement of the EMCDDA alone; credit must also go the drivers of drug demand and vice versa. For example, to the Member States of the European Union, which have to understand the changes that we are seeing in heroin long recognised the value of developing a comprehensive availability in Europe today, we need to take into account picture of Europe’s drug problem. And, while we are very the impact of interdiction efforts that have effectively proud of the work of the EMCDDA staff in producing this targeted major crime organisations. But, critically, we publication, we also have to acknowledge that it is very need to also consider that this has taken place at a time much a collective effort. This report is only made possible when an increase in investment in treatment has removed by the support and hard work of our partners, especially a significant part of the demand from the marketplace. those in the Reitox network, who provide the national data As you will see from our report this year, these are on which the analysis is based. We are also indebted to equally important pieces of information that need to be the many other European and international agencies and considered together in order to achieve a sound overview bodies that support our work. of the developments we are seeing in the European heroin This year’s report comes at an important and difficult situation. time for Europe. Many countries are experiencing We need this breadth of vision if we are to respond to financial and economic problems, and this must form the the complex and dynamic nature of the drug problem backdrop for our reporting. The austerity measures that in Europe today. We are presented with a range of are being adopted bring multiple challenges, and present policymakers with difficult choices as competing priorities challenges, both new and old. They may be linked to call on the public purse. In such times, it is more important advances in information and communication technology, than ever that investments are made wisely, based on the spread of new psychoactive substances, and increased an understanding of the nature of the problem and what availability and use of synthetic drugs. Or they may stem measures are likely to deliver the greatest benefits. The from long-established problems that continue to defy our EMCDDA’s mission is to work with experts from across responses, and cause damage to both individuals and Europe to provide this analysis. You will find here, and in communities. The EMCDDA is committed to providing the accompanying web-based elements, an up-to-date, the evidence base to ensure that the debate on drugs scientifically robust and comprehensive overview of the in Europe remains informed by a comprehensive, contemporary European drugs problem, together with dispassionate and, most importantly, helpful understanding examples of innovative and good practice. of this complex issue. When considering drug issues, there can be a tendency to be reductive, focusing only on individual elements in João Goulão this complex problem, as though they exist in isolation. Chairman, EMCDDA Management Board This is not the approach we adopt here. In our view, the strength of the EMCDDA’s analysis is that it brings Wolfgang Götz together disparate information on topics that range Director, EMCDDA 5 Acknowledgements The EMCDDA would like to thank the following for their help in producing this report: • the heads of the Reitox national focal points and their staff; • the services and experts within each Member State that collected the raw data for this report; • the members of the Management Board and the Scientific Committee of the EMCDDA; • the European Parliament, the Council of the European Union — in particular its Horizontal Working Party on Drugs — and the European Commission; • the European Centre for Disease Prevention and Control (ECDC), the European Medicines Agency (EMA) and Europol; • the Pompidou Group of the Council of Europe, the United Nations Office on Drugs and Crime, the WHO Regional Office for Europe, Interpol, the World Customs Organisation, the European school survey project on alcohol and other drugs (ESPAD) and the Swedish Council for Information on Alcohol and other Drugs (CAN), the Controlled Substances and Tobacco Directorate of Health Canada, the US Substance Abuse and Mental Health Services Administration; • the Translation Centre for Bodies of the European Union and the Publications Office of the European Union. Reitox national focal points Reitox is the European information network on drugs and drug addiction. The network is comprised of national focal points in the EU Member States, Norway, the candidate countries and at the European Commission.