(2013 Data) to the EMCDDA by the Reitox National Focal Point New
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Tim Pfeiffer-Gerschel, Lisa Jakob & Daniela Stumpf IFT Institute for Therapy Research Axel Budde, Federal Centre for Health Education Christina Rummel, Federal Centre for Health Education Assisted by Alicia Casati, IFT Institute for Therapy Research 2014 NATIONAL REPORT (2013 data) TO THE EMCDDA by the Reitox National Focal Point New Developments and Trends GERMANY Drug Situation 2013/2014 IFT Institute for Therapy Research (Epidemiology and Coordination) Responsible for chapters 1, 2, 4, 5, 6, 7, 8, 9 and 10 Dr. Tim Pfeiffer-Gerschel (Head of DBDD) Parzivalstr. 25 Lisa Jakob D - 80804 München Daniela Stumpf Tel.: +49 (0) 89 - 360804-40 Alicia Casati Fax: +49 (0) 89 - 360804-49 E-Mail: [email protected] Federal Centre for Health Education (BZgA) German Centre for Addiction Issues (Prevention) (DHS) (Treatment) Responsible for chapter 3 Responsible for chapter 5 Axel Budde Christina Rummel Michaela Goecke Gabriele Bartsch Ostmerheimer Str. 220 Westenwall 4 D - 51109 Köln D - 59065 Hamm Tel.: +49 (0) 221 - 8992-529 Tel.: +49 (0) 2381 - 9015-24 Fax: +49 (0) 221 - 8992-300 Fax: +49 (0) 2381 - 9015-30 E-Mail: [email protected] E-Mail: [email protected] II National Experts In its function as national focal point for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the DBDD assigns national experts to the five epidemiological key indicators. Serving as contact persons for the EMCDDA, these experts take part in the experts’ annual conferences, held at European and national levels, with a view to further harmonising and developing the key indicators. They moreover contribute to the creation of this annual report by writing texts on specific topics and giving feedback to the draft versions of the individual chapters. Key indicator population surveys (chapter 2) National expert: Dr. Daniela Piontek, IFT Munich Key indicator prevalence estimate on problem drug use (chapter 4) National expert: Dr. Ludwig Kraus, IFT Munich Key indicator drug-related infectious diseases (chapter 6) National expert: Dr. Ruth Zimmermann, Robert Koch-Institut Key indicator Treatment demand (chapter 5) National expert: Dr. Barbara Braun, IFT Munich Key indicator drug-related deaths (chapter 6) National expert: Dr. Axel Heinemann, Universitätsklinikum Hamburg-Eppendorf (UKE) In addition to the persons mentioned above, the following experts have also contributed to the creation of this annual report: Michael Hoffmann, BKA Wiesbaden (chapter 10), Boris Orth, BZgA (chapters 2 and 10), Dr. Bernd Werse, CDR Frankfurt (chapter 2). Notice: For reasons of improved readability, the following refrains from using female grammatical forms that are instead subsumed under the respective male form. III Contents Introduction Summary PART A: NEW DEVELOPMENTS AND TRENDS ………………………………………….……1 1 DRUG POLICY: LEGISLATION, STRATEGIES AND ECONOMIC ANALYSIS ......... 1 1.1 Overview ....................................................................................................................... 1 1.1.1 Definitions .................................................................................................................................... 1 1.1.2 Objectives and focal points of “drug and addiction policy” ..........................................................1 1.1.3 Political Framework ..................................................................................................................... 3 1.2 Legal framework conditions .......................................................................................... 4 1.2.1 Laws, regulations, directives or guidelines in the field of drug issues .........................................4 1.2.2 Implementation of legal framework conditions ............................................................................6 1.3 National action plan, evaluation and coordination ...................................................... 10 1.3.1 National Strategy ....................................................................................................................... 10 1.3.2 Implementation and evaluation of the National Strategy ...........................................................11 1.3.3 Other drug policy developments ................................................................................................ 18 1.3.4 Coordination arrangements ....................................................................................................... 18 1.4 Economic analysis ...................................................................................................... 19 1.4.1 Introduction ................................................................................................................................ 19 1.4.2 Public expenditures and budgets ..............................................................................................19 1.4.3 Social Costs ............................................................................................................................... 20 2 DRUG USE IN THE POPULATION AND SPECIFIC TARGETED GROUPS ............ 21 2.1 Overview ..................................................................................................................... 21 2.2 Drug use in the general population ............................................................................. 25 2.2.1 Overview of the use of various drugs ........................................................................................25 2.2.2 Comparison of the use of individual drugs ................................................................................26 2.3 Drug use in the school and youth population .............................................................. 30 2.3.1 Use of legal psychotropic substances .......................................................................................30 2.3.2 Use of illegal drugs .................................................................................................................... 32 2.4 Drug use among targeted groups ............................................................................... 43 2.5 Further research results and findings ......................................................................... 45 V 3 PREVENTION ............................................................................................................ 53 3.1 Overview ..................................................................................................................... 53 3.1.1 Institutions involved and organisational framework ...................................................................53 3.1.2 Current developments and trends .............................................................................................53 3.1.3 Effectiveness and efficiency in addiction prevention ................................................................. 61 3.2 Universal prevention ................................................................................................... 64 3.2.1 School ........................................................................................................................................ 64 3.2.2 Family ........................................................................................................................................ 66 3.2.3 Community Prevention .............................................................................................................. 67 3.2.4 Recreational settings and sports clubs ......................................................................................68 3.3 Selective Prevention ................................................................................................... 68 3.3.1 At-risk groups ............................................................................................................................. 69 3.3.2 At-risk families ........................................................................................................................... 71 3.3.3 Selective prevention in recreational settings .............................................................................73 3.4 Indicated prevention ................................................................................................... 73 3.4.1 Children and teenagers with behavioural disorders ..................................................................74 3.4.2 Children with ADHD ................................................................................................................... 74 3.4.3 Early recognition and early intervention .................................................................................... 74 3.4.4 National and regional media campaigns ...................................................................................76 4 HIGH RISK DRUG USE ............................................................................................. 79 4.1 Overview ..................................................................................................................... 79 4.2 Prevalence and incidence estimate of problem drug use ........................................... 81 4.2.1 EMCDDA estimate methods (indirect estimates) ......................................................................81 4.2.2 Incidence estimates of problem drug use .................................................................................. 83 4.3 Data on problem drug use from non-treatment sources ............................................. 84 4.4 Intensive frequent, long-term