The State of the Drugs Problem in Europe
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ISS N1 60 9- 61 50 RT AL 08 PO 20 THESTATE OF THEDRUGSNU PROBLEMINEUROPE RE AN EN RT AL 08 PO 20 THESTATE OF THEDRUGSNU PROBLEMINEUROPE RE AN Legalnotice This publicationofthe European MonitoringCentrefor Drugsand Drug Addiction(EMCDDA)isprotected by copyright.The EMCDDA acceptsnoresponsibility or liability forany consequences arisingfromthe useofthe data contained in this document. The contentofthis publicationdoesnot necessarilyreflect theofficial opinions of theEMCDDA’spartners, theEUMemberStatesorany institution or agencyofthe European UnionorEuropeanCommunities. Agreat deal of additionalinformation on theEuropeanUnion is availableonthe Internet. It canbe accessedthrough theEuropaserver(http://europa.eu). Europe Direct is aservice to help youfind answerstoyourquestionsabout theEuropeanUnion Freephonenumber (*): 00 80067891011 (*)Certain mobile telephone operatorsdonot allowaccess to 00 800numbersorthese callsmay be billed. This report is availableinBulgarian,Spanish, Czech, Danish, German, Estonian,Greek,English,French, Italian, Latvian, Lithuanian,Hungarian, Dutch, Polish,Portuguese,Romanian,Slovak, Slovenian,Finnish, Swedish, Turkishand Norwegian. Alltranslations were made by theTranslationCentrefor theBodiesofthe European Union. Cataloguingdata canbefound at theend of this publication. Luxembourg:Office forOfficial Publications of theEuropeanCommunities,2008 ISBN 978-92-9168-324-6 ©EuropeanMonitoringCentrefor Drugsand Drug Addiction, 2008 Reproductionisauthorisedprovidedthe sourceisacknowledged. PrintedinLuxembourg PRINTED ON WHITECHLORINE-FREE PAPER RuadaCruzdeSanta Apolónia,23–25,1149-045Lisbon, Portugal Tel. (351)218 11 30 00 • Fax(351) 218131711 [email protected] • http://www.emcdda.europa.eu Contents Foreword 5 Acknowledgements 7 Introductorynote 9 Commentary:The drug situationinEurope— newperspectivesand some old realities 11 Chapter1:Policies andlaws Internationaland EU policy developments •Nationalstrategies• Public expenditure•Nationallegislation•Crime •Nationalresearch 18 Chapter2:Respondingtodrug problemsinEurope—anoverview Prevention •Treatment•Harmreduction•Socialreintegration • Health andsocialresponses in prison 28 Chapter3:Cannabis Supplyand availability •Prevalenceand patterns of use•Treatment 36 Chapter4:Amphetamines,ecstasy andLSD Supplyand availability •Prevalenceand patterns of use•Recreationalsettings• Treatmentprovision 47 Chapter5:Cocaine andcrack cocaine Supplyand availability •Prevalenceand patterns of use• Treatmentand harm reduction 58 Chapter6:Opioid useand drug injection Heroin supplyand availability •Prevalenceand patterns of use• Injectingdrug use•Treatment of problem opioid use 68 Chapter7:Drug-relatedinfectiousdiseasesand drug-relateddeaths Infectiousdiseases •Preventinginfectiousdiseases •Deathsand mortality• Reducing deaths 78 Chapter8:Newdrugsand emergingtrends EU actiononnew psychoactivesubstances •Internetshops •GHB andGBL 90 References 95 3 Foreword We areproud to present this,the thirteenth,annual report developmentand politicalstability of producer and of theEuropeanMonitoringCentrefor Drugsand Drug transitcountries? Onehas only to considerthe worrying Addiction. This report is only possible throughthe hard developments resultingfromthe transiting of cocaine work anddedicationofour partners in theReitoxnetwork throughWestAfricatoberemindedofthe collateral of nationalfocal points andthe expertsthroughout damage that this problem cancause. Europe whohavecontributed to theanalysis. We also On apositivenote, drug useinEuropeappears to be areindebted to thoseEUagenciesand international stabilising,and progress canbenoted in theway in which organisations workinginthe drugsfield.Our report is a EU Member States areaddressingthis issue. Formost collective endeavourand we thank all thosewho have formsofdrug use, ouroverall assessmentisthatweare contributed to it.The rationale behind this work is that a not seeing increases,and in someareas thetrendsappear cool-headedanalysisofwhatweknowabout thedrug to be downward.Interms of responses,wehaveseen situationisaconditionfor an informed, productiveand virtuallyall Member States adoptastrategic approach, reasoneddebate. It ensuresthatopinionsare enlightened andgreater cohesion is visible at theEuropeanlevel. by facts, andthatthose making difficultpolicychoices can Treatmentavailability continues to grow,and in some have aclear understandingofthe costsand benefitsofthe countriesithas reachedthe pointwhere themajorityof optionsavailable. heroin users, onceconsideredahiddenpopulation, are This year hasbeenanexceptionallybusytimefor drug nowincontactwithservices of one sort or another. Not many yearsago,HIV infection amongdrug injectors was policy,and theEMCDDAhas been honoured to have acentral concern in thedrug policy debate.Since then, supported both thefinalevaluationofthe currentEU apragmatic mixtureofprevention, treatmentand harm- actionplanondrugsand thereviewofthe 1998 United reductionmeasureshas become thenorminEurope, and NationsGeneralAssemblySpecialSessiononthe drug ratesofnew infection attributed to drug usehavefallen problem.Itisgratifyingtonotethat, by international andcontinuetodoso. standards, Europe stands outasone of theparts of the worldwhere monitoringcapacitiesare most developed. Good news makespoorheadlines andcan be overlooked. Nonetheless,weare awareofthe limitationsofour current However, it is importanttorecogniseprogress where information resources,and areconstantlyworkingwithour it hasbeenmade. Increasingly, in Europe,wehave partners to improvethe qualityand relevanceofthe data an understandingofwhatmeasurescan be effective available. in addressingdrug problems. An acceptance that our activities can, anddo, make adifferenceisaprerequisite An underlying theme of thepolicydebateondrugsis to securing investmentand policy support. This is not to say thecosts, both hidden andmorevisible,ofEurope’sdrug that ourreportdoesnot highlightmanyareas of concern problem.This issueisaddressedinvarious partsofthis forthe European Union. Examplesinclude thecontinuing report.The EMCDDA hasbeenworkingtodevelopan increases in cocaineuse andthe considerabledifferences understandingofthe public expenditures associated with that still existbetween countriesinthe availability and tacklingdrug useinEUMemberStates. This work is in qualityofservices forthose with problems. We must itsinfancy,and estimatesderived areindicativerather thereforeconcludethat, even if progress hasbeenmade, than precise. Nonetheless,theypoint to considerable thejourneyremainsfar from finished. However, today sums beingspent,withpreliminary figuresofbetween in Europe,morethanatany time in thepast,wehavea EUR28billion andEUR 40 billion. Less easy to express stronger agreementonthe direction we should take. in economic termsisthe harm caused by drug use. MarcelReimen What costsdowecount in lookingatthe tragic loss Chairman, EMCDDA ManagementBoard of lifecausedbydrugsinEurope, thenegativeimpact on communities wheredrugsare producedorsold,or WolfgangGötz in theway that drug trafficking undermines thesocial Director, EMCDDA 5 Acknowledgements The EMCDDA wouldliketothank thefollowing fortheir help in producingthis report: • theheads of theReitoxnationalfocal points andtheir staff; • theservices within each Member Statethatcollectedthe rawdatafor this report; • themembers of theManagementBoard andthe Scientific Committeeofthe EMCDDA; • theEuropeanParliament, theCouncil of theEuropeanUnion —inparticularits Horizontal WorkingParty on Drugs— andthe European Commission; • theEuropeanCentrefor DiseasePreventionand Control(ECDC), theEuropeanMedicinesAgency (EMEA)and Europol; • thePompidou Groupofthe CouncilofEurope, theUnited NationsOffice on Drugsand Crime, theWHO Regional Officefor Europe,Interpol,the WorldCustoms Organisation, theESPAD project andthe SwedishCouncil forInformation on Alcoholand otherDrugs(CAN),and theEuropeanCentrefor theEpidemiologicalMonitoringofAIDS(EuroHIV); • theTranslationCentrefor theBodiesofthe European Unionand theOffice forOfficial Publications of theEuropean Communities. Reitox nationalfocal points Reitox is theEuropeaninformation network on drugsand drug addiction.The network is comprised of nationalfocal points in theEUMemberStates, Norway,the candidatecountriesand at theEuropeanCommission.Under theresponsibility of their governments, thefocal points arethe nationalauthorities providing drug information to theEMCDDA. The contactdetailsofthe nationalfocal points maybefound at: http://www.emcdda.europa.eu/about/partners/reitox-network 7 Introductory note This annual report is basedoninformation provided to theEMCDDAbythe EU Member States andcandidatecountries andNorway(participating in thework of theEMCDDAsince 2001)inthe form of anationalreport. The statisticaldata reported here relatetothe year 2006 (orthe last year available).Graphicsand tables in this report mayreflectasubset of EU countries: theselection is made on thebasis of thosecountriesfromwhich dataare availablefor theperiodof interest. Retail prices of drugsreported to theEMCDDAreflectthe pricetothe user.Reports on purity or potency, from most countries, arebased on asample of alldrugsseized, anditisgenerally not possible to relatethe reported datatoa specific levelofthe drug market.For purity or potencyand retail prices,all analyses arebased on typical(modal) values or,intheir absence, mean (ormedian) values. Reportsofthe prevalenceofdrug usebased on general populationsurveysmostly refertothe nationalpopulationaged 15– 64 years. Countriesusing different upperorlower agelimitsinclude:Bulgaria (18–60),