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Marta Molina, Noelia Llorens y Begoña Brime Government Delegation for the National Plan on Drugs Ministry of Health, Consumption and Social Welfare Lisbon, May 28th,2019May Lisbon, consumption in Spain Spanish Observatory on Drugs and National Consumption 01 DDD (Defined daily dose) per 1000 inhabitants per day

20 18 16 14 12 10 8 6 4 2 0 2010 2011 2012 2013 2014 2015 2016 2017

Opioids , , , , dihydrocodeine or with non- analgesics Tramadol, , , and Surveys National Consumption 02 Consumption prevalence. 15-64 years old population.

Lifetime prevalence for opioids: 14.5%

0,5 1,3 1,4 1,5 1,6 Consumption prevalence (%) by sex 1,9 2,2

3,4 14,7 Last month 2,3

69,2 7,4 Last year 5,9 35,5

16,0 Lifetime 13,1

Hydromorphone Buprenorphine Pethidine Tapentadol Fentanyl Women Men Oxycodone Morphine Tramadol Dihydrocodeine Consumption characteristics 03 Last year consumption prevalence. 15-64 years old population

would you dare to obtain them illegally

No 98,2

Yes 1,8

Use with or without other 6,9 drugs 3,2 2,1

87,8

Opioids analgesics with Opioids analgesics with illegal drugs Opioids analgesics with alcohol and illegal drugs Opioids analgesics Consumption characteristics 04 Last year consumption prevalence. 15-64 years old population

Reasons for using OA

1,3 0,5 10,0

Exact dose and timing Less time 15,0 Less dose Increased dose More time To counteract other drugs To get high 1,0 0,7 57,4 2,6 3,0 7,7 15,8

11,1 Acute After Chronic pain To treat my pain because other medicines did not work To overcome the effects of other drugs OST

74,0

Ways of using OA Consumption 05 Doctor's prescription characteristics Last year consumption prevalence. 15- 64 years old population 98.3% OA availability 98,3

1,7 0.0% 1.7%

Pharmacy without a doctor's prescription Friend or family Other ways Drug dealer Fake doctor's prescription Internet Other indicators Fentanyl 06 Number of people in DRD, TDI and Emergency rooms

Treatment (45,788 number of people admitted to treatment) 70 66 Emergency rooms Mortality

44

28 25 19 20 15 12 8 6 5 6 6 2 1 4 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

* 2017 are preliminary figures Tramadol 07 Number of people in DRD, TDI and Emergency rooms

Mortality 58 Treatment (45,788 number of people admitted to treatment) Emergency rooms 43 40 39 34

24 22 28 27 24 24 12 19 10 2 9 2009 2010 2011 2012 2013 2014 2015 2016 2016 Opioids analgesics Morphine, Fentanil, Pethidine, Tramadol, Buprenorphine, Dihydrocodeine, 08 Number of people in DRD, TDI and Emergency rooms , Hydromorphone, Oxycodone, Tapentadol

Main Drug (treatment) Secondary drug (treatment) Emergency rooms Mortality (45,788 number of people admitted to treatment)

217 223 204 212 198 195 194 190 192 167 167 163 157 182 147 136 122 127 163 115 153 151 144 106 98 144 82 88 122 122 116 73 76 113 107 64 62 62 55 13459 53 138 98 59 50 46 44 76 75 54

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 * 2017 are preliminary figures Marta Molina, Noelia Llorens y Begoña Brime Government Delegation for the National Plan on Drugs Ministry of Health, Consumption and Social Welfare Lisbon, May 28th,2019May Lisbon, Thank you Spanish Observatory on Drugs and Addictions