2009 NATIONAL REPORT (2008 data) TO THE EMCDDA by the Reitox National Focal Point AUSTRIA New Development, Trends and in-depth information on selected issues REITOX Gesundheit Österreich GmbH Geschäftsbereich ÖBIG Report on the Drug Situation 2009 Marion Weigl Martin Busch Alexander Eggerth Ilonka Horvath Christine Knaller Elisabeth Türscherl Charlotte Wirl Vienna, October 2009 On behalf of the European Monitoring Centre for Drugs and Drug Addiction (Lisbon) and the Austrian Federal Ministry for Health (Vienna) ISBN 10 3-85159-132-1 Gesundheit Österreich GmbH (ÖBIG Department), A-1010 Vienna, Stubenring 6, phone +43 1 515 61-0, fax +43 1 513 84 72, e-mail: [email protected] Translation: Phoenix Übersetzungen, Daniela Beuren, Susanne Ofner Environmentally friendly publication: this report has been printed on paper bleached without chlorine and without optical brighteners. Summary National reports on the drug situation in Austria are drawn up annually for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the Federal Ministry re- sponsible for health affairs. They deal with the subject of illicit drugs. This report gives an overview of current developments regarding the political and legal framework, the epidemiol- ogical situation and demand reduction interventions in the reporting period 2008/9. Every year specific issues are also highlighted; for this report, the themes of market and production of cannabis as well as treatment for older drug users have been selected. Summary and discussion of the most important trends In 2008 the Narcotic Substances Act (SMG) was amended in order to harmonise with EU legislation the Austrian provisions on use and handling of narcotic substances and precur- sors. Under the amended act it has been admissible to grow cannabis for the purpose of ob- taining active substances for the production of pharmaceuticals. In addition, the legal basis has been provided for using e-government functions to maintain the central narcotic sub- stances database, for establishing nationwide substitution monitoring and for regulating the exchange of information in the context of coordinated, comprehensive treatment and coun- selling routines for substitution patients. Several decrees were issued to control the sub- stances of BZP, oripavine, Spice as well as smoking blends similar to Spice. In the Government Policy Statement of the new Federal Government, the theme of addiction is only mentioned with regard to the further development of the national strategy to prevent addiction and suicide, with special regard to risks for children and young people, and with re- gard to strategies for healthy schools. According to the current political focuses, legal sub- stances as well as forms of addiction that are not related to substances have played an in- creasingly important role in prevention activities as well as in the services of drug help units. This is reflected in the fact that, in addition to the Federal Drug Forum, also an Alcohol Fo- rum was established, which has already started to prepare a national alcohol prevention strategy. The main themes of drug policy discussions included measures to prevent drug-related deaths and, as also in previous years, opioid substitution treatment and the effects of the new decrees of 2007. Reports from the provinces, among other themes, document the struc- tural changes that were necessary as a consequence of the new legal situation. In the report- ing period, recommendations were drawn up that are to be integrated in amendments to the Narcotic Drugs Decree and the Oral Substitution Further Training Decree. A number of recent data assessing the current drug situation are available. Approximately one out of five people used cannabis at some point in life, with the highest shares (up to 40%) found among young adults. The rates concerning other substances are considerably lower in the general population, i.e. between 2% (heroin) and 4% (ecstasy, amphetamines, cocaine) at most. Moreover, the rates covering current drug use (12-month prevalence) are even smaller, which shows that use of illicit substances is typically limited to experimental use and to a certain period in life. The prevalence rates obtained in new surveys are much smaller than in past years. Part of the results sowing strong declines with regard to lifetime III prevalence rates are in fact impossible, and methodologies should thus be discussed in more detail. In 2008, smoking of Spice was a relevant issue in the media coverage of psychoactive substance use, but it is unknown whether Spice, obtained in black markets or through the internet, is still used. According to reports on the party scene, pills sold as ecstasy increas- ingly often contain (also) ingredients such as mCPP or PMA, which is a considerable health risk. Only 15% of drugs sold as speed actually contained only amphetamines. In addition, in- stances of high-risk use of GBL, which converts into GHB in the body, were reported. The most recent prevalence estimates on problem drug use (in Austria, this primarily con- cerns poly-drug use with opioids) relate to the year 2007 and indicate between 22 000 and 33 000 problem drug users. The client year 2008 is the third year for which data from DOKLI, the nationwide documenta- tion system of clients of Austrian drug help units, are available. In the treatment sector, opioids continue to predominate as primary drugs among problem drug users, while cocaine plays a marginal role only. Different to a number of other EU members, in Austria opioids are the substances most frequently involved in drug use relevant for treatment. People with can- nabis as their primary drug are the second-largest group in the treatment system. It would be a point worth discussing whether this high share actually is the result of health problems or psychosocial problems caused by cannabis use or whether it rather reflects repressive poli- cies regarding cannabis. Another question is whether the needs of this group of clients can always adequately be met in the existing drug help units. More detailed studies based on these results found in the context of the routine monitoring of DOKLI would be needed in or- der to obtain further insight. The data quality of statistics on drug-related deaths has deteriorated because autopsies now tend to be performed less often in cases of suspected drug overdoses. This significantly re- duces the epidemiological conclusiveness of the corresponding data. In order to maintain a high quality of this epidemiological key indicator, activities at several levels are imperative. Regarding prevalence rates of infectious diseases, again no data basis is available that would permit reliable statements on extents or trends. Great attention has been paid to psy- chiatric comorbidity; the shares of drug users who also suffer from mental or behavioural dis- orders continue to be high. Recent trends in the fields of prevention and drug help services show increasing regionalisa- tion, e.g., in the form of control bodies at district level and local intervention plans. These plans are often drawn up in the context of community prevention but in part they also relate to services by drug help units. Technical standards are taken into account in all areas: for in- stance, both prevention programmes to be implemented at nationwide level as well as guide- lines for the treatment of benzodiazepine addiction are being prepared. The target groups of drug users with a background of immigration and their families have begun to play a more prominent role in the drug help sector, and existing services are being adapted in order to address this group. In the treatment sector, regional capacities still are insufficient, mainly due to rather high shares of clients undergoing compulsory health-related measures because of use of cannabis and also the fact that opioid substitution treatment has increasingly often been carried out at drug outpatient departments or drug counselling centres. Attempts to im- prove the treatment of infectious diseases among drug users focus on the cooperation be- tween the drug help sector and the corresponding medical care institutions. Activities to facili- IV tate coexistence without conflicts in public places – and thus to prevent drug-related crime – are being expanded, as are activities aimed at reintegration by means of occupation pro- grammes. 2008 saw a decline in police reports, in particular reports relating to cannabis, which the Federal Ministry of the Interior explains with investigations of drug dealing structures in order to smash drug gangs. This does not mean that drug use has gone down, however. Selected Issue: Market and Production of Cannabis According to the Federal Criminal Agency at the Federal Ministry of the Interior the produc- tion of cannabis in Austria is insignificant compared to other countries. Cannabis products are primarily imported to Austria from the Netherlands, the Balkan countries, the Schengen Area, Morocco and Switzerland. Austria is of growing relevance as a country of transit for cannabis products from the Far East (India, Nepal) to Western Europe. According to BMI/.BK, cannabis products are sold all over Austria, but especially in and around cities in both public places or streets and bars known as places of drug dealing. The majority of sei- zures concern herbal cannabis, although pronounced variations show in individual years with regard to both number of seizures and quantities seized. In 2008 92% of reports relating to cannabis were made because of violations of Section 27 of the SMG, which regulates illegal handling of drugs, 3% of cannabis reports concerned Section 28 of the SMG (preparation of narcotic drug trafficking), and 5% related to Section 28a (narcotic drug trafficking). Selected Issue: Treatment and Care for Older Drug Users There are some indications that the number of drug users aged 40 or older is rising. Analy- ses of the DOKLI data of the client year 2008 have shown differences in patterns of use in different age groups.