CES-POINT FOCAL OEDT GRAND-DUCHE DE LUXEMBOURG 2007 NATIONAL REPORT TO THE EMCDDA by the Reitox National Focal Point “GRAND DUCHY OF LUXEMBOURG” New Development, Trends and in-depth Information on selected issues Alain Origer REITOX Summary................................................................................................................................................................................ 5 Political, legal and organisational framework..........................................................................................................................5 Epidemiological Indicators ......................................................................................................Error! Bookmark not defined. Law enforcement indicators....................................................................................................................................................9 Profile of the national drug market........................................................................................................................................10 Harm reduction activities ......................................................................................................................................................11 Most Relevant Trends...........................................................................................................................................................11 Consistency between Indicators ...........................................................................................................................................12 Part A: New Developments and Trends .............................................................................................................................. 13 1. National Policies and Context...........................................................................................................................................13 • LEGAL FRAMEWORK (NNIA)................................................................................................................................... 13 • INSTITUTIONAL FRAMEWORK, STRATEGIES AND POLICIES (NNIA)............................................................................. 16 • BUDGET AND PUBLIC EXPENDITURE ........................................................................................................................ 19 • SOCIAL AND CULTURAL CONTEXT ........................................................................................................................... 20 2. Drug Use in the General Population and specific sub-groups..........................................................................................24 • DRUG USE IN THE GENERAL POPULATION (NNIA) ................................................................................................... 24 • DRUG USE IN THE SCHOOL AND YOUTH POPULATION.............................................................................................. 26 • DRUG USE AMONG SPECIFIC GROUPS..................................................................................................................... 32 • ATTITUDES TO DRUGS AND DRUG USERS ................................................................................................................ 32 3. Prevention.........................................................................................................................................................................33 • UNIVERSAL PREVENTION ....................................................................................................................................... 35 • SELECTIVE ............................................................................................................................................................ 37 • INDICATED PREVENTION ......................................................................................................................................... 41 4. Problem Drug Use and the Treatment Demand Population .............................................................................................41 • PREVALENCE AND INCIDENCE ESTIMATES OF PDU.................................................................................................. 42 • TREATMENT DEMAND INDICATOR............................................................................................................................ 47 5. Drug-Related Treatment ...................................................................................................................................................49 • TREATMENT SYSTEMS ........................................................................................................................................... 51 • DRUG FREE TREATMENT ........................................................................................................................................ 54 • PHARMACOLOGICALLY ASSISTED TREATMENT ......................................................................................................... 55 6. Health Correlates and Consequences..............................................................................................................................58 • DRUG RELATED DEATHS AND MORTALITY OF DRUG USERS ...................................................................................... 58 • DRUG RELATED INFECTIOUS DESEASES .................................................................................................................. 63 • PSYCHIATRIC CO-MORBIDITY (DUAL DIAGNOSIS)...................................................................................................... 66 • OTHER DRUG-RELATED HEALTH CORRELATES AND CONSEQUENCES ........................................................................ 69 7. Responses to Health Correlates and Consequences.......................................................................................................69 • PREVENTION OF DRUG RELATED DEATHS ................................................................................................................ 69 • PREVENTION AND TREATMENT OF DRUG-RELATED INFECTIOUS DISEASES................................................................. 72 • INTERVENTIONS RELATED TO PSYCHIATRIC CO-MORBIDITY (NNIA).......................................................................... 74 • INTERVENTIONS RELATED TO OTHER HEALTH CORRELATES AND CONSEQUENCES..................................................... 74 8. Social Correlates and Consequences ..............................................................................................................................76 • SOCIAL EXCLUSION (AMONG DRUG USERS AND DRUG USE AMONG SOCIALLY EXCLUDED GROUPS) ............................ 77 • DRUG-RELATED CRIME........................................................................................................................................... 79 • DRUG USE IN PRISON ............................................................................................................................................. 82 • SOCIAL COSTS ...................................................................................................................................................... 83 9. Responses to Social Correlates and Consequences .......................................................................................................84 • SOCIAL REINTEGRATION ........................................................................................................................................ 84 • PREVENTION OF DRUG-RELATED CRIME .................................................................................................................. 85 10. Drug Markets ..................................................................................................................................................................88 • AVAILABILITY AND SUPPLY...................................................................................................................................... 89 • SEIZURES.............................................................................................................................................................. 90 • PRICE/PURITY ....................................................................................................................................................... 92 Part B: Selected Issues........................................................................................................................................................ 94 11. Public Expenditure..........................................................................................................................................................94 12. Vulnerable Groups of Young People ............................................................................................................................105 13. Drug-Related research in Luxembourg.........................................................................................................................111 Part C................................................................................................................................................................................. 122 14. Bibliography ..................................................................................................................................................................122 15. Annexes........................................................................................................................................................................128