Tim Pfeiffer-Gerschel, Ingo Kipke, Stephanie Floeter & Lisa Jakob IFT Institute for Therapy Research Diana Hammes, Federal Centre for Health Education Peter Raiser, German Centre for Addiction Issues Assisted by Alicia Casati and Johanna Wenig IFT Institute for Therapy Research 2011 National Report to the EMCDDA by the Reitox National Focal Point GERMANY New Developments, Trends and In-Depth Information on Selected Issues Drug Situation 2010/2011 IFT Institute for Therapy Research (Institut fuer Therapieforschung, IFT) (Epidemiology and Coordination) Responsible for chapters 1, 2, 4, 5, 6, 7, 8, 9, 10 and 11 Dr. Tim Pfeiffer-Gerschel (head of the DBDD) Dr. Stephanie Floeter Lisa Jakob Ingo Kipke Alicia Casati and Johanna Wenig Parzivalstr. 25 80804 Munich, Germany Tel.: +49 (0) 89 - 360804-40 Fax: +49 (0) 89 - 360804-49 Email: [email protected] Federal Centre for Health Education (Bundeszentrale fuer gesundheitliche Aufklaerung, BZgA) (Prevention) Responsible for chapter 3 Diana Hammes Peter Lang Ostmerheimer Str. 220 51109 Cologne, Germany Tel.: +49 (0) 221-8992 - 290 Fax: +49 (0) 221-8992 - 300 Email: [email protected] German Centre for Addiction Issues (Deutsche Hauptstelle fuer Suchtfragen, DHS) (Therapy) Responsible for chapter 12 Peter Raiser Westring 2 59065 Hamm, Germany Tel.: +49 (0) 2381-901521 Fax: +49 (0) 2381-901530 Email: [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 EMCDA, these experts take part in the experts’ conferences held yearly at European and national level with a view to further harmonize and develop 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. Ludwig Kraus, 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. Tim Pfeiffer-Gerschel, IFT Munich • Key indicator drug-related deaths (chapter 6) National expert: Dr. Axel Heinemann, Universitaetsklinikum Hamburg-Eppendorf (UKE) In addition to the persons mentioned above, the following experts have also contributed to the creation of this annual report: Heiko Hergenhahn, BKA Wiesbaden (chapter 10), Oliver Mueller, CDR Frankfurt (chapter 2 and 10), Boris Orth, BZgA (chapter 2), Dr. Bernd Werse, CDR Frankfurt (chapter 2 and 10). Note: For better legibility, the present report refrains from using female grammatical forms that are instead subsumed under the respective male gender. III Table of contents Introduction Summary PART A: NEW DEVELOPMENTS AND TRENDS .................................................................. 1! 1! DRUG POLICY: LEGISLATION, STRATEGIES AND ECONOMIC ANALYSIS ......... 1! 1.1! Introduction ................................................................................................................... 1! 1.1.1 Definitions ................................................................................................................................... 1 1.1.2 Objectives and focal points of “drug and addiction policy“ ......................................................... 1 1.1.3 Political framework ..................................................................................................................... 2 1.2! Legal framework ........................................................................................................... 3! 1.2.1 Laws, regulations, directives or guidelines in the field of drug issues ........................................ 3 1.2.2 Laws implementation .................................................................................................................. 5 1.3! National action plan, evaluation and coordination ........................................................ 9! 1.3.1 National action plan .................................................................................................................... 9 1.3.2 Implementation and evaluation of the National Action Plan for Fighting Drugs and Addiction . 10 1.3.3 Other drug policy developments ............................................................................................... 29 1.3.4 Coordination arrangements ...................................................................................................... 29 1.4! Economic analysis ...................................................................................................... 30! 1.4.1 Overview ................................................................................................................................... 30 1.4.2 Public expenditures and budgets ............................................................................................. 30 1.4.3 Social costs .............................................................................................................................. 31 2! DRUG USE IN THE POPULATION AND SPECIFIC TARGETED GROUPS ............ 33! 2.1! Introduction ................................................................................................................. 33! 2.2! Drug use in the general population ............................................................................. 37! 2.2.1 Overview of the use of various drugs ....................................................................................... 37 2.2.2 Comparison of the use of individual drugs ............................................................................... 38 2.3! Drug use in the school and youth population .............................................................. 39! 2.3.1 Use of licit psychotropic substances ......................................................................................... 40 2.3.2 Use of illicit drugs ..................................................................................................................... 41 2.4! Drug use among targeted groups/settings at national and local level ........................ 52! V 2.5! Further research results and findings with a focus on diagnostics ............................. 55! 3! PREVENTION ............................................................................................................ 57! 3.1! Introduction ................................................................................................................. 57! 3.1.1 Organisational framework ......................................................................................................... 57 3.1.2 Current developments and trends ............................................................................................ 57 3.1.3 Effectiveness and efficiency in addiction prevention ................................................................ 59 3.2! Universal prevention ................................................................................................... 61! 3.2.1 School ....................................................................................................................................... 62 3.2.2 Family ....................................................................................................................................... 65 3.2.3 Community ............................................................................................................................... 67 3.2.4 Recreational and sports settings .............................................................................................. 67 3.3! Selective prevention ................................................................................................... 68! 3.3.1 At-risk groups ........................................................................................................................... 70 3.3.2 At-risk families .......................................................................................................................... 72 3.4! Recreational settings .................................................................................................. 74! 3.5! Indicated prevention ................................................................................................... 75! 3.5.1 Children and teenagers at risk with individually attributable risk factors .................................. 76 3.5.2 Children with ADHD .................................................................................................................. 76 3.5.3 Early recognition and early intervention ................................................................................... 76 3.6! National and regional media campaigns ..................................................................... 79! 4! PROBLEM DRUG USE .............................................................................................. 81! 4.1! Introduction ................................................................................................................. 81! 4.2! Prevalence and incidence estimate of PDU ............................................................... 83! 4.2.1 EMCDDA estimate methods (indirect estimates) ....................................................................