CES-POINT FOCAL OEDT GRAND-DUCHE DE LUXEMBOURG 2008 NATIONAL REPORT (2007 data) TO THE EMCDDA by the Reitox National Focal Point “GRAND DUCHY OF LUXEMBOURG” New Developments, Trends and in-depth Information on selected issues Alain Origer REITOX Summary .....................................................................................................................................................................................6 Political, legal and organisational framework ............................................................................................................................6 Epidemiological Indicators..........................................................................................................................................................7 Law enforcement indicators .....................................................................................................................................................10 Profile of the national drug market ...........................................................................................................................................11 Harm reduction activities ..........................................................................................................................................................12 Most Relevant Trends...............................................................................................................................................................12 Consistency between Indicators ..............................................................................................................................................13 Part A: New Developments and Trends...................................................................................................................................14 1. National Policies and Context ..............................................................................................................................................14 • LEGAL FRAMEWORK (NNIA) .......................................................................................................................................14 • INSTITUTIONAL FRAMEWORK, STRATEGIES AND POLICIES (NNIA)................................................................................19 • BUDGET AND PUBLIC EXPENDITURE ............................................................................................................................22 • SOCIAL AND CULTURAL CONTEXT................................................................................................................................33 2. Drug Use in the General Population and specific sub-groups............................................................................................37 • DRUG USE IN THE GENERAL POPULATION (NNIA).......................................................................................................38 • DRUG USE IN THE SCHOOL AND YOUTH POPULATION .................................................................................................40 • DRUG USE AMONG SPECIFIC GROUPS.........................................................................................................................46 • ATTITUDES TO DRUGS AND DRUG USERS ....................................................................................................................46 3. Prevention.............................................................................................................................................................................47 • UNIVERSAL PREVENTION............................................................................................................................................48 • SELECTIVE .................................................................................................................................................................51 • INDICATED PREVENTION .............................................................................................................................................54 4. Problem Drug Use and the Treatment Demand Indicator...................................................................................................55 • PREVALENCE AND INCIDENCE ESTIMATES OF PDU .....................................................................................................56 • TREATMENT DEMAND INDICATOR ................................................................................................................................60 5. Drug-Related Treatment.......................................................................................................................................................62 • TREATMENT SYSTEMS................................................................................................................................................63 • DRUG FREE TREATMENT ............................................................................................................................................66 • PHARMACOLOGICALLY ASSISTED TREATMENT.............................................................................................................68 6. Health Correlates and Consequences.................................................................................................................................72 • DRUG RELATED DEATHS AND MORTALITY OF DRUG USERS .........................................................................................73 • DRUG RELATED INFECTIOUS DESEASES ......................................................................................................................77 • PSYCHIATRIC CO-MORBIDITY (DUAL DIAGNOSIS) .........................................................................................................81 • OTHER DRUG-RELATED HEALTH CORRELATES AND CONSEQUENCES...........................................................................84 7. Responses to Health Correlates and Consequences .........................................................................................................85 • PREVENTION OF DRUG RELATED DEATHS....................................................................................................................85 • PREVENTION AND TREATMENT OF DRUG-RELATED INFECTIOUS DISEASES ...................................................................87 • INTERVENTIONS RELATED TO PSYCHIATRIC CO-MORBIDITY (NNIA).............................................................................89 • INTERVENTIONS RELATED TO OTHER HEALTH CORRELATES AND CONSEQUENCES .......................................................90 8. Social Correlates and Consequences .................................................................................................................................92 • SOCIAL EXCLUSION (AMONG DRUG USERS AND DRUG USE AMONG SOCIALLY EXCLUDED GROUPS)..............................93 • DRUG-RELATED CRIME ...............................................................................................................................................96 • DRUG USE IN PRISON..................................................................................................................................................99 • SOCIAL COSTS .........................................................................................................................................................100 9. Responses to Social Correlates and Consequences........................................................................................................101 • SOCIAL REINTEGRATION...........................................................................................................................................101 • PREVENTION OF DRUG-RELATED CRIME ....................................................................................................................102 10. Drug Markets ....................................................................................................................................................................106 • AVAILABILITY AND SUPPLY ........................................................................................................................................107 • SEIZURES.................................................................................................................................................................109 • PRICE/PURITY ..........................................................................................................................................................110 Part B: Selected Issue ............................................................................................................................................................112 11. Sentencing Statistics ........................................................................................................................................................112 Part C ......................................................................................................................................................................................120 14. Bibliography ......................................................................................................................................................................120 15. Annexes ............................................................................................................................................................................126