Italy Country Drug Report 2019

Drug use

Prevalence and trends

The 2017 general population survey on drugs found that a third of the Italian population aged 15-64 years had used a psychoactive substance at least once in their lifetime and 1 in 10 had done so in the last year. The majority of users are male. Cannabis is the most widely used substance, with 1 out of 10 people having used it at least once in the last year. The use of cocaine, opioids and spice (synthetic cannabinoids) is lower. Among adults reporting the use of illegal psychoactive substances in 2017, 1 in 10 reported polydrug use.

The 2017 school survey among students aged 15-19 years reported that cannabis is the most used substance among adolescents. One third reported having used cannabis at least once in their lifetime.

Milan has participated in the Europe-wide annual wastewater campaign undertaken by the Sewage Analysis Core Group Europe (SCORE) since 2011. Since 2018, data have also been available for for Bozen. This study provides data on drug use at a municipal level, based on the levels of illicit drugs and their metabolites found in wastewater. With regard to stimulants, the results show a considerable increase between 2015 and 2018 in cocaine metabolites detected in wastewater in Milan. Cocaine levels in Bozen in 2018 were similar to those in Milan. The levels of MDMA/ecstasy and methamphetamine detected have remained low since 2012, indicating limited use of these substances in Milan. No amphetamine was found in wastewater in Milan in 2018 and very low levels of the stimulant were found in Bozen. Use of all stimulants detected in wastewater in Milan and Bozen was higher at the weekends than on weekdays.

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Drug use among 15- to 16-year-old students is reported in the European School Survey Project on Alcohol and Other Drugs (ESPAD). In 2015, Italian students reported prevalence rates of lifetime use of cannabis above the ESPAD average (based on data from 35 countries), whereas lifetime use of illicit drugs other than cannabis and of NPS was slightly higher than the ESPAD average.

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High-risk drug use and trends

Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment centres, when considered alongside other indicators, can inform an understanding of the nature of and trends in high-risk drug use.

In Italy, high-risk drug use remains predominantly linked to heroin use. The latest estimate based on a treatment multiplier suggests that there were approximately 235 000 high-risk heroin users in Italy in 2015. Based on the 2017 general population survey, it was estimated that 1.1 % of 15- to 64-year-olds use cannabis daily or almost daily.

Data from the specialised treatment centres indicate that in 2017 powder cocaine was the most commonly reported primary substance among first-time clients entering treatment, followed by heroin and cannabis. The number of cocaine-using first-time entrants increased again in 2017. Around 20 % of treatment clients in Italy report injecting the substance.

Approximately 1 in 10 clients entering drug treatment is female, but the proportion varies by primary drug. The long-term trend indicates a steady increase in the age of heroin users seeking treatment. However, because of substantial changes in the national reporting system in 2011/12, long-term trends derived from specialised treatment centres should be interpreted with caution.

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.