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Malta country overview — a summary of the national drug situation

 

 

Malta country overview
A summary of the national drug situation

Map of Malta

Our partner in Malta

The Maltese National Focal Point is based within the Ministry for Justice, Dialogue and the Family and operates under the umbrella of the National Commission for the Abuse of Drugs Alcohol and other Dependencies. The National Focal Point started its operations in June 2004 as a result of a Twinning Light Project with The Netherlands. Read more »

Ministry for Justice, Dialogue and the Family

AĊĊESS Community & Resource Centre
72, Melita Street
MT -Valletta, VLT 1120
Malta
Tel. +356 2590 3324/86/78

Head of focal point: Mr Carlo Olivari Demanuele

Our partner in Malta

Ministry for Justice, Dialogue and the Family

AĊĊESS Community & Resource Centre
72, Melita Street
MT -Valletta, VLT 1120
Malta
Tel. +356 2590 3324/86/78

Head of focal point: Mr Carlo Olivari Demanuele

The Maltese National Focal Point is based within the Ministry for Justice, Dialogue and the Family and operates under the umbrella of the National Commission for the Abuse of Drugs Alcohol and other Dependencies. The National Focal Point started its operations in June 2004 as a result of a Twinning Light Project with The Netherlands.

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Drug use among the general population and young people

The second general population survey on drugs in Malta was conducted among a random sample of 1 869 people aged 18–65 in 2013, while the first dates back to 2001. As was also found in the 2001 study, cannabis use appears to be predominantly experimental in Malta. In 2013 about 4.3 % of respondents used cannabis during their lifetime, which is slightly more than was reported in 2001 study (3.5 %). Lifetime experience with illicit drugs other than cannabis was 1.4 % (including ecstasy, amphetamines, cocaine, heroin and/or LSD), with ecstasy being the most popular among this group of substances. Drug use was more prevalent in younger adults, with lifetime prevalence of cannabis reported at 5.1 % among 18- to 24- year-olds.

To date, the European School Survey Project on Alcohol and Other Drugs (ESPAD) has been conducted five times among students aged 15–16 in Malta. The lifetime prevalence rates of marijuana or hashish use were: 8 % in 1995; 7 % in 1999; 10 % in 2003; 13 % in 2007; and 10 % in 2011. Compared with other European countries, the prevalence rates for cannabis use and other illicit drugs were among the lowest, except for lifetime prevalence estimates for the use of inhalants (17 % in 1995; 16 % in 1999, 2003 and 2007; 14 % in 2011), which are high in relation to other European countries. In 2011 the lifetime prevalence rate for other illicit drugs was much lower than for cannabis, at 3 % for ecstasy, 3 % for amphetamines, 4 % for cocaine and 1 % for heroin.

Look for Prevalence of drug use in the 'Statistical bulletin' for more information  

High-risk drug use

Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use (IDU) or long duration/regular use of opiates, cocaine and/or amphetamines. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.

Capture–recapture methodology was used to estimate the prevalence of high-risk opioid users (including people receiving daily opioid substitution treatment) in Malta between 2010–13. The data includes clients registered each year as daily heroin or other opioid users attending the treatment services. It was estimated that there were 1 997 high-risk opioid users in 2012 (range: 1 861–2 201), which translates to a rate of 6.97 (range: 6.49–7.68) per 1 000 residents aged 15–64. This is considered to be an over-estimate by the national experts, mainly owing to inclusion of high-risk opioid users in long-term opioid substitution treatment, who have a low probability of appearing in other data sources, which leads to the inflation of the resulting capture–recapture estimate.

Look for High risk drug-use in the Statistical bulletin for more information.  

Treatment demand

All five drug treatment providers, including inpatient and outpatient treatment units, low-threshold agencies and treatment units in prison participate in the treatment data collection system. On the basis of that data collection system the total number of clients entering drug treatment in Malta in 2013 was 1 834, of whom 220 were new clients entering treatment for the first time. More than half of drug clients entered outpatient specialised treatment units and around 40 % attended low-threshold units. A significant increase in all clients entering treatment has been reported between 2006 and 2013 (from 758 to 1 834); this increase might be related to an improvement in data collection and reporting, and enhanced coordination between services, with an improvement in referrals to treatment from several agencies.

In 2013, around 75 % of all clients entering treatment reported that heroin was their primary drug, followed by 14 % for cocaine and 8 % for cannabis. Heroin also continues to be the most frequently reported primary drug among new treatment clients (34 % among those with a known primary substance); however, its share had declined compared to the previous year, whilst the proportion of those using cocaine and cannabis had increased. Thus, among new clients with a known primary substance, 32 % entered treatment for the primary use of cocaine and some 25 % reported cannabis as their primary drug in 2013.

In 2013, more than half of all clients and more than a quarter of new clients entering treatment reported injecting their primary drug, with heroin being the main drug injected in both groups.

The mean age of all clients entering treatment in 2013 was 25 years, while new treatment clients were older — on average 29 years old. In terms of gender, 82 % of all treatment clients were male and 18 % were female. Among new clients, females represented 23 %.

Look for Treatment demand indicator in the Statistical bulletin for more information.  

Drug-related infectious diseases

At present, the National Infectious Disease Surveillance Unit in the Department of Health receives notifications of positive cases from virology departments and prisons. Human immunodeficiency virus (HIV) only became notifiable in 2004. The last time when injecting drug use-linked HIV cases were notified was in 2008, and in the period 2009–12 no HIV cases linked to injecting drug use were reported. In 2013, however, three HIV cases linked to injecting drug use were notified in Malta, which is of particular concern due to the absence of such cases in the previous five years.

An additional information source is testing among those seeking treatment at the Sedqa outpatient treatment unit. In 2013 some 3.5 % of 114 clients tested positive for HIV, 13.8 % of 109 PWID tested positive for hepatitis C virus (HCV) and 0.9 % for hepatitis B virus (HBV).

Look for Drug-related infectious diseases in the Statistical bulletin for more information.  

Drug-induced deaths and mortality among drug users

Information on drug-induced deaths in Malta is collected by the Department of Health Information in the National Mortality Register (NMR). These records are based on death certificates and toxicology reports. Another source of information on drug-induced deaths is the Police Special Registry, which collects information on all drug-related death cases. Malta complies with the EMCDDA definitions and recommendations to extract and report the cases from these sources. Efforts are under way to cross-validate the data between the two sources.

The annual number of reported drug-induced deaths has ranged from 1 to 11 over the past 15 years, and in the majority of cases the cause of death was opiates. In 2013 three drug-induced deaths were registered in the Police Special Registry, all of which involved opiates. The mean age of the deceased was 31.5 years.

The drug-induced mortality rates among adults (aged 15–64) was 10.4 deaths per million in 2012, which is lower than the European average of 17.2 deaths per million.

Look for Drug-related deaths in the Statistical bulletin for more information.  

Treatment responses

Drug treatment in Malta is delivered by Sedqa, the national agency against drugs and alcohol abuse, and the Substance Misuse Outpatient Unit (both of which are under the remit of the Ministry for Family and Social Solidarity) and the Substance Abuse Therapeutic Unit in the prison system; and the Dual Diagnosis Unit (DDU) with a special ward for female clients within Mount Carmel Hospital. These services are fully funded by the government. Two NGOs, Caritas and the OASI Foundation, which are partially funded by local government, also provide drug treatment in Malta, with the OASI Foundation active in Gozo.

These treatment providers deliver different types of treatment, which can be classified into several main categories: outpatient and low-threshold services, rehabilitation residential programmes, detoxification treatment and substitution maintenance treatment. NGO-based outpatient services offer long- or short-term support through social work, counselling, group therapy and psychological interventions, while low-threshold programmes offer day-care services.

There are three main residential rehabilitation programmes: a DDU within Mount Carmel Hospital, which offers help to drug users with mental health issues; a two-year programme provided by Caritas; and an 18-month programme provided by Sedqa. All programmes offer a holistic, multidisciplinary approach to therapy in a communal living environment and aim to guide clients towards abstinence. The OASI Foundation provides a short-term residential programme followed by continuing care sessions, and also offers day programmes. Detoxification is offered through an in-patient unit run by Sedqa.

A centralised methadone treatment unit in Malta, the Substance Misuse Outpatient Unit (SMOPU), provides substitution treatment. The Craig Hospital in Gozo also offers methadone treatment. Methadone maintenance treatment was introduced in 1987. In 2005 take-home methadone prescriptions were introduced, and in 2006 treatment with buprenorphine began, in addition to methadone. Buprenorphine is given as a take-home dose, and is available by prescription from either SMOPU or a general practitioner. However, the treatment is mainly initiated and administered by treatment centres, and only a few general practitioners offer substitution treatment. Opioid substitution treatment (OST) is also available in prisons. In 2013 a total of 1 078 clients were in OST, of which 976 received exclusively methadone. The remaining patients in substitution treatment switched medication, including buprenorphine-based medications and dihydrocodeine, during the year.

See the Treatment profile for Malta for additional information.  

Harm reduction responses

One of the main objectives of the Draft National Drugs Policy 2008 is to achieve a high level of health protection and social cohesion by preventing and reducing drug-related harm to health and society. The policy’s aim is to provide the general public with information on the dangers of drug use and to promote ongoing public health campaigns. Harm reduction responses relate to the prevention of drug-related infectious diseases, and include access to clean injecting equipment, testing and counselling for infectious diseases such as HIV, HBV and HCV, risk awareness and HBV vaccinations. In 2009 a new Female Harm Reduction Centre for females who inject drugs was opened by Caritas to provide short-term intensive therapy to clients who cannot achieve abstinence in the short term; sheltered accommodation and protection from abuse and sex work is also provided.

Syringe distribution started in Malta in 1987 and reached a nationwide geographical coverage in 1994, with seven fixed locations across Malta. Since then, the number of syringes distributed annually has increased steadily, from 22 000 in 1994 to 376 000 in 2012. In 2013 this trend changed for the first time when the number of syringes distributed decreased to 358 000. The majority of syringes are distributed from health centres in the Southern and Northern Harbour regions of Malta.

See the Harm reduction overview for Malta for additional information.  

Drug markets and drug-law offences

Cannabis is the only illicit substance cultivated locally, as a result of climatic conditions on the island. It is very easy to grow, even without artificial assistance. Home growers are not uncommon and commercial operations are occasionally discovered. Cannabis resin is imported from Tunisia and Libya. Heroin is imported from Turkey, North Africa or western European countries, while cocaine, ecstasy and other amphetamines are imported from other European countries, particularly from Italy or the Netherlands. Malta has also become a recipient of new psychoactive substances.

In 2013, there was an overall increase in drug seizures, when compared to the previous year. Cannabis was the most widely seized drug (71 seizures of resin, 85 seizures of herbal cannabis and three seizures of cannabis plants), followed by 115 seizures of cocaine, 51 seizures of heroin and 45 seizures of ecstasy. Although there has been an increasing trend since 2008 in the quantity of cannabis resin seized, and in 2011 a record quantity (89 kg) was seized, in 2013 the amounts of cannabis resin seized fell to 0.5 kg. With regard to herbal cannabis, the quantity seized rose to 9.74 kg and exceeded those reported between 2010–12. Between 2001–11 the amount of cocaine seized ranged from 0.15 kg to 21 kg; in 2012 a record amount of 143 kg of cocaine was seized, while in 2013 only 3.6 kg of cocaine was seized in Malta. The amount of heroin seized fell sharply between 2008–12 (from 8 kg to 1 kg). In 2012 and also in 2013 a total of 1 kg of heroin was seized by law enforcement agencies.

In 2013, a total of 30 374 ecstasy tablets were seized, the highest number ever recorded. The previous high-volume seizure report dates back to 2009, after which a sharp decline in number of ecstasy tablets was reported in 2010–12.

A considerable proportion of the crimes committed in Malta are assumed to be drug-related. This is especially true in cases of petty crime, such as thefts from vehicles, street robbery and other kinds of opportunistic thefts. Crimes that are more violent in nature are not normally associated with drugs. In 2013 the Malta Police Force arrested 429 people for drug-law offences. Of these, 322 were arrested for possession and 107 for supply. Most of the drug-law offences were related to cannabis, cocaine and heroin.

Look for Drug law offences in the Statistical bulletin for additional data.  

National drug laws

The principal pieces of legislation dealing with substance abuse in Malta are the Medical and Kindred Professions Ordinance (Cap. 31) concerning psychotropic drugs, and the Dangerous Drugs Ordinance (Cap. 101) concerning narcotic drugs, combined with the new Drug Dependence (Treatment not Imprisonment) Act 2014.

The illegal use of psychotropic and narcotic drugs is not, per se, recognised in Maltese law, although the use of these substances, if proven in court, will lead to a conviction for possession or trafficking. Maltese law recognises two kinds of possession: simple possession, or possession for personal use; and aggravated possession, or possession not for the offender’s exclusive use.

In April 2015 the Drug Dependence (Treatment not Imprisonment) Act 2014 came into force. Under this Act, drug possession for personal use is not a criminal offence and the person found in possession will be tried in front of the Commissioner of Justice. If found guilty, there will be a fine of EUR 50–100 for cannabis or EUR 75–125 for other drugs. In the case of a second offence within the period of two years, the person will be required to attend to the Drug Offenders Rehabilitation Board where they will be assessed for drug dependence and any necessary order may be made accordingly; failure to comply may be punished by a fine or three months in prison. A person found in possession of one cannabis plant, for personal use, will not be liable to a mandatory prison term. For a limited number of offences committed due to drug dependence, the Court may assume the function of a Drug Court, and refer the offender to the Drug Offenders Rehabilitation Board.

For supply offences, the range of punishment that may be awarded by the lower courts is six months–10 years’ imprisonment, whereas the superior courts may award a maximum punishment of life imprisonment. When certain offences take place within 100 metres of the perimeter of a school, youth club or centre, or such other place where young people habitually meet, the normal punishment is increased because these circumstances are deemed to be an aggravation of the offence. However, an amendment to the Dangerous Drugs Ordinance in 2006 allowed the court not to apply the mandatory prison term of six months if the offender intended to consume the drug on the spot with others. In 2014 the laws were further amended to guide the choice of prosecution of trafficking in a lower or superior court considering if the role of the offender was leading, significant or lesser, and defining quantity guidelines for ecstasy, LSD, amphetamine and ketamine. Courts may also opt for the lower punishment range if the higher range is considered disproportionate.

Go to the European Legal Database on Drugs (ELDD) for additional information.  

National drug strategy

The first Maltese national drug policy document was adopted in February 2008. It aims to streamline the actions of government and non-government bodies responsible for delivering services to drug users. It seeks to: (i) improve the quality and provision of drug-related services; and (ii) provide a more coordinated mechanism to reduce the supply of and demand for drugs in society. The strategy’s main objectives are to ensure a high level of security, health protection, well-being and social cohesion. It is primarily concerned with illicit drugs, but it also considers the abuse of prescription medications. The strategy is built around six main pillars addressing: (i) coordination; (ii) the legal and judicial framework; (iii) supply reduction; (iv) demand reduction, including harm reduction; (v) monitoring evaluation, research, information and training; and (vi) international cooperation and funding. Forty-eight different actions are set out under these six pillars. A first progress review of the strategy was conducted in 2011 and annual reviews of its implementation are planned.

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Coordination mechanism in the field of drugs

The main body responsible for drug-related matters is the Advisory Board on Drugs and Addiction (part of the Ministry for the Family and Social Solidarity), which was set up when the National Commission on the Abuse of Drugs, Alcohol and other Dependencies became part of the Presidential Office. The seven members are independent experts from fields such as law, youth studies, education, clinical psychology, psychiatry, epidemiology and neuroscience. The National Co-ordinating Unit for Drugs and Alcohol, also within the Ministry, is responsible for the implementation of the National Drug Policy, while the main remit of the National Focal Point for Drugs and Drug Addiction is that of monitoring the situation and the responses, including the effectiveness of the actions put in place as a result of the national drug policy

Public expenditure

In Malta, the financing of drug-related activities is decided annually by the entities in charge of their implementation. The available information is very limited and does not allow the size and trends of drug-related expenditures to be reported.

The most recent estimate, for the year 2012, suggests that drug-related expenditure represented close to 0.08 % of gross domestic product, which means that Malta spent an estimated EUR 5 493 421 on drug reduction activities. However, what proportion this amount represents of the total drug-related expenditure is unknown.

Drug-related research

Research is one of the sections of the current national drug policy, which recognises the need for adequate monitoring, collection and dissemination of information, periodical evaluation of policy measures, and ongoing research and training. The National Commission on the Abuse of Drugs, Alcohol and other Dependencies is responsible for all drug-related issues. The National Focal Point for Drugs and Drug Addiction is responsible for gathering the necessary information to support the policy cycle, and to monitor the drug situation and the responses. Both governmental and university departments play an important role in undertaking research, which is mainly funded by the state budget. Drug-related research findings are then disseminated by the national focal point through regular meetings with its network of partners, direct mailing to interested parties, via the media, and on the national focal point website. Recent drug-related studies mentioned in the 2014 Maltese National report focused primarily on prevalence, incidence and patterns of drug use.

See Drug-related research for more detailed information. 

Key national figures and statistics

b Break in time series.

e Estimated.

p Eurostat provisional value.

1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.

2  Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.

3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.

4 Situation of penal institutions on 1 September, 2012.

5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).

  Year   EU (27 countries) Source
Population  2014 425 384
506 824 509 ep
Eurostat
Population by age classes 15–24  2014 12.9 % 11.3 % bep
Eurostat
25–49  33.9 % 34.7 % bep
50–64  20.9 % 19.9 % bep
GDP per capita in PPS (Purchasing Power Standards) 1  2013 86 100 Eurostat
Total expenditure on social protection (% of GDP) 2  2012 19.4 % 29.5 % p Eurostat
Unemployment rate 3  2014 5.9 % 10.2 % Eurostat
Unemployment rate of population aged under 25 years  2014 11.8 % 22.2 % Eurostat
Prison population rate (per 100 000 of national population) 4  2013 136.9  : Council of Europe, SPACE I-2013
At risk of poverty rate 5  2013 15.7 16.6 % SILC

Data sheet — key statistics on the drug situation

        EU range      
  Year   Country data Min. Max. Average Rank Reporting Countries
Opioids                
Problem opioid use (rate/1 000) 2013 1 6.97 0.2 10.7   20 21
All clients entering treatment (%) 2013   74.8% 6% 93%      
New clients entering treatment (%) 2013   33.7% 2% 81%      
Purity — heroin brown (%) 2013   21.0% 6% 42%   16 24
Price per gram — heroin brown (EUR) 2013   EUR 58 EUR 25 EUR 158   13 22
                 
Cocaine                
Prevalence of drug use — schools (%) 2011   4.0% 1% 5%      
Prevalence of drug use — young adults (%) :   : 0% 4% 2%    
Prevalence of drug use — all adults (%) :   : 0% 2% 1%    
All clients entering treatment (%) 2013   14.4% 0% 39%      
New clients entering treatment (%) 2013   32.2% 0% 40%      
Purity (%) 2013   20.0% 20% 75%   1 27
Price per gram (EUR) 2013   EUR 50 EUR 47 EUR 103   2 24
                 
Amphetamines                
Prevalence of drug use — schools (%) 2011   3.0% 1% 7%      
Prevalence of drug use — young adults (%) :   : 0% 3% 1%    
Prevalence of drug use — all adults (%) :   : 0% 1% 1%    
All clients entering treatment (%) 2013   0.2% 0% 70%      
New clients entering treatment (%) :   : 0% 22%      
Purity (%) :   : 5% 71%      
Price per gram (EUR) 2013   EUR 46 EUR 8 EUR 63   20 21
                 
Ecstasy                
Prevalence of drug use — schools (%) 2011   3.0% 1% 4%      
Prevalence of drug use — young adults (%) :   : 0% 3% 1%    
Prevalence of drug use — all adults (%) :   : 0% 2% 1%    
All clients entering treatment (%) 2013   1.2% 0% 2%      
New clients entering treatment (%) :   3.5% 0% 4%      
Purity (mg of MDMA base per unit) 2013   55 mg 26 mg 144 mg   5 23
Price per tablet (EUR) 2013   EUR 24 EUR 3 EUR 24   19 19
                 
Cannabis                
Prevalence of drug use — schools (%) 2011   10.0% 5% 42%      
Prevalence of drug use — young adults (%) :   : 0% 22% 12%    
Prevalence of drug use — all adults (%) :   : 0% 11% 6%    
All clients entering treatment (%) 2013   7.9% 3% 63%      
New clients entering treatment (%) :   25.1% 5% 80%      
Potency — herbal (%) 2013   6.8% 2% 13%   6 22
Potency — resin (%) 2013   7.3% 3% 22%   3 20
Price per gram — herbal (EUR) 2013   EUR 25 EUR 4 EUR 25   19 19
Price per gram — resin (EUR) 2013   EUR 21 EUR 3 EUR 21   21 21
                 
Prevalence of problem drug use                
Problem drug use (rate/1 000) :   : 2.0 10.0      
Injecting drug use (rate/1 000) :   : 0.2 9.2      
                 
Drug-related infectious diseases/deaths                
HIV infections newly diagnosed (rate/million) 2013   7.1 0.0 54.5      
HIV prevalence (%) 2013   3.5% 0% 49%      
HCV prevalence (%) 2013   13.8% 14% 84%      
Drug-related deaths (rate/million) 2013   7.1 1.5 84.1      
                 
Health and social responses                
Syringes distributed 2013   357 691 124 406 9 457 256      
Clients in substitution treatment 2013   1 078 180 172 513      
                 
Treatment demand                
All clients 2013   1 834 289 101 753      
New clients 2013   220 19 35 229      
All clients with known primary drug 2013   1 807 287 99 186      
New clients with known primary drug 2013   199 19 34 524      
                 
Drug law offences                
Number of reports of offences 2013   429 429 426 707      
Offences for use/possession 2013   322 58 397 713      

Notes

See the explanatory notes for further information on the methods and definitions.

Only the most recent data are available for each key statistic. Data before 2006 were excluded.

1 - Daily opioid users.

Additional sources of national information

In addition to the information provided above, you might find the following resources useful sources of national data.

Page last updated: Tuesday, 07 July 2015