Ladies and Gentlemen,
It is my pleasure to present to you today the latest findings from the EMCDDA’s 2012 Annual report on the state of the drugs problem in Europe. And I am particularly pleased to be doing this with the European Commissioner who has in her portfolio responsibility for all six EU-Home Affairs agencies including the EMCDDA. Ms Malmström, thank you very much for having accepted our invitation to come to Lisbon. I would also like to thank the Chairman of our Management Board, Dr João Goulão, for continuing our tradition of launching the Annual report together.
Our analysis this year highlights the challenges we face in addressing a dynamic and volatile drug market, especially with regard to stimulants and synthetic drugs. Nevertheless, although drug use levels remain high, there are grounds for encouragement… We observe that for Europe’s major illicit drugs — heroin, cocaine and cannabis — many countries report declining consumption levels.
First, let us look at heroin and opioid drugs. Since the 1970s, heroin use has remained at the heart of Europe’s drug problem. Indeed, the need to respond effectively to heroin use was one of the driving factors behind the creation of my agency, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in the early 1990s.
Our most recent estimate suggests that Europe has 1.4 million regular opioid users, which corresponds to about one in 250 of our adult citizens. Over the last two decades, European drug policy has largely concentrated on responding effectively to heroin-related problems — and measures have been put in place to respond to the thousands of overdose deaths each year, to the spread of HIV and hepatitis C, and to the resulting societal damage.
Ms Malmström has already talked about the decline in heroin use and heroin availability. I would like to give you a few more details on the supply situation in Europe: the latest figures for heroin seizures and drug-law offences show an overall decrease. The reasons for this vary. In Estonia and Finland, heroin has been largely replaced by synthetic opioids such as fentanyl and buprenorphine. In Ireland and the United Kingdom, the recent heroin shortages reported are probably the result of law enforcement successes. And I am pleased to note that Turkey, a key partner in reducing the EU’s heroin supply, is collaborating closely with the EMCDDA.
Moving on to the demand side, I would like to underline that last year at least 1.1 million Europeans received treatment for drug use. And most of them received opioid substitution treatment. We now estimate that more than half of Europe’s regular opioid users have access to substitution treatment, but in many countries there are still insufficient treatment opportunities.
Mr Goulão has already stressed that infectious diseases, although declining, continue to be a challenge. The recent outbreaks of HIV in Greece and Romania remind us that despite our success in fighting the transmission of this virus among drug users, the potential for rapid spread remains. Ensuring adequate provision of HIV prevention and harm reduction services for at-risk populations remains vital.
Many regular opioid users spend time in prison — and we know that some of them stop using drugs when incarcerated, but we also know that others initiate drug use, or engage in more damaging behaviours.
The risk of dying from drug overdose greatly increases in the period after release from prison, due to high rates of relapse and to lower opioid tolerance. This is a critical time for action, when ensuring continuity of care and targeted interventions will support recovery and save lives.
Now to our findings on Europe’s increasingly complex stimulant drugs market. There is a growing variety of powders and pills now available to consumers. Cocaine, amphetamines and ecstasy continue to play the most important role but in some countries we see synthetic cathinones, such as mephedrone and MDPV, joining the stimulant drug market.
Cocaine remains the second most used illicit drug in Europe (after cannabis) — and about four million Europeans have consumed cocaine during the last year. In countries where the level of consumption is high indicators show that use appears to have peaked and is now trending downwards. Reasons for this are varied. Low cocaine purity may be causing some users to switch to other stimulants. And potential users may now be more aware of the negative consequences that can result from cocaine consumption.
Cocaine is just one of the stimulant drugs popular in Europe. We estimate that last year, 2 million Europeans used ecstasy. The ecstasy market has undergone some transformation in recent years. First we saw a substantial reduction in the levels of MDMA in ecstasy tablets, with substances such as BZP and mephedrone being sold as ecstasy. Now, the ecstasy market appears to have bounced back from the shortage of MDMA, and high purity powders and tablets are again being reported in some countries. [By the way, the patent for synthesising MDMA/ecstasy will be 100 years old on Christmas Eve…]
Amphetamines continue to be used extensively in parts of north, central and eastern Europe. An estimated 2 million Europeans used amphetamines last year. While use of amphetamine has been stable for some years, there are more worrying signs linked to methamphetamine. With the exception of the Czech Republic and Slovakia, methamphetamine use has traditionally been rare in Europe, but we have received reports, from the north of Europe, from Germany (Bavaria), Greece, Cyprus and Hungary, that methamphetamine use may be on the rise.
In general, we can say that innovation in the stimulant market continues… And tomorrow, a European Union risk assessment on 4-methylamphetamine (4-MA) will take place here in Lisbon, involving members of the EMCDDA Scientific Committee and experts from Europol, the European Medicines Agency and other relevant partners. This exercise was prompted by clusters of deaths associated with 4-MA. This form of amphetamine — currently not controlled in most of Europe — was probably manufactured in clandestine laboratories by producers seeking new chemical routes for amphetamine production.
Ms Malmström has clearly set out the considerable challenges posed by new psychoactive substances. I would like to add a few technical details here: I have just received an update on the number of new substances reported for the first time to the EMCDDA or to Europol in 2012 — we are now at 56 new molecules. Synthetic cannabinoids and cathinones are still prominent, but substances from more obscure chemical groups are increasingly reported.
To date, the recreational drug market has been the main target for new substances. However, we have received reports from a few countries that in times of heroin shortage regular opioid users are switching to injecting cathinones, such as mephedrone and MDPV.
In some groups of young people, we have seen a rapid increase in the use of new drugs and evidence is growing of this problem internationally. We cannot ignore the threat that these substances pose to our current drug policies.
We need to step up our support to policymakers as they struggle to develop effective national responses. In this context, we need to improve our forensic science capacity and more systematically monitor medical emergencies and deaths associated with the use of new psychoactive substances. A better understanding of the health and social impact of these new drugs will enable us to develop effective demand reduction strategies.
In recent years, a number of what I would call ‘older-new’ substances have gradually established themselves on the European drug market. I am talking about drugs such as GHB, ketamine and now mephedrone. The overall numbers using these drugs remain low, making it easy for them to slip under the monitoring radar… However, high levels of consumption have been identified in some groups of young people. We have also received reports of serious acute and chronic health problems linked with the use of these substances. These developments are a stark reminder that our current vision is often too limited, inhibiting our ability to identify and respond to new and emerging threats.
Let us now move to the cannabis situation. Our recent analysis of the cannabis market shows that herbal cannabis production within Europe’s borders is increasingly displacing imported cannabis resin. This so-called ‘domestic’ cannabis production varies considerably from small numbers of cannabis plants grown for personal consumption to large plantations using sophisticated techniques.
Cannabis continues to be by far the most used illicit drug in Europe. Here the 3 million European adults who are using cannabis on a daily or almost daily basis are of particular concern. Cannabis-related problems (anxiety, impaired coordination and performance, school failure, professional failure) are now better understood and are often associated with the intensive and long-term use of the drug. We do have some worries here… For example, the shift towards herbal cannabis may be exposing users to more potent forms of the drug, and we note that Europe is still seeing growing numbers of people entering drug treatment for cannabis problems.
Journalists often ask me what is happening with substance use among Europe’s younger generation. The latest results from the ‘European school survey project on alcohol and other drugs’ (ESPAD) — with over 100 000 participating school students — show a decline in students’ recent use of alcohol and no drop in levels of cigarette smoking. When we look at students’ experience of cannabis use the picture is mixed with diverging trends in individual countries. But overall we see that cannabis use was on the rise until 2003, dropped slightly in 2007 and since then has largely stabilised.
We also note a relationship between the use of different substances. For example, in those countries where many students report recent alcohol use and heavy drinking more students also report experience with cannabis and other illicit drugs. In this context, the increasingly common practice of integrating licit and illicit strategies in national policy documents is a timely one. Here we are reminded of the important role that prevention interventions play — both in establishing healthy environments and norms, and in supporting our most vulnerable young people.
Our new report provides you with insight into the diverse and complex nature of the drugs problem we now face. Some of what I have presented is clearly ‘good news’. However, I am too often surrounded by pessimistic voices questioning the success of efforts made… I think, when one looks carefully at the evidence, one can easily see that a European approach — which recognises that demand and supply are of equal importance,… which recognises the value of a scientific and evidence-based approach,… which is pragmatic,… which evaluates its actions… and most important of all which recognises the need to pursue long-term goals — [that this European approach] is making a positive difference. That’s what I would invite you to remember from what I have said today.
Having said that, I cannot avoid finishing with some words of warning…
National decision-makers are currently faced with difficult choices and competing priorities. In such times, it is more important than ever that wise investments are made in the illicit drugs area — investments based on a sound understanding of the problem and of the measures that will deliver the greatest benefits. The progress we have observed could be very easily undermined if investment in the areas we know to be effective is discontinued.
Thank you very much for your attention, I welcome your questions.