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Please note that the information on this page is based on the EMCDDA Annual report 2011: the state of the drugs problem in Europe. Most statistical data relate to the year 2009 (or the last year available).

 
 

Annual report 2011: the state of the drugs problem in Europe
Amphetamines, ecstasy, hallucinogens, GHB and ketamine

Published: 15 November 2011

Prevalence and patterns of use

In a few countries, the use of amphetamine or methamphetamine, often by injection, accounts for a substantial proportion of the overall number of problem drug users and those seeking help for drug problems. In contrast to these chronic user populations, a more general association exists between the use of synthetic drugs, often together with alcohol, and attendance at nightclubs and dance events. This results in significantly higher levels of use being reported among young people, and exceedingly high levels of use being found in some settings or specific sub-populations. The overall prevalence levels of hallucinogenic drugs such as lysergic acid diethylamide (LSD) and hallucinogenic mushrooms are generally low and have been largely stable in recent years.

Amphetamines

Drug prevalence estimates suggest that about 12.5 million Europeans have tried amphetamines, and about 2 million have used the drug during the last year (see Table 6 for a summary of the data). Among young adults (15-34 years), lifetime prevalence of amphetamines use varies considerably between countries, from 0.1 % to 14.3 %, with a weighted European average of 5.0 %. Last year use of amphetamines in this age group ranges from 0.1 % to 2.5 %, with most countries reporting prevalence levels of 0.5-2.0 %. It is estimated that about 1.5 million (1.1 %) young Europeans have used amphetamines during the last year.

Among 15- to 16-year-old school students, lifetime prevalence of amphetamines use ranged from 1 % to 8 % in the 26 EU Member States, Norway and Croatia, surveyed in 2007, although only Bulgaria and Latvia reported prevalence levels of more than 5 %. The four countries that conducted school surveys in 2009 and 2010 (Italy, Slovakia, Sweden, United Kingdom) reported lifetime prevalence of amphetamines of 3 % or less (1).

Data on the prevalence of amphetamines use in nightlife settings in 2009, provided by four countries (Belgium, Czech Republic, Netherlands, United Kingdom), show considerable variation, ranging from 6 % to 24 % for last year use of amphetamines.

Over the last decade, last year amphetamines use has remained relatively low and stable in most European countries, with prevalence levels of less than 3 % for almost all reporting countries, with the exception of the United Kingdom and Denmark. In the United Kingdom, last year use of amphetamines among young adults (15-34) declined from 6.2 % in 1998 to 1.8 % in 2009-10; in Denmark, after increasing to 3.1 % in 2000, it declined to 2 % in 2010 (see Figure 8). During the period 2004-09, only Norway and the Czech Republic reported a change of more than one percentage point in last year prevalence of amphetamines use among young adults. In the Czech Republic, differences in survey methods do not allow confirmation of recent trends. School surveys suggest, overall, little change in the levels of experimentation with amphetamines among school students aged 15 to 16 years. Between 2003 and 2007, most countries reported both low and stable trends in lifetime prevalence in this group.

Table 6: Prevalence of amphetamines use in the general population — summary of the data

Age group

Time frame of use

Lifetime

Last year

European estimates are computed from national prevalence estimates weighted by the population of the relevant age group in each country. To obtain estimates of the overall number of users in Europe, the EU average is applied for countries lacking prevalence data (representing not more than 3 % of the target population). Populations used as basis: 15–64, 336 million; 15–34, 132 million. As European estimates are based on surveys conducted between 2001 and 2009/10 (mainly 2004–08), they do not refer to a single year. The data summarised here are available under General population surveys in the 2011 statistical bulletin.

15–64 years Estimated number of users in Europe 12.5 million 1.5–2 million
European average 3.8 % 0.5 %
Range 0.0–11.7 % 0.0–1.1 %
Lowest-prevalence countries Romania (0.0 %)
Greece (0.1 %)
Malta (0.4 %)
Cyprus (0.7 %)  
Romania, Malta, Greece (0.0 %)
France (0.1 %)
Czech Republic, Portugal (0.2 %)  
Highest-prevalence countries United Kingdom (11.7 %)
Denmark (6.2 %)
Sweden (5.0 %)
Norway (3.8 %)  

Estonia (1.1 %)
United Kingdom (1.0 %)
Bulgaria, Latvia (0.9 %)
Sweden (0.8 %)  

15–34 years Estimated number of users in Europe 6.5 million 1.5 million
European average 5.0 % 1.1 %
Range 0.1–14.3 % 0.1–2.5 %
Lowest-prevalence countries Romania (0.1 %)
Greece (0.2 %)
Malta (0.7 %)
Cyprus (1.2 %)
Romania, Greece (0.1 %)
France (0.2 %)
Czech Republic (0.3 %)
Portugal (0.4 %)
Highest-prevalence countries United Kingdom (14.3 %)
Denmark (10.3 %)
Latvia (6.1 %)
Norway (6.0 %)
Estonia (2.5 %)
Bulgaria (2.1 %)
Denmark (2.0 %)
Germany, Latvia (2.3 %)

Problem amphetamines use

Only a small number of countries can provide estimates of the prevalence of problem amphetamines use (2), but data on users entering treatment for problems related to these substances are available across Europe.

A small proportion of those entering treatment in Europe mention amphetamine as their primary drug: about 5 % of reported drug clients in 2009 (20 000 clients). However, amphetamine users account for a sizeable proportion of reported treatment entries in Sweden (28 %), Poland (25 %) and Finland (17 %). Amphetamine clients make up between 6 % and 10 % of reported treatment entrants in five other countries (Belgium, Denmark, Germany, Hungary, Netherlands); elsewhere the proportion is less than 5 %. In addition, non-cocaine stimulants are mentioned as a secondary drug by almost 20 000 clients entering treatment for problems related to other primary drugs (3).

Amphetamine users entering treatment are on average 30 years old, with a lower male to female ratio (two to one) than for any other illicit drug. High levels of amphetamine injecting are reported by the countries where amphetamine users make up the highest proportions of treatment entrants (Latvia, Sweden, Finland), with between 59 % and 83 % of primary amphetamine clients injecting the drug (4).

Trends in amphetamine users entering treatment between 2004 and 2009 have remained stable in most countries, with a slight decrease among the clients who entered treatment for the first time in their life, mainly attributable to a decrease in the number of new amphetamine clients in Finland and Sweden (EMCDDA, 2010d).

In contrast to other parts of the world, where the use of methamphetamine has increased in recent years, levels of use in Europe appear limited. Historically, use of this drug in Europe has been concentrated in the Czech Republic and, more recently, Slovakia. In 2009, the number of problem methamphetamine users in the Czech Republic was estimated to be approximately 24 600-25 900 (3.3 to 3.5 cases per 1 000 aged 15-64 years), roughly twice the estimated number of problem opioid users. This represents a statistically significant increase in comparison to the previous years. For Slovakia, there were estimated to be approximately 5 800-15 700 problem methamphetamine users in 2007 (1.5 to 4.0 cases per 1 000 aged 15-64 years), about 20 % fewer than the estimated number of problem opioid users.

Methamphetamine is cited as the primary drug by a large proportion of clients reported entering treatment in the Czech Republic (61 %) and Slovakia (30 %). Both countries report an increase in the number and overall proportion of new treatment entrants related to methamphetamine over the last decade. Among those seeking help for a methamphetamine problem, injecting is common in the Czech Republic (79 %) and to a lesser extent in Slovakia (37 %), with overall declining levels since 2004. Methamphetamine clients in these countries are on average around 25 years old when entering treatment (5).

In recent years, methamphetamine has also appeared on the drug market in other countries, particularly in the north of Europe (Norway, Sweden, Latvia and, to a lesser extent, Finland), where it appears to have partially replaced amphetamine, the two substances being virtually indistinguishable to users.

Ecstasy

Drug prevalence estimates suggest that about 11 million Europeans have tried ecstasy, and about 2.5 million have used the drug during the last year (see Table 7 for a summary of the data). Use of the drug in the last year is concentrated among young adults, with males reporting levels of use much higher than females in all countries except Greece, Romania, Finland and Sweden. Lifetime prevalence of ecstasy use among the 15-34 age group ranges from under 0.6 % to 12.7 %, with most countries reporting estimates in the 2.1-5.8 % range (6).

Among 15- to 16-year-old school students, lifetime prevalence of ecstasy use ranged from 1 % to 5 % in most of the European countries surveyed in 2007. Only four countries reported higher prevalence levels: Bulgaria, Estonia, Slovakia (all 6 %) and Latvia (7 %). The four countries that conducted school surveys in 2009 (Italy, Slovakia, Sweden, United Kingdom) reported lifetime prevalence of ecstasy use of 5 % or less (7).

Qualitative studies provide a window into 'recreational' use of stimulant drugs by young adults attending a range of different nightlife venues across Europe. These studies highlight significant differences in the drug use profiles of customers, with those attending electronic dance music venues much more likely to report drug use than those in other nightlife settings. Data on the prevalence of ecstasy use in nightlife settings in 2009 is only available for four countries (Belgium, Czech Republic, Netherlands, United Kingdom), but does show considerable variation in reported levels of recent (last year) use, ranging from 10 % to 75 %. Ecstasy use was more common than amphetamines use in the settings sampled.

Over the period 2003-09, no country reported an increase in ecstasy use, while Estonia, Spain, Germany, Hungary and the United Kingdom reported a decrease of about one percentage point in last year ecstasy use in the 15-34 age group. There is, however, some variation between countries. In the countries reporting higher than average levels of last year ecstasy use, consumption of the drug among 15- to 34-year-olds typically peaked at somewhere between 3 % and 5 % in the early 2000s (Estonia, Spain, Slovakia, United Kingdom; see Figure 8). An exception to this is the Czech Republic, where last year ecstasy use estimates peaked in 2008 at 7.7 % and decreased to 2.8 % in 2009. In the Czech Republic, differences in survey methods do not allow confirmation of recent trends.

School surveys suggest, overall, little change in the levels of experimentation with ecstasy among students aged 15 to 16 years. Between 2003 and 2007, most countries reported low and stable trends in lifetime prevalence of ecstasy among this group, while seven countries reported an increase and three a decrease - using a difference of two percentage points as the threshold. A decrease in the prevalence of ecstasy may be suggested by studies carried out in recreational settings in Europe. In Amsterdam, a study of visitors to 'coffee shops' reported a sharp drop in last month use of ecstasy, from 23 % in 2001 to 6 % in 2009; the study also reported a decline in lifetime amphetamine use, from 63 % to 41 % over the same period. A Belgian study conducted regularly in nightlife settings reported that ecstasy is no longer the second most used illicit drug. In previous surveys, last year ecstasy use always ranged between 15 % and 20 %, but decreased to 10 % in 2009.

Table 7: Prevalence of ecstasy use in the general population — summary of the data

Age group

Time frame of use

Lifetime

Last year

European estimates are computed from national prevalence estimates weighted by the population of the relevant age group in each country. To obtain estimates of the overall number of users in Europe, the EU average is applied for countries lacking prevalence data (representing not more than 3 % of the target population). Populations used as basis: 15–64, 336 million; 15–34, 132 million. As European estimates are based on surveys conducted between 2001 and 2009/10 (mainly 2004–08), they do not refer to a single year. The data summarised here are available under General population surveys in the 2011 statistical bulletin.

15–64 years Estimated number of users in Europe 11 million 2.5 million
European average 3.2 % 0.7 %
Range 0.3–8.3 % 0.1–1.6 %
Lowest-prevalence countries Romania (0.3 %)
Greece (0.4 %)
Malta (0.7 %)
Norway (1.0 %)
Romania, Sweden (0.1 %)
Malta, Greece (0.2 %)
Denmark, Poland, Norway (0.3 %)
Highest-prevalence countries United Kingdom (8.3 %)
Ireland (5.4 %)
Spain (4.9 %)
Latvia (4.7 %)
United Kingdom, Slovakia (1.6 %)
Latvia (1.5 %)
Czech Republic (1.4 %) 
15–34 years Estimated number of users in Europe 7.5 million 2 million
European average 5.5 % 1.4 %
Range 0.6–12.7 % 0.2–7.7 %
Lowest-prevalence countries Romania, Greece (0.6 %)
Malta (1.4 %)
Poland, Norway (2.1 %)
Portugal (2.6 %)
Romania, Sweden (0.2 %)
Greece (0.4 %)
Norway (0.6 %)
Poland (0.7 %)
Highest-prevalence countries United Kingdom (12.7 %)
Czech Republic (9.3 %)
Ireland (9.0 %)
Latvia (8.5 %)
United Kingdom (3.2 %)
Czech Republic (2.8 %)
Slovakia, Latvia, Netherlands (2.7 %)

 

Few drug users seek treatment for problems relating to ecstasy. In 2009, ecstasy was mentioned as the primary drug by less than 1 % (1 300) of all reported treatment entrants. With an average age of 26 years, ecstasy clients are among the youngest entering drug treatment, and there are three to four males for every female. Ecstasy clients often report the concomitant use of other substances, including alcohol, cocaine and, to a lesser extent, cannabis and amphetamines (8).

The combined use of ecstasy or amphetamines with alcohol has been reported in European studies. In nine European countries, general population surveys show that frequent or heavy alcohol users report levels of prevalence of amphetamines or ecstasy use that are much higher than the population average (EMCDDA, 2009). Similarly, ESPAD school survey data for 22 countries show that 86 % of the 15- to 16-year-old students who reported using ecstasy during the last month also reported drinking five or more alcoholic drinks on one occasion (EMCDDA, 2009).

Hallucinogens, GHB and ketamine

Among young adults (15-34 years), lifetime prevalence estimates of LSD use in Europe range from zero to 5.5 %. Much lower prevalence levels are reported for last year use (9). In the few countries providing comparable data, most report higher levels of use for hallucinogenic mushrooms than for LSD, among both the general population and school students. Lifetime prevalence estimates for hallucinogenic mushrooms among young adults range from 0.3 % to 14.1 %, and last year prevalence estimates are in the range of 0.2-5.9 %. Among 15- to 16-year-old school students, most countries report lifetime prevalence estimates for the use of hallucinogenic mushrooms of between 1 % and 4 %, with Slovakia (5 %) and the Czech Republic (7 %) reporting higher levels (10).

Estimates of the prevalence of GHB and ketamine use in the adult and school populations are much lower than those for the use of cocaine and ecstasy. However, use of these substances can be higher in specific groups, settings and geographical areas. Targeted surveys that report prevalence estimates for the use of these substances have recently been conducted in Belgium, the Czech Republic, the Netherlands and the United Kingdom. These studies report lifetime prevalence of GHB use ranging from 3.9 % to 14.3 %, and last month prevalence of up to 4.6 %. Estimates of ketamine use in the same surveys range from 2.9 % to 62 % for lifetime use and 0.3 % to 28 % for last month use. There are marked differences between surveys and countries, and the high prevalence of ketamine use reported is unique to a 2010 UK music magazine survey (Winstock, 2011). In this survey, levels of ketamine use are very much higher than those for GHB. Such high ketamine prevalence may be due to the self-selection of respondents to the survey and their particular drug use profiles and attitudes. The Netherlands reported that ketamine has gained some popularity among trend-setters in the western region, but last month prevalence levels among visitors to large-scale parties in 2009 remain lower (at 1.2 %) than those for GHB (4.6 %). Among visitors to Amsterdam 'coffee shops' in 2009, last month GHB use equalled last month amphetamine use at 1.5 %. A high perceived risk of overdose leading to unconsciousness or coma, associated with the use of GHB, is highlighted by qualitative studies in Germany, Estonia, France and the Netherlands.

No overall trends can be identified for GHB and ketamine use from repeat surveys among party-goers or in recreational settings, and the changes reported are in most cases small. Studies of recreational settings in Belgium report that last month use of GHB and ketamine increased from 2 % to 3 % between 2008 and 2009. In the Czech Republic, studies in nightlife settings report that last year prevalence of GHB use increased from 1.4 % in 2007 to 3.9 % in 2009, and ketamine use increased from 2.2 % to 2.9 % over the same period. Decreases in last month use of GHB were reported among visitors to Amsterdam 'coffee shops', from 2.8 % in 2001 to 1.5 % in 2009. However, trends in Amsterdam are not representative for the rest of the Netherlands. Also, among respondents to the UK music magazine survey, last month use of GHB decreased from 1.7 % in 2009 to less than 1 % in 2010, and ketamine use decreased from 32.4 % to 28 % over the same period.

Footnotes

(1) See Table EYE-11 in the 2011 statistical bulletin.

(2) Problem amphetamines use is defined as the injecting or long duration and/or regular use of the substances.

(3) See Tables TDI-5 (part ii) and TDI-22 in the 2011 statistical bulletin.

(4) See Tables TDI-5 (part iv) and TDI-37 in the 2011 statistical bulletin.

(5) See Tables TDI-2 (part i), TDI-3 (part iii) and TDI-5 (part ii) and (part iv) in the 2011 statistical bulletin and Table TDI-5 (part ii) in the 2006 statistical bulletin.

(6) See Table GPS-7 (part iv) in the 2011 statistical bulletin.

(7) See Table EYE-11 in the 2011 statistical bulletin.

(8) See Tables TDI-5, TDI-8 and TDI-37 (part i), (part ii) and (part iii) in the 2011 statistical bulletin.

(9) See Table GPS-1 in the 2011 statistical bulletin.

(10) Data from ESPAD for all countries but Spain. See Figure EYE-3 (part v) in the 2011 statistical bulletin.

Bibliographic references

EMCDDA (2009), Polydrug use: patterns and responses, Selected issue, Publications Office of the European Union, Luxembourg.

EMCDDA (2010), Problem amphetamine and methamphetamine use in Europe, Selected issue, Publications Office of the European Union, Luxembourg.

Winstock, A. (2011), 'The 2011 Mixmag drugs survey', Mixmag March pp. 49-59.

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Page last updated: Friday, 28 October 2011