European Drug Report 2017

Drug-related harms and responses

Illicit drug use is a recognised contributor to the global burden of disease. Chronic and acute health problems are associated with the use of illicit drugs, and these are compounded by various factors including properties of the substances, the route of administration, individual vulnerability and the social context in which drugs are consumed. Chronic problems include dependence and drug-related infectious disease, while there is a range of acute harms, with drug overdose the best documented of these. Although relatively rare, the use of opioids still accounts for much of the morbidity and mortality associated with drug use. Risks are elevated through injecting drug use. In comparison, although the health problems associated with cannabis use are clearly lower, the high prevalence of use of this drug may have implications for public health. The variation in content and purity of substances now available to users increases potential harms and creates a challenging environment for drug-related responses.

The design and delivery of effective evidenced-based responses to drug problems is a central focus for European drug policies and involves a range of measures. Prevention and early intervention approaches aim to prevent drug use and related problems, while treatment, including both psychosocial and pharmacological approaches, represents the primary response to dependence. Some core interventions, such as opioid substitution treatment and needle and syringe programmes, were developed in part as a response to injecting opioid use and related problems, particularly the spread of infectious diseases and overdose deaths.

Monitoring drug-related harms and responses

Information on health and social responses to drug use, including drug strategies and drug-related public expenditure, are provided to the EMCDDA by Reitox national focal points and expert working groups. Expert ratings provide supplementary information on the availability of interventions where more formalised datasets are unavailable. This chapter is also informed by reviews of the scientific evidence on the effectiveness of public health interventions. Supporting information can be found on the EMCDDA website in the Health and social responses profiles and the Best practice portal.

Drug-related infectious diseases and mortality and morbidity associated with drug use are the principal health harms monitored systematically by the EMCDDA. These are complemented by more limited data on acute drug-related hospital presentations and data from the EU Early Warning System, which monitors harms associated with new psychoactive substances. Further information is available online under Key epidemiological indicators, the Statistical Bulletin and Action on new drugs.