International - Germany

Basic Data

(Prevalence of Illicit Drug Use) "While the lifetime prevalences of the use of illicit drugs among adults in the age group 18-64 years (ESA [Epidemiological Survey on Addiction]) slightly increased between 2006 and 2009 (2006: 23.7%; 2009: 26.7%), the figures for the use of illicit drugs in the 12-month category remained practically unchanged between the two data collection years 2006 and 2009 (2006: 5.0%; 2009: 5.1%). The situation is similar for the use within the last 30 days prior to the survey (2006: 2.5%; 2009: 2.6%) (Pabst et al. 2010a).
"Since the prevalence of the use of illicit drugs (total) significantly depends on the use experience with cannabis (and is almost identical with it), the findings of the ESA 2009 indicate a stabilisation of the decline of the current use of cannabis in the general population, which had already been observed by the ESA 2007. Within the framework of the ESA 2009, only 7.4% of the interviewees (2006: 5.8%) report experience with other illicit drugs in the lifetime category. Even lower are the values for the 12-month (1.3%) and 30-day prevalence (0.6%), which have remained practically unchanged in comparison with the survey carried out in 2006 (1.2% and 0.7% respectively) (cf. also Table 2.2)."

^{DAS: Drogenaffinitaetsstudie der BZgA (Drug affinity study of the Federal Centre for Health Education)
ESA: Europaeische Suchtstudie (frueher Bundesstudie) (Epidemiological Survey on Addiction)}

(Prevalence and Trends of Illicit Drug Use Among Youth) "Trend data on the use of illicit substances by adolescents (12- to 17-year olds) and young adults (18- to 25-year olds) have been provided by the DAS since 1979 (BZgA 2010). From 1979 to 1993, the development of the lifetime prevalences of illicit drugs among adolescents between 12 and 17 years of age vary only slightly on the whole running almost parallel for females and males until 1989. Afterwards, the portion of those who have already had experience with any illicit drug, is subject to diverging developments in the female and male adolescents: among the female adolescents, the portion of those with consumption experience with illicit drugs jumped from 4.5% (1993) to 15.2% (1997)29. From 2001 (11.7%) onwards, the lifetime prevalence declined again and was at 8.0% in the year 2008.The lifetime prevalence among the male adolescents continually increased from 8.7 percent in 1993 to 19.0 percent in the year 2004 and fell back to 12.0 percent in 2008 (for a graphic presentation of this development, see REITOX Report 2010, figure 2.1)."

(Prevalence of Illicit Drug Use, by Age) "Use of illicit drugs is a phenomenon occurring primarily in younger age groups. The portion of the 12-month-users among the below-30-year olds lies on average around 14%, among older users however, it is only about 2%. For many substances (except cannabis), the current (i.e. 12-month) consumption prevelances are already low among younger age groups, among the above-30-year olds they lie for all older age groups consistently below 1%. Apart from cannabis, only amphetamines and cocaine play a major role among the 20-29-year olds, although consumption experience with ecstasy, LSD and hallucinogenic mushrooms in the age groups above 30 years is quite common in the lifetime category. Looking at the relation between lifetime prevalences and current consumption, it is to be assumed that use of these substances is only of a transitional nature in the majority of users."

^{LT: Lifetime; 12 M: 12 Months; 30 D: 30 Days
DAS: Drogenaffinitaetsstudie der BZgA (Drug affinity study of the Federal Centre for Health Education)
ESA: Europaeische Suchtstudie (frueher Bundesstudie) (Epidemiological Survey on Addiction)}

(Seizure of Cannabis Plants) "In the year 2010, 101,549 cannabis plants were seized in 1,517 cases (Table 10.6), which corresponds to a significant decline in seized plants (-20.5%) and an increase in the case figure (+11.6%). With this, the seized quantity has reached the lowest level since 2005, whereas the case figure is the second highest since 2000, which seems to be an indication of a larger number of producers running smaller plantations (BKA 2011a)."

(Prevalence of Cannabis Use Among Youth) "In 2011, the Federal Centre for Health Education presented the findings of a recent representative survey on cannabis use among teenagers and young adults in Germany (BZgA 2011c). According to this survey, 7.4% of the adolescents aged between 12 and 17 years and 35% of the young adults aged between 18 and 25 years have used cannabis at least once in their lives (lifetime prevalence).
"The portion of those who used cannabis in the last 12 months before the interview was at 5.0% among the 12- to 17-year olds and respectively at 12.7% among the 18- to 25-year olds (12-month prevalence; Figure 2.1). In the last 30 days before the interview, 1.7% of the adolescents and 5.3% of the young adults used cannabis (30-day prevalence; Figure 2.2).
"After having significantly increased in 1990s, the lifetime prevalence of cannabis use is currently declining again in all age and gender groups. The 12-month prevalence and the 30-day prevalence found by the recent survey are lower on a statistically significant scale than in previous years (Figure 2.3, Figure 2.4)."

(Prevalence of Alcohol Use Among Youth) "The findings of the representative survey conducted by the Federal Centre for Health Education in the year 2010 with a focus on alcohol use (BZgA 2011b) confirm that experience with the consumption of alcohol among 12-25-year olds is very common. About three quarters (72.3%) of the 12- to 17-year olds already have had experience with alcohol once in their lifetime. Among the 18- to 25-year olds, the quasi totality of all interviewees report consumption at least once in their lifetime (96.6%). The 12-month prevalences for both age groups are slightly lower (63.3% and 92.2% respectively). Gender-specific differences were not found with regard to prevalences. As for regular consumption (defined as at least once a week) though, gender- and age-specific differences are substantial. Generally speaking, more male teenagers and young adults regularly drink alcohol. Regular consumption has been on the decline since 1979 among adolescents and young adults (from 44.7% to 26.1%).
"An indicator for measuring risky consumption behaviour among young people is the so-called binge drinking, defined as consuming five or more drinks at a time. At present, one in six teenagers aged between 12 and 17 years states to have engaged in binge drinking at least once in the last 30 days, about five percent of this group report to do this four times or more in the last 30 years. With this, there is a sizeable figure of young people showing risky alcohol use behaviour that increases the probability of the later onset of alcohol-related problems and disorders."

(Prevalence of Tobacco Use Among Youth) "Data on the use of tobacco among adolescents and young adults are also available from the alcohol survey conducted by the Federal Centre for Health Education in 2010 (BZgA 2011f). The lifetime prevalence of smoking among the 12- to 25-year olds was at 55.8% in 2010. About one in six teenagers and young adults smokes daily, 11.4% even more than 10 cigarettes a day. The average age at onset of smoking is 14.0 years and has slightly increased since 1986. The quota of smokers among the 12- to 17-year old teenagers continually declined between 1979 and 1993, rose again until 1997 and stagnated at a high level until 2001. Since 2001, the portion has considerably shrunk again and currently is at 14.2% (male teenagers) and 11.5% respectively (female teenagers)."

(Drug Trafficking Offenses, by Drug Type) "These crimes are related to offences committed in connection with commercial/professional dealing in narcotic drugs or smuggling of larger quantities of narcotic drugs. All drug dealing/trafficking crimes recorded by police are - just as consumption-related crimes - taken account of in this report irrespective of the outcome of later legal proceedings.
"Both in terms of portions and absolute figures, cannabis played the most important role in drug dealing/trafficking crimes (29,306 crimes, 59.1% of all crimes; 2009: 28,867 crimes, 56.6%), followed – at a large distance by heroin (6,403, 12.9%; 2009: 7,205, 14.1%; 2008: 7,687, 13.8%) (Figure 9.1). Similar to heroin, the number and portions of trafficking crimes in connection with cocaine (3,763, 7.6%; 2009: 4,522, 8.9%; 2008: 5,278, 9.4%) have slightly decreased over the last years. Since 2000, the portion of trafficking crimes involving amphetamines has been on a continual rise and the case figure too slightly increased again after a slight decline in the previous two years. In 2010, amphetamines accounted for 12.8% (6,372 crimes; 2009: 5,870, 11.5%) in all dealing/trafficking crimes ranking third on this list as in the previous two years (BMI 2011)."

(Crimes Believed to Have Been Committed to Obtain Drugs) "Direct economic compulsive crimes are taken as referring to all criminal offences committed in order to obtain narcotic drugs, substitute or alternative drugs. In 2010, 2,556 cases (2009: 2,479) of direct economic compulsive crimes were recorded by the Police Criminal Statistics (Polizeilichen Kriminalstatistik, PKS), which corresponds to an increase of 3.1% compared to the previous year. With this, the number of this type of offences has remained at about the same level since 2007. Almost three quarters (70.8%) of these offences were related to forgery of prescriptions or theft of prescription forms to get access to narcotic substances (BMI 2011)."

(Drug Offenses) "In the year 2010, a total of 231,007 drug law offences (2009: 235,842) were recorded, out of these 165,880 were general offences committed against the Narcotics Act and a little less than 50,000 drug dealing/trafficking offences. With this, the number of drug related offences decreased by 2.1% compared to the previous year (BMI 2011)."

(Consumption-Related Offenses) "This section is about drug offences that are - due to the frame conditions (quantity, persons involved) - classified by police as “general offences” and are therefore taken as referring to consumption-related offences (Figure 9.2).
"The police criminal statistics (BMI 2011) show that in this category of offences cannabis also played a predominant role accounting for about 60.0% of all respective cases in 2010. Heroin (11.0%), amphetamines (15.5%) and cocaine (6.3%) account together for 32.8% of the recorded cases. The remaining portions are split between ecstasy, LSD and other drugs. In 2010, the total number (165,880) decreased by 2.2% in comparison with the previous year (2009: 169,689). The number of consumption-related offences in connection with amphetamines increased by 14.8% from 2009 (22,387) to 2010 (25,695) and thus continued the trend since the middle of the 1990s. As for consumption-related offences involving other substances, there were either minimal changes (cannabis: -2.5%; LSD: +8.7%; other: +1.2%) or pronounced declines (heroin: -9.7%; cocaine: -14.8%; ecstasy: -26.6%) to be found."

(Trends in Drugs Seizures) "When looking at the seized quantities and the number of seizures, one can see that figures increased since 2000 especially for amphetamines (+344% and respectively +148%) and declined for ecstasy (-86% respectively -74%) (Table 10.5). The case figures 2010 for heroin and cocaine declined respectively by approximately 10% (heroin -9%; cocaine -13%) in comparison to 2009 and respectively by approximately 30% in comparison with the year 2000 although the changes in the seized quantities were very different from each other. In 2010, approximately 37% less heroin was seized in comparison to 2009 and approximately 40% less in comparison with the year 2000 while the quantity of cocaine seized in 2010 very strongly increased compared to the years 2009 (+78%) and 2000 (+232%) mainly because of few large individual seizures (cf. also 10.2.3 and 10.3.1) in 2010 (BKA 2011a)."

(Seizure of Synthetic Drug Labs) "In the year 2010, 16 illicit drug laboratories were uncovered, which corresponds to a decline in comparison with the previous year (24 laboratories). As in the previous year, the detected production sites were mainly small laboratories that produced methamphetamines to meet the operators’ private demands or to supply a limited circle of local buyers. For the first time, a laboratory manufacturing synthetic cannabinoids was detected (BKA 2011a).
"On the whole, 0.39 kg amphetamine, 0.52 kg methamphetamine and 1 g synthetic cannabinoids were seized in the detected laboratories. Basic material found was acetic anhydride (12.0 l), phenyl acetic acid (1.5 kg), hydrochloric and sulfuric acid (24.8 l and respectively 12.1 l), acetone (31.3 l), ethyl ether (1.5 l), potassium permanganate (0.3 kg), toluol (18.9 l), pseudoephedrine (0.1 kg), pills containing pseudoephedrine (182 consumption units) as well as very small quantities of ephedrine, pills containing ephedrine, isosafrole, norephedrine and sassafras oil (BKA 2011b)."

(New HIV Cases Among IDUs) "A total of 2,918 newly diagnosed HIV infections were reported to the RKI [Robert Koch Institute] for the year 2010. This means that there was no significant change in the total number of new HIV diagnoses in comparison with the year 2009 (N=2,885). Since 2007, the increase in new HIV diagnoses has significantly slowed down.
"Data on the route of transmission was available for 85% (n=2,482) of the newly diagnosed HIV infections in the year 2010. The share of persons who probably contracted an HIV infection through injecting drug use was at 3.7%.
"The number of new HIV diagnoses in IDUs dropped with 93 reported cases in 2010 (2009: 101) to the lowest level ever recorded since the start of differentiated data collection in the year 1993. Moreover, the decline of new HIV diagnoses is connected with a change in the age structure: the portion of the below 30-year olds decreased from von 35% in the year 2006 to little less than 23% in the year 2010.
"The portion of the new HIV diagnoses in IDUs reported from North Rhine-Westphalia used to be overproportionally high (45%) in relation to the number of inhabitants in the past, in 2010 however, it declined to 31%.
"The majority of the newly diagnosed HIV infections in IDUs were contracted in Germany. 10% of the infections were contracted in Eastern Europe. Central Europe was mentioned for the first time in 2010 more often as an infection region than Western Europe (4% vs. 1%). In view of the small case figures, it would however be too early to speak of an increasing HIV epidemic in IDUs in Central Europe (RKI 2011a)."

(Prevalence of New AIDS Cases Among IDUs) "Between 1.1.2008 and 31.12.2010, a total of 1,337 cases of new AIDS infections were reported to the RKI [Robert Koch Institute] (notifications until 1.3.2011). With this, the total number of persons with full blown AIDS has increased to 28,027 since the start of the epidemic. There are however considerable divergences between regions to be found with regard to completeness of the reported AIDS-cases.
"Among the new AIDS cases registered between 1.1.2008 and 31.12.2010, 82% were men and 18% women. With 7% of the infected men and 14% of the infected women, injecting drug use was for both genders in third place on the list of known infection risks. For 22% of the reported AIDS cases among men and 18% of the AIDS cases among women, there was no information given on the infection risk (RKI 2011a)."

(Mortality Related to Drug Use) "The reliability of information on drug-induced deaths strongly depends on the question as to whether autopsies and toxicological examinations have been used to validate the initial classification as drug-induced death or not (cf. chapter 6.1). The autopsy rate of all drug-induced deaths in the reporting year 2010 was on average at 66% (2009: 66%; 2008: 62%), whereby individual Laender considerably diverged from this value.
"In the year 2010, a total of 1,237 people died because of the use of illicit drugs which corresponds to a decline of seven percent in comparison with the previous year (1,331). Overdose of heroin (including use of heroin in connection with other drugs) remains with 855 cases the most common cause of death (69%; 2009: 70%; 2008: 66%). The portion of drug-related deaths in which substitution substances alone or in combination with other drugs were detected, was at 14% (2009: 13%; 2008: 12%); in 2002, this portion was still at 40%. Since 2006, the statistics of the federal criminal police office discriminate in the detected substitution substances between methadone/polamidone and subutex® (buprenorphine). According to the BKA data, the majority of death cases that were attributable to one substitution substance alone happened in connection with methadone/polamidone (N=45; 88%). Among the 116 death cases, in which substitution drugs in combination with other drugs were found, there were also two cases in which buprenorphine was detected¹¹¹ (see also Table 6.1) (BKA 2011b)."

(Users of Hard Drugs Who Have Come to the Attention of the Police, 2009-2010) "The overall figure of users of hard drugs increased from the year 2009 to the year 2010 by 2.7% to a total of 18,621 (2009: 18,139). As in the previous years, pronounced declines were found for heroin (2010: 3,201; 2009: 3,592; -10.9%) and cocaine (2010: 3,211; 2009: 3,591; - 10.6%). As in the previous years, the number of ecstasy users who came to the notice of the police for the first time strongly declined (2010: 840; 2009:1,357; -38.1%). Following the trend of previous years, the number of users of amphetamines who came to the notice of the police for the first time113 increased (+12.8%) and reached a new peak in 2010 (12,043 cases; 2009: 10,679).
"At respectively low overall figures, the figures for methamphetamine users who came to the notice of police for the first time increased strongly (2010: 642; 2009: 364; +76.4%) and so did the ones for crack (2010: 311; 2009: 181; +71.8%), whereas figures for LSD (2010: 141; 2009: 127; +11.0%) and other “hard“ drugs (2010: 333; 2009: 321; +3.7%) increased slightly. First-time offenders in connection with amphetamines accounted for little less than 2/3 (64.7%) of the total of first-time offenders (heroin: 17.2%; cocaine: 17.2%, ecstasy: 4.5%, crack: 1.7% and others including LSD: 2.5%)114in 2010. In this statistical documentation cannabis users are not taken account of since only so-called hard drugs are recorded (BKA 2011a)."

(Treatment Use, by Substance) "For the year 2010, the German Statistical Report on Treatment Centres for Substance Use Disorders contains data on the main diagnoses of a total of 60,473 treatments from N=776 facilities that were started or completed in outpatient psychosocial addiction support centres because of problems with illicit drugs. The main diagnoses are based on the diagnostic categories of the international classification system of the WHO (ICD 10) for disorders caused by psychotropic substances (harmful use or dependence).
"When looking at the DSHS data and confining oneself to illicit substances, one finds that meanwhile less than half of the clients (46.3%; 2009: 47.5%) sought treatment or counselling primarily for dependence on or harmful use of opioids84. The portion of persons primarily treated for disorders in connection with the use of opioids has been on a continual decline since 2007. In more than a third of the cases (35.6%; 2009: 35.4%), clients were treated for primary cannabis problems. After having increased over the last years, this portion has stabilized. On the rise is the portion of clients who receive counselling and treatment because of problems connected to the use of stimulants (8.2%; 2009: 6.6%). The comparative values for cocaine (5.9%; 2009: 6.3%) and other substances practically remained unchanged in comparison with the previous year."

(Primary Substance of Abuse, Clients Entering Treatment) "Among the persons who underwent addiction therapy for the first time, cannabis clearly led the league with a nearly unchanged share in all substances (59.8%; 2009: 61.0% of all clients) and was followed at a clear distance by the portion of clients treated for opioids for the first time. Their portion continued to decline (17.7%; 2009: 18.3%), whereas the portion of users of stimulants (12.5%; 2009: 10.2%) increased (Table 5.1). The portion of persons with cocaine-related disorders declined also among the patients treated for the first time in comparison with the previous year (6.6%; 2009: 7.2%). The portions of all other substance groups practically remained unchanged in respect of the previous year.
"Secondary addiction diagnoses made in addition to the main diagnosis are relatively common. Out of the clients with primary opioid-related problems⁸⁵ about one in four (24.3%) also displayed an alcohol-related disorder (dependence or harmful use) or a disorder in connection with the use of cocaine (20.6%) (Table 5.2) in 2010. Dependence on or harmful use of cannabis continued to represent the most common non-opioid secondary diagnosis in this patient group (31.8%)."

(Access to Substitution Treatment) "The most recent census carried out within the framework of the substitution register permits to make inferences about the number of persons reached on a set day but not over the course of the year. The number of persons recorded on the census day of each calendar year (01.07.) increased continually since the inception of the register and significantly from 46,000 in the year 2002 to 77,400 in 2010 (BOPST 2011). As in 2009, approximately 190 double treatments could be detected in the year 2010 through the substitution register.
"Access to substitution treatment is subject to strong regional divergences. Still only 3.0% (N=2,336; 2009: 2.9%; N=2,195) of the patients reported to the register (cut off date: 01.10.2009) and 5.2% (N=140; 2009: 4.8%, N=130) of the substituting doctors are from the eastern Laender (without Berlin) (BOPST 2011). Experts and people eligible for substitution treatment still rate the availability of substitution offers especially outside of larger cities as insufficient (Stoever 2010b, Stoever 2011). An alternative explanation of the low figures could be that the number of opiate users in rural regions is smaller than in city regions."

(Parents in Treatment) "A total of N=11,627 persons receiving supervision/assistance or undergoing treatment live in the same household with at least one child. The largest group of clients (principal diagnosis opioids) are the group living with at least one child in a household (n=7,465, 17.4%) (see Table 12.3). Clients with a principal diagnosis of cannabis compose the second largest group of clients and also the second largest group living with children in the same household (n=2,340). With other principal diagnoses the figure is 17.1% (n=781) for persons with a principal diagnosis of cocaine, 15.3% (n=713) for persons with a principal diagnosis of stimulants and 20.5% (n=317) for persons with a principal diagnosis of sedatives/hypnotics. With all main diagnoses, more than half of the clients living in a household with children live with one child and more than one-fourth with two children in the same household. (see Table 12.3).
"The majority of clients at ambulatory facilities do not live alone. Out of the total principal diagnosis, the persons not living alone account for between 58.5% (principal diagnosis opioids) and 62.1% (principal diagnosis stimulants). Among these the percentage of persons who live with children varies considerably. While somewhat more than one in every ten clients not living alone with a principal diagnosis of cannabis lives with children (11.0%), among persons with a principal diagnosis of stimulants this figure is almost one in every five (18.2%). The figure for persons with a principal diagnosis of cocaine is 22.8% and a principal diagnosis of opioids is 25.0%. The share among persons with a principal diagnosis of sedatives/hypnotics is even more than one in every three at 36.9% (see Table 12.5)."

(Syringe Vending Machines) "Especially syringe dispensing machines can provide 24h supply for sterile drug use equipment for drug users. With approximately 160 syringe dispensing machines, Germany has the largest number of syringe dispensing machines worldwide. In the year 2009, approximately 380,000 boxes with syringes, needles and accessories were dispensed in this way. Nevertheless, the syringe exchange programme is far from covering the whole of Germany – there are still no locations in six Laender. Only North Rhine-Westphalia (with about 100 dispensing machines) and Berlin (17 dispensing machines) have a well developed network."

(Availability of Drug Consumption Rooms) "In view of the still highly risky use pattern linked with heroin, drug consumption rooms and low-threshold facilities play an important role in offering help for addicted people at an early stage. Drugs are brought along to drug consumption rooms by the drug users themselves. Infection prophylaxis forms systematically part of the service provided. Paraphernalia brought along to the consumption rooms may not be used. The goal of this initiative is to secure the survival and stabilization of the health conditions of the drug users as well as to attract drug users who can otherwise not be reached by the system in order to provide them with motivational offers to quit drug use. Based on §10a of the Narcotics Act, which defines minimum requirements for the operation of these facilities, the governments of the Laender may pass regulations specifying the authorization criteria to be fulfilled for setting up and running drug consumption rooms.
"In 6 out of 16 Laender, corresponding regulations have been passed. According to a survey carried out among the Laender, there are currently 28 drug consumption rooms with 251 consumption places (Floeter & Pfeiffer-Gerschel 2011)."

(Lives Saved By Drug Consumption Rooms) "The German aids help organization Deutsche AIDS-Hilfe conducted a national survey on drug emergencies that occurred in 2009 in drug consumption rooms in order to be better able to assess what contribution consumption rooms can make to avoiding drug-related deaths. With 13 facilities from eleven cities, half of all consumption rooms in Germany took part. During the six-month period of enquiry, a total of 266 drug-related emergencies were documented, out of which 263 could be evaluated. 139 cases (53%) were classified as ”light“ or “moderately severe“, 124 (47%) as “severe“ or ”life threatening“. According to the author, it can be assumed that 47% of the people affected would in all probability not have survived the emergency in a different setting (e.g. in their own flat or in public space) and thank their lives to the competent intervention of the consumption room staff (Schaeffer & Stoever 2011)."

Laws & Policy

(Evolution of National Drug Strategy) "In Germany, the term ‘drug policy’ is undergoing a gradual change of meaning. Until the end of the last century, it was exclusively related to illicit drugs that were at the centre of the political interest. There was no comparable conception neither for an alcohol or tobacco policy nor for an ‘addiction‘2 policy, comprising the whole range of addictive substances. Since a few years however, (1) disorders resulting from licit psychotropic substances and (2) common aspects of all substances (e.g. in universal prevention or in patients with multiple abuse) as well as non-substance-related forms of addiction3 (e.g. pathological gambling) have increasingly moved into the focus of the political interest. This is the reason why the terms ‘drug and addiction policy’ or ‘addiction policy’ find more frequent use gradually replacing the term ‘drug policy’. As a result of the differences in the policy aims pursued and strategies deployed in the area of licit and illicit substances, the term ‘drug and addiction policy’ finds preferred usage in the German language.
"Moreover, the range of vision is expanding from the original main focus on substance-related addiction to risky and harmful use and thus to a comprehensive understanding of health policy for substance-related disorders and risks. However, in the German language there is no appropriate term reflecting this expansion of the concept, so that the term of ‘addiction policy’ continues to be used. As a consequence, licit substances and common strategies for both licit and illicit substances have to be taken into account in the annual reports of the DBDD. In many cases however, it is not possible any more to set the two categories apart due to technical and political developments. Nevertheless, in line with the guidelines given for the topic of this report, exclusively illicit substances will be taken into consideration, where possible. Non-substance-related addiction is currently of no relevance for this report."

(New National Strategy) "The National Board on Drugs and Addiction of the 17 legislative period set to work in its constituent meeting on 10 November 2010. The Board serves as an advisory body for the Federal Government Commissioner on Narcotic Drugs. Like in the past, the Board is made up of experts from science, politics, administration, associations and institutions of the health care system. In its first session, the National Board on Drugs and Addiction debated at length on its tasks, goals and subjects areas that need to be dealt with. Moreover, the Board appointed the working groups “Prevention of Addiction“ and “Interfaces in the care of addicts“. The members and the rules of procedure of the National Board on Drugs and Addiction can be looked up at the website www.drogenbeauftragte.de.
"National strategy for a modern drug and addiction policy
"Today’s drug and addiction policy is faced with new challenges and needs to keep abreast of the developments of the last years. The Federal Government Commissioner on Narcotic Drugs has set herself the goal of combining the basic principles and targets of this policy in a “national strategy of drug and addiction policy“. This strategy is to replace the Action Plan for Fighting Drugs and Addiction that ran from 2003 to 2009. To this purpose, a modern and contemporary strategy for a drug and addiction policy was developed in 2010 that is currently coordinated with the departments of the Federal Government. It describes the challenges to be taken up and the basic principles to be followed by responsible drug and addiction policy and outlines concrete political measures and goals for the years to come. Hereby, current developments and activities undertaken by the government are taken into account as well as new use patterns and forms of addiction. The strategy comprises international initiatives and activities undertaken at the European and international level. This strategy is to react to the challenges posed to our society in the future by demographic change, societal transformations but also new forms of addiction."

(Needle and Syringe Access) "Prevention of drug-related infectious diseases by low-threshold drug help facilities consists mainly of providing information on infectious diseases and risks as well as distributing safer use articles. Distribution of needles and needle exchange is explicitly permitted by the Narcotics Act and is also practiced by many facilities."

(Law on Heroin Maintenance) "On 28 May 2009, the German Bundestag passed the “Act on diamorphine-assisted substitution therapy“ creating the legal preconditions for a transfer of the diamorphine-assisted therapy into regular care by changing the Narcotics Act, the Medical Products Act and the Regulation on the Prescription of Narcotic Drugs. The act stipulates among others that diamorphine (pharmaceutically produced heroin) becomes eligible to prescription – on very narrow criteria – as a narcotic drug used for heavily dependent opioid addicts. The act was then presented to the Bundesrat and finally endorsed in a plenary session on 10 June 2009. The Act on diamorphine-assisted substitution therapy entered into force on 21 June 2009.
"The act makes it possible for the findings of a clinical study funded by the Federal Ministry for Health, which investigated the treatment of heavily dependent opioid addicts with diamorphine in comparison with a methadone-assisted treatment, to be turned into actual practice (cf. the REITOX Reports 2007 and 2008).
"Government funding for the Laender and municipalities that participated in the demonstration project stopped end of February 2008. The Federal Government continues to fund the documentation and the monitoring of the diamorphine-assisted therapy in Germany till the end of 2011 in order to ensure quality assurance in terms of course of therapy, therapy standards and effects."

(Discontinuation of Prosecution in Cases of Personal Use Amounts) "The German Narcotics Act § 31a provides for the possibility to discontinue prosecution for possession of drugs under certain circumstances, namely when the offender has grown, produced, imported, exported, bought or received and possessed in any other way narcotic substances in small amounts exclusively for personal use and when his guilt is deemed as minor and there is no public interest in prosecution. This provides the public prosecutor with an instrument to stop proceedings for consumption-related offences without court approval.
"All Federal Laender have regulated details of the application of § 31a BtMG through recommendations or guidelines. These guidelines considerably diverged from each other in the individual Laender a few years ago, but have meanwhile largely converged. Some divergences in the Laender regulations do however persist (cf. Schaefer & Paoli 2006).
"Threshold values for “small amounts” of cannabis and other substances
"Most of the Laender have introduced comparable threshold values for “small amounts“ (upper/lower limit) for cannabis. The limits set by the individual Laender are guideline values from which public prosecutors and judges may diverge in individual cases. There is no legal claim to the discontinuance of prosecution in the case of possession of small quantities of drugs. However, discontinuance of prosecution does not automatically mean that the crime has no consequences. Public prosecutors have the right to stop proceedings under certain conditions (e.g. community service, fines or counselling in a social institution)."

(Alternatives to Prison) "According to §63 and §64 of the Penal Code (Strafgesetzbuch, StGB) it is possible under certain circumstances to order the placement of mentally ill or addicted offenders in special closed correctional facilities (like psychiatric facilities or withdrawal clinics).
"The Narcotics Act (Betaeubungsmittelgesetz, BtMG) allows the suspension of proceedings in cases of minor guilt or lack of public interest in prosecution (§31a BtMG). This applies mainly to consumption-related offences, in particular when they occur for the first time and third parties are not involved. These regulations are subject to different regional application as shown by a study carried out by Schaefer & Paoli (2006). With regard to the prosecution of consumption-related offences involving cannabis, there has recently been a move to greater convergence of the definitions of limit values for “small quantities“ in the Laender in line with the guidelines passed by the Federal Constitutional Court. Further details can be found in chapter 1.2.2.
"It is moreover possible to defer a prison sentence of up to two years to provide the drug addict with the chance to undergo therapy (“therapy instead of punishment“, §35 BtMG).
"The Federal Association for Inpatient Addiction Help (buss 2010) notes that since 2010 an increasing number of petitions for the deferment of sentences according to §35 BtMG have been rejected on the grounds of „lacking causal connection“ between the offence and drug dependence. A more restricted interpretation of the causal connection has recently lead to a in part massive decline in the admissions to therapy facilities which is intensified by a judgement rendered by the Federal High Court of Justice on 04.08.2010 (5 AR (VS) 23/10) abolishing the common practice of reversing the prosecution order with the effect that a lot of petitions for the deferment are bound to be rejected."

(Reintegration of Drug Users After Release from Prison) "With regard to the preparation of the release of detainees from prison, the legal framework establishes that detainees are to receive assistance upon prison release (§ 74 Prison Law in connection with § 15 Prison Law) with a view to promote societal integration after prison. In order to reach this goal prison services are to cooperate at inter-departmental level (§ 154 Prison Law). Moreover, providers of social security services are to form networks and cooperate with the competent agencies to complement each other in the pursuit of the same goal (§ 68 paragraph 3 Social Code XII and § 16 paragraph 2 Social Code II). Corresponding strategies and measures are developed and implemented under the term transition management. On the one hand, it is tried to facilitate a smooth transition from prison to freedom with integration into training, work and employment, on the other, to tackle problems linked with detention and criminal careers. The main task of transition management is to improve the situation of the clients by offering them counselling and care but also possibilities of professional qualification and training as well as job placement.
"Although from an historic viewpoint there have been corresponding efforts undertaken already 150 years ago with the introduction of the assistance for offenders and the introduction of the probation service in the 1950s, the discussion and the implementation of a transition management still require further development."

(Employment Assistance for People with Addiction-Related Illnesses) "Within the framework of the content-related and structural further development of existing rehabilitation offers, the targeted promotion of employment opportunities of jobless rehabilitants by the Pension Insurances has become an integral part of the therapy for persons with addiction-related illnesses. It comprises for example indicative groups with regard to unemployment and trainings for job application. From the viewpoint of the social security administration, the central goal of addiction therapy is to restore the working capacity. Apart from somatic aspects also psychological factors – i.e. personal and social competences of the clients – are taken into account to prepare clients for working life.
"Persons with drug-related problems do not seldom form part of the target groups of specific programs offered by employment agencies to promote reintegration of long-term unemployed people on the labour market. However, in general, the available statistical material does not provide specific data on this sub-group, so that measures undertaken and results achieved for this group cannot be presented separately in this report."

(Drug Control Spending) "Adding the identified and calculated expenditures, one gets a range between 5.2 and 6.1 billion EUR spent in 2006 for the area of illicit drugs which breaks down as follows: the portion of the German National Statutory Pension Insurance in the funding for medical rehabilitation, participation in working life and benefits granted for the reduction in earning capacity amounted to about 172 million EUR. The extrapolation of the expenditures of the medical health insurance institutions for medication, hospital treatment, rehabilitation etc. came to 1.4 billion EUR. At the institutional level, an amount of 3.6 to 4.5 billion EUR was provided for the prevention and reduction of the consequences of drug-related problems in the form of prevention, intervention and repression measures."