Drug War Facts

International Facts, Policies and Trends: Data From Various Nations

  1. Overview

    1. "The EU drug strategy 2005–12, adopted by the European Council in December 2004, takes into account the results of the final evaluation of progress made during the previous period (2000–04). It aims to add value to the national strategies while respecting the principles of subsidiarity and proportionality set out in the treaties. It sets out two general goals for the EU with regard to drugs: "-to achieve a high level of health protection, well-being and social cohesion by complementing the Member States' action in preventing and reducing drug use and dependence and drug-related harm to health and the fabric of society; "-to ensure a high level of security for the general public by taking action against drug production and supply and cross-border trafficking, and intensifying preventive action against drug-related crime through effective cooperation between Member States."

      Source: "Annual Report 2005: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2005), p. 18.

    2. "Important policy differences between European Member States still exist, often reflecting differences in the national drug situations and in the configuration of responses. Nonetheless, the new drug strategy suggests that the European policy debate on drugs is increasingly characterised by agreement on a common framework for activities. For example, virtually all demand reduction strategies include prevention, treatment and harm reduction elements, although the emphasis on each varies between Member States."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 11.

    3. "A continuing trend, again evident in the new information reported this year, is for changes to national drug laws to emphasise more strongly a distinction between offences of drug possession for personal use and those involving trafficking and supply. Generally, there is a shift towards increased penalties for the latter and a reduced emphasis on custodial sentences for the former. This development is in line with a greater emphasis overall across Europe on widening the opportunities for drug treatment and on giving more attention to interventions that divert those with drug problems away from the criminal justice system towards treatment and rehabilitation options."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 11.

    4. "For those countries that have made a legal distinction with respect to the possession of drugs for use rather than supply, the question arises whether there is an explicit need to legislate on what quantities of drugs constitute a threshold for personal use. Here no consensus currently prevails and different approaches have been adopted across Europe, ranging from the issuing of general operational guidelines through to specification of legal limits."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 11.

    5. "Although expenditure is frequently measured over differing time periods, and there is no common definition of drugrelated public expenditure, available estimates suggest that drug spending has increased in several countries, including the Czech Republic, Denmark, Luxembourg, Austria and Poland. "Countries reporting drug expenditure for the year 2004 included the Czech Republic (EUR 11.0 million), Spain (EUR 302 to 325 million), Cyprus (EUR 2.8 million), Poland (EUR 51 million) and Norway (EUR 46 million). Two countries reported more recent budgeted expenditure for tackling drugs: Luxembourg (EUR 6 million in 2005) and the United Kingdom (EUR 2 billion in 2004/05). "In Slovakia, it is estimated that total public expenditure in the field of drugs in 2004 was EUR 14.5 million, of which law enforcement accounted for approximately EUR 8.4 million and social and healthcare for EUR 6.1 million. "In Sweden, it is estimated that drug policy expenditure during 2002 was around EUR 0.9 billion (lower estimate EUR 0.5 billion, higher estimate EUR 1.2 billion). Comparing the 2002 estimates with figures for 1991 shows that public expenditure on drug policy has increased substantially. "In Ireland, the mid-term review of the national drug strategy, published in June 2005, recognises that 'a measure of the expenditure is vital to gauge the cost effectiveness of the different elements of the strategy', and work will commence shortly to estimate police expenditure. In Portugal, the Institute for Drug and Drug Addiction (IDT) is funding research to develop and test a model to estimate the costs of drug abuse, and in Belgium a follow-up to a 2004 study on public expenditure was instituted at the end of 2005. Although sparse, these interesting data show that research on drug expenditure constitutes an increasingly important part of the policy agenda of some Member States."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 18-19.

    6. "Differences in the prevalence of drug use are influenced by a variety of factors in each country. As countries with more liberal drug policies (such as the Netherlands) and those with a more restricted approach (such as Sweden) have not very different prevalence rates, the impact of national drug policies (more liberal versus more restrictive approaches) on the prevalence of drug use and especially problem drug use remains unclear. However, comprehensive national drug policies are of high importance in reducing adverse consequences of problem drug use such as HIV infections, hepatitis B and C and overdose deaths."

      Source: European Monitoring Center for Drugs and Drug Addiction, "2001 Annual Report on the State of the Drugs Problem in the European Union" (Brussells, Belgium: Office for Official Publications of the European Communities, 2001), p. 12.

    7. "In Europe, the scope of drug policies is beginning to stretch beyond illicit drugs and to encompass other addictive substances or even types of behaviour. This is found in the drug policies of some Member States and in EU drug strategies. Increasingly, research is addressing the issue of addiction or addictive behaviours irrespective of the substances concerned."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 25.

    8. "It can thus be concluded that consumption trends move in different directions in the European countries in question (Norway and the 15 countries which until recently made up the EU), the result being in fact a convergence of consumption patterns: 'wine countries' reduce their wine consumption and see beer and spirits account for ever-larger shares of total alcohol consumption, while trends are the direct opposite in typical 'spirits countries'. This convergence across countries of consumption levels also brings about a convergence of alcohol-related mortality. This is true in particular of liver-cirrhosis mortality, which has been falling in the 'wine countries' of the EU and rising in the 'beer countries' while Norway, Finland and Sweden, taken together, manifest a fairly stable level."

      Source: Centralfφrbundet fφr alkohol- och narkotikaupplysning, "Drogutvecklingen i Sverige 2006" (Stockholm, Sweden: CAN, 2006), Report No. 98, p. 34.

    9. "When it comes to alcohol policy, it seems that the 15 'old' EU member states have converged to some extent. While alcohol policy has grown weaker in Finland and Sweden, several other countries -- including Southern European ones -- have reinforced their policies, for instance by lowering legal blood-alcohol levels for drivers and introducing stricter age limits for purchasing alcohol in both shops and restaurants."

      Source: Centralfφrbundet fφr alkohol- och narkotikaupplysning, "Drogutvecklingen i Sverige 2006" (Stockholm, Sweden: CAN, 2006), Report No. 98, p. 34.

  2. Prevalence Estimates

    1. "Cannabis is the illegal substance most frequently used in Europe. Its use increased in almost all EU countries during the 1990s, in particular among young people, including school students. "It is estimated that about 65 million European adults, that is about 20% of those aged 15–64, have tried the substance at least once, although it should be remembered that most of these will not be using the substance at the present time. National figures vary widely, ranging from 2% to 31%, with the lowest figures in Malta, Bulgaria and Romania, and the highest in Denmark (31%), Spain (29%), France (26%) and the United Kingdom (30%). Of the 25 countries for which information is available, 13 presented lifetime prevalence rates in the range 10–20%."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 38.

    2. "Use of illegal drugs, including cannabis, is concentrated mainly among young people. In 2004, between 3% and 44% of Europeans aged 15–34 reported having tried cannabis, 3–20% had used it in the last year, and 1.5–13% had used it in the last month, with the highest figures again coming from the Czech Republic, Spain and the United Kingdom. The European averages for this age group are 32% for lifetime use, 14% for last year use (compared with 2% for 35- to 64-year-olds) and over 7% for last month use (compared with 1% for 35- to 64-year-olds). "Cannabis use is even higher among 15- to 24-year-olds, with lifetime prevalence ranging between 3% and 44% (most countries report figures in the range 20–40%), last year use ranging from 4% to 28% (in most countries 10–25%) (Figure 2) and last month use ranging from 1% to 15% (in most countries 5–12%), with higher rates among males than females. In the new Member States levels of cannabis use among young adults aged 15–24 are typically in the same range as those in the EU-15 Member States, but among older age groups rates of use drop substantially."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 39.

    3. "By contrast, in the 2004 US national survey on drug use and health (60), 40.2% of adults (defined as aged 12 years and older) reported lifetime use [of cannabis], compared with the EU average of about 20%. This is higher even than in those European countries with the highest lifetime rates (Denmark 31.3% and the United Kingdom 29.7%) although differences in last year use estimates are less marked: this figure is 10.6% in the United States compared with a European average of 7%, and several European countries reported figures similar to those found in the United States."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 39-40.

    4. "Although the predominant European trend since the mid-1990s has been upward, some countries exhibit a more stable pattern. For example, although rates of cannabis use in the United Kingdom since the 1990s have been particularly high, they have remained stable over this period. In addition, there has been little change in the levels of cannabis use in several low-prevalence countries, including Finland and Sweden in the north of Europe and Greece and Malta in the south. Most of the increases in cannabis use recorded in ESPAD since 1999 have occurred in the new EU Member States. Analysis of school data and general population survey evidence suggests that, on most measures, the Czech Republic, Spain and France have now joined the United Kingdom to form a group of high-prevalence countries."

      Source: "Annual Report 2005: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2005), p. 11.

    5. "In many European countries the second most commonly used illegal substance is some form of synthetically produced drug. The use of these substances among the general population is typically low, but prevalence rates among younger age groups are significantly higher, and in some social settings or cultural groups the use of these drugs may be particularly high. Globally, amphetamines (amphetamine and methamphetamine) and ecstasy are among the most prevalent synthetic drugs."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 47.

    6. "Globally, Europe remains the main centre of ecstasy production, although its relative importance appears to be declining as ecstasy manufacture has spread in recent years to other parts of the world, notably to North America (United States, Canada) and East and South-East Asia (China, Indonesia, Hong Kong) (CND, 2006; UNODC, 2006). Although the Netherlands remained in 2004 the main source of ecstasy for Europe and the world as a whole, ecstasy laboratories were also uncovered in Belgium, Estonia, Spain and Norway (Reitox national reports, 2005; UNODC, 2006). The ecstasy seized in the EU is reported to originate from the Netherlands and Belgium, and to a lesser extent Poland and the United Kingdom (Reitox national reports, 2005)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 48.

    7. "Traditionally, population surveys have shown that, next to cannabis, amphetamines and ecstasy are the illegal substances most commonly used, albeit the overall prevalence of their use is lower than that of cannabis. Use of ecstasy became popular during the 1990s, whereas amphetamines have been used for much longer."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 50.

    8. "Among EU Member States, use of amphetamines and ecstasy appears to be relatively high in only a few countries, namely the Czech Republic, Estonia and the United Kingdom. Recent surveys among the adult population (15–64 years) report that lifetime prevalence of amphetamine use in Europe ranges from 0.1% to 5.9%, except in the United Kingdom (England and Wales), where it reaches 11.2%. On average about 3.1% of all European adults have used amphetamines at least once. After the United Kingdom, the countries with the next highest figures are Denmark (5.9%), Norway (3.6%) and Germany (3.4%). Last year use is much lower: 0.6% on average (range 0–1.4%). Based on general population surveys, it has been estimated that almost 10 million Europeans have tried this substance, and more than 2 million will have used amphetamine in the previous 12 months."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 50-51.

    9. "Among young adults (15–34 years) experience of amphetamine use is reported by 0.1–9.6%, with the United Kingdom (England and Wales) reporting a lifetime prevalence rate of 16.5% (which may reflect a historical phenomenon, see below). Half of the countries providing data have prevalence rates below 4%, with the highest rates after the United Kingdom reported by Denmark (9.6%), Norway (5.9%) and Germany (5.4%). An average of 4.8 % of young Europeans have tried amphetamine. Denmark (3.1%) and Estonia (2.9%) report the highest last year prevalence rates. It is estimated that, on average, 1.4% of young Europeans have used amphetamine in the last year (see also Figure 4)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 51.

    10. "Ecstasy has been tried by 0.2–7.1 % of all adults [in EU member nations] (average 2.6%). Half of the countries report prevalence rates of 1.8% or lower, with highest prevalence rates being reported by the Czech Republic (7.1%) and the United Kingdom (6.7%). The prevalence of last year use of ecstasy ranges from 0.2% to 3.5%, but half of the countries report prevalence rates of 0.5% or below. It has been estimated that almost 8.5 million Europeans have tried ecstasy, and almost 3 million have used it in the last year."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 51.

    11. "Among young adults across the European countries, the prevalence of lifetime use of ecstasy is 5.2%, ranging from 0.5% to 14.6%, although rates of less than 3.6% are reported by half of the countries. The Czech Republic (14.6%), the United Kingdom (12.7%) and Spain (8.3%) report the highest prevalence rates."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 51.

    12. "For comparison, in the 2004 US national survey on drug use and health, 4.6% of adults (defined as 12 years and older) reported lifetime experience with ecstasy and 0.8% reported last year use (the corresponding figures for the EU are 2.6% and 0.9%). Among young adults aged 16–34 years, lifetime experience was 11.3%, and last year use 2.2% (5.2% and 1.9% respectively in Europe)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 51.

    13. "Lifetime experience of the use of LSD among adults ranges from 0.2% to 5.9%, with two thirds of countries reporting prevalence rates between 0.4% and 1.7%. Among young adults (15–34 years), lifetime prevalence of LSD use ranges from 0.3% to 9%, and among the 15–24 years age group it does not exceed 4.5%. The prevalence of last year use of this drug in the 15–24 years age group is over 1% only in the Czech Republic, Estonia, Latvia, Hungary, Poland and Bulgaria."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 51.

    14. "Based on recent national population surveys, it is estimated that about 10 million Europeans have tried cocaine at least once (lifetime prevalence), representing over 3% of all adults. National figures on reported use range between 0.5% and 6%, with Italy (4.6%), Spain (5.9%) and the United Kingdom (6.1%) at the upper end of this range. It is estimated that about 3.5 million adults have used cocaine in the last year, representing 1% of all adults. National figures in most countries range between 0.3% and 1%, although prevalence levels are higher in Spain (2.7%) and the United Kingdom (2%)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 59.

    15. "As with other illegal drugs, cocaine use is concentrated among young adults. Lifetime experience is highest among young adults aged 15–34 years, although last year use is slightly higher among 15- to 24-year-olds. Cocaine seems to be predominantly a drug used by those in their 20s, but, compared with cannabis use, cocaine use is less concentrated among younger people. Lifetime experience among 15- to 34-year-olds ranges from 1% to 10%, with the highest levels again found in Spain (8.9%) and the United Kingdom (10.5%). Last year use ranges between 0.2% and 4.8%, with the figures for Denmark, Ireland, Italy and the Netherlands being around 2%, and for Spain and the United Kingdom over 4% (Figure 6). Data from school surveys show very low lifetime prevalence for the use of cocaine, ranging from 0% in Cyprus, Finland and Sweden to 6% in Spain, with even lower lifetime prevalence rates for use of crack cocaine, ranging from 0% to 3% (Hibell et al., 2004)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 59.

    16. "A rough estimate of current cocaine use in Europe would be about 1.5 million adults aged 15–64 years (80% in the age range 15–34 years). This can be considered as a minimum estimate, given probable under-reporting."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 61.

    17. "For comparison, according to the 2004 United States national survey on drug use and health, 14.2% of adults (defined as 12 years or older) reported lifetime experience with cocaine, which contrasts with a European average of 3%. Last year use was 2.4%, compared with a European average of 1%, although in some EU countries, e.g. Spain (2.7%) and the United Kingdom (2%), reported figures are in the same range as in the United States. The comparatively higher lifetime figures in the United States may be in part related to earlier spread of cocaine use in that country."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 61.

    18. "The levels and patterns of illicit drug use in the selected English-speaking countries vary considerably (Table 4.3). Marijuana/cannabis use in the last 12 months was most prevalent in Canada (17%), and least prevalent in the Republic of Ireland and Northern Ireland (5%). Ecstasy and amphetamine use was most prevalent in Australia (4%). Cocaine use was most common in the USA (3%)."

      Source: Australian Institute of Health and Welfare, "Statistics on drug use in Australia 2006" (Canberra, Australia: Australian Institute of Health and Welfare, April 2007), Drug Statistics Series No. 18., Cat. no. PHE 80, p. 25.

    19. "Among young adults (aged 16–34), US figures [for cocaine use] were 14.6% (lifetime), 5.1% (last year) and 1.7% (last month), whereas the EU average figures for 15- to 34-year-olds were, respectively, about 5% (lifetime), 2% (last year) and 1% (last month)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 61.

    20. "Recent cocaine use (last year) increased markedly in the second half of the 1990s among young adults in the United Kingdom, until 2000, and in Spain, until 2001, with an apparent stabilisation in recent years. In Germany, a moderate increase was observed over the 1990s, but the figures have remained stable in recent years, at levels clearly lower than in Spain and the United Kingdom. "Moderate increases in last year use have been observed in Denmark (up to 2000), Italy, Hungary, the Netherlands (up to 2001) and Norway. This trend needs to be interpreted carefully as it is based on only two surveys in each country."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 61.

    21. "In Europe, two forms of imported heroin are found: the commonly available brown heroin (its chemical base form) and the less common and usually more expensive white heroin (a salt form), which typically originates from South-East Asia. In addition, some opioid drugs are produced within the EU, but manufacture is mainly confined to small-scale production of home-made poppy products (e.g. poppy straw, poppy concentrate from crushed poppy stalks or heads) in a number of eastern EU countries, for example Lithuania, where the market for poppy stalks and concentrate seems to have stabilised, and Poland, where production of 'Polish heroin' might be decreasing (CND, 2006)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 66.

    22. "Heroin consumed in Europe is predominantly manufactured in Afghanistan, which remains the world leader in illicit opium supply and in 2005 accounted for 89% of global illicit opium production, followed by Myanmar (7%)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 66.

    23. "Worldwide, tobacco consumption seems to have been in decline since around 1996. Per capita demand for cigarettes in the industrialised countries started to decline in the early 1980s, and while per capita demand has not declined overall in countries outside the OECD, demand growth has slowed down since about 1995, and no longer compensates for declining demand in the industrialised countries (van Liemt 2002). World unmanufactured tobacco supply was projected to decline nearly 14% in 2002 in an effort to bring supplies more in line with consumption (USDA 2002)."

      Source: Australian Institute of Health and Welfare, "Statistics on drug use in Australia 2006" (Canberra, Australia: Australian Institute of Health and Welfare, April 2007), Drug Statistics Series No. 18., Cat. no. PHE 80, p. 11.

  3. Problem Substance Use and Substance-Related Harm

    1. "Estimates of the prevalence of problem opioid use at national level over the period 2000–04 range between one and eight cases per 1,000 population aged 15–64 (based on midpoints of estimates). Estimated prevalence rates of problem opioid use differ greatly between countries, although when different methods have been used within one country the results are largely consistent. Higher estimates of problem opioid use are reported by Ireland, Italy, Luxembourg, Malta and Austria (5–8 cases per 1,000 inhabitants aged 15–64 years), and lower rates are reported by the Czech Republic, Germany, Greece, Cyprus, Latvia and the Netherlands (fewer than four cases per 1,000 inhabitants aged 15–64 years) (Figure 8). Some of the lowest well-documented estimates now available are from the new countries of the EU, but in Malta a higher prevalence has been reported (5.4–6.2 cases per 1,000 aged 15–64). One can derive from the limited data a general EU prevalence of problem opioid use of between two and eight cases per 1 000 of the population aged 15–64. However, these estimates are still far from robust and will need to be refined as more data become available."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 68-69.

    2. "Reports from some countries, supported by other indicator data, suggest that problem opioid use continued to increase during the latter half of the 1990s (Figure 9) but appears to have stabilised or declined somewhat in more recent years. Repeated estimates on problem opioid use for the period between 2000 and 2004 are available from seven countries (the Czech Republic, Germany, Greece, Spain, Ireland, Italy, Austria): four countries (the Czech Republic, Germany, Greece, Spain) have recorded a decrease in problem opioid use, while one reported an increase (Austria -- although this is difficult to interpret as the data collection system changed during this period). Evidence from people entering treatment for the first time suggests that the incidence of problem opioid use may in general be slowly declining; therefore in the near future a decline in prevalence is to be expected."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 69.

    3. "Getting homeless problem drug users into stable accommodation is the first step towards stabilisation and rehabilitation. Based on the estimated numbers of problem drug users and the proportion of homeless people among clients in treatment, there are approximately 75,600 to 123,300 homeless problem drug users in Europe. As facilities are currently available in most countries, and as some countries continue to implement new structures, the effect of these measures will depend on ensuring that homeless problem drug users can access these services."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 34-35.

    4. "In the Baltic states, the available seroprevalence data indicate that transmission among IDUs may still not be under control (Figure 10). In Estonia, a recent study suggests that prevalence in IDUs is increasing in one region (Tallinn: from 41% of a sample of 964 in 2001 to 54% of 350 in 2005) and exceptionally high in another (Kohtla-Jδrve: 90 % out of 100). In Latvia, two time series of seroprevalence data among IDUs show a continued increase until 2002/03 while a third series suggests a decrease since the peak in 2001. In Lithuania, data for 2003 suggest an increase in HIV among tested IDUs in drug treatment, needle exchanges schemes and hospitals, from between 1.0% and 1.7% during 1997–2002 to 2.4% (27/1,112) in 2003."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 75-76.

    5. "In the countries that have historically had high rates of HIV infection among IDUs (Spain, France, Italy, Poland and Portugal) there are new signs of continuing transmission at national level or in specific regions or among specific subgroups of IDUs. In these countries, it is important to note that the high background prevalence, resulting from the large-scale epidemics that occurred in the 1980s and 1990s, increases the likelihood that high-risk behaviour will lead to infection."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 76.

    6. "HIV prevalence among tested IDUs continues to vary widely between countries in the EU (Figure 10). In a number of countries HIV prevalence among IDUs has recently increased or has been high for many years. In contrast, in several countries, HIV prevalence among IDUs remained very low during 2003–04: HIV prevalence was less than or around 1% in the Czech Republic, Greece, Hungary, Malta, Slovenia (based on national samples), and in Slovakia, Bulgaria, Romania, Turkey and Norway (based on subnational samples). In some of these countries (e.g. Hungary), both HIV prevalence and hepatitis C virus (HCV) prevalence are among the lowest in Europe, suggesting low levels of injecting (see 'Hepatitis B and C'), although in some countries (e.g. Romania) there is evidence that the prevalence of hepatitis C is increasing."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 77.

    7. "The prevalence of antibodies against hepatitis C virus (HCV) among IDUs is, in general, extremely high, although there is wide variation both within and between countries. Prevalence rates of over 60% among various IDU samples tested in 2003–04 are reported from Belgium, Denmark, Germany, Greece, Spain, Ireland, Italy, Poland, Portugal, the United Kingdom, Romania and Norway, while prevalence rates less than 40% have been found in samples from Belgium, the Czech Republic, Greece, Cyprus, Hungary, Malta, Austria, Slovenia, Finland and the United Kingdom."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 77.

    8. "HCV antibody prevalence data among young IDUs (aged under 25) are available from 14 countries, although in some cases sample sizes are small. There is wide variation in results, with countries reporting both high and low figures from different samples. The highest prevalence rates among young IDUs in 2003–04 (over 40%) were found in samples from Belgium, Greece, Austria, Poland, Portugal, Slovakia and the United Kingdom, and the lowest prevalence (under 20%) in samples from Belgium, Greece, Cyprus, Hungary, Malta, Austria, Slovenia, Finland, the United Kingdom and Turkey. Considering only studies of young IDUs with national coverage, the highest prevalence rates (over 60%) are found in Portugal and the lowest (under 40%) in Cyprus, Hungary, Malta, Austria and Slovenia. Although the sampling procedures used may result in bias towards a more chronic group, the high prevalence of HCV antibodies found in a national sample in Portugal (67% among 108 IDUs under 25 years) is still worrying and may be indicative of continuing high-risk behaviour among young IDUs."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 77-78.

  4. Harm Reduction Efforts

    1. "Harm reduction strategies form an important part of the European response to drug use today, and improving access to services for the prevention and reduction of health-related harm is a main priority of the EU drug strategy 2005–12. The common strategic platform on the reduction of health related harm that the EU drug strategy provides is mirrored in many national policies across the EU and has supported a mainstreaming of evidence-based responses in this area."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 33.

    2. "Experiences in some Member States suggest that drug prevention interventions at the individual level may be more effective if also supported by regulatory policies on legal drugs that can limit the access of young people to these substances and reduce their social acceptability. As a result, environmental prevention strategies that address the normative and cultural framework of substance use are gaining ground in parts of Europe, supported by the first steps taken at EU level: the tobacco advertisement directive and the WHO framework convention on tobacco control."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 27.

    3. "While health promotion — as a framework condition for prevention — strives to encourage people to adopt healthy lifestyles and to create healthy living conditions for all, the new term 'public health prevention' is increasingly mentioned by some Member States (Italy, Netherlands, Slovakia) and Norway. Public health prevention entails a range of prevention measures aimed at improving the health of vulnerable sections of society, among which drug prevention is one element. These measures are particularly suited to the needs of young people, whose problem behaviours, including drug use, are strongly conditioned by vulnerability (social and personal) and by living conditions."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 27.

    4. "The reduction of drug-related deaths was defined for the first time as a European drug policy objective six years ago, and it is an objective of the current EU action plan. The number of countries which include a direct reference to the target of reducing drug-related deaths in their national policies has continued to increase in recent years, with eight countries adopting such strategies during 2004 and 2005 (bringing the total number to 15). Besides national policies, complementary approaches at city level are common: several capital cities (including Athens, Berlin, Brussels, Lisbon and Tallinn) but also wider semi-urban regions (e.g. the eastern region of Ireland, around Dublin) have their own strategies for reducing drug-related deaths. In the Czech Republic, Italy, the Netherlands and the United Kingdom, local or regional policies are reported to exist, and in Bulgaria strategies have been drawn up at local level in nine cities."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 31.

    5. "In many EU countries, strategies aimed at reducing infectious disease are clearly geared towards HIV/AIDS, particularly Estonia, Spain, Cyprus, Latvia and Lithuania. However, in 10 countries (37%), infectious disease strategies explicitly mention the prevention of hepatitis C infection among drug users. Ireland launched a consultation process in 2004, preparing such a strategy, and in Germany recommendations on prevention and treatment were issued. Professional and public discussion in Austria was boosted by an international conference on the topic held in Vienna in 2005."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 32-33.

    6. "Although most European countries now distribute sterile injecting equipment, the nature and range of provision vary between countries. The most common model is to provide the service in a fixed location, usually a specialised drugs service, but often this type of provision is complemented by mobile services that attempt to reach out to drug users in community settings. Syringe exchange or vending machines complement the available NSP services in eight countries, although provision appears to be restricted to a handful of sites, with only Germany and France reporting substantial activities (around 200 and 250 machines respectively). Spain is the only EU country where needle and syringe exchange is regularly available in a prison setting, with provision available in 27 prisons in 2003. The only other EU country reporting activity in this area is Germany, where provision is limited to one prison."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 79.

    7. "Pharmacy-based exchange schemes also help to extend the geographical coverage of the provision and, in addition, the sale of clean syringes in pharmacies may increase their availability. The sale of syringes without prescription is permitted in all EU countries except Sweden, although some pharmacists are unwilling to do so and some will even actively discourage drug users from patronising their premises."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 79.

    8. "Formally organised pharmacy syringe exchange or distribution networks exist in nine European countries (Belgium, Denmark, Germany, Spain, France, the Netherlands, Portugal, Slovenia and the United Kingdom), although participation in the schemes varies considerably, from nearly half of pharmacies (45%) in Portugal to less than 1% in Belgium. In Northern Ireland, needle and syringe exchange is currently organised exclusively through pharmacies."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 79.

    9. "The purchase of syringes through pharmacies may be a major source of contact with the health service for some injectors, and the potential to exploit this contact point as a conduit to other services clearly exists. Work to motivate and support pharmacists to develop the services they offer to drug users could form an important part of extending the role of pharmacies, but to date only France, Portugal and the United Kingdom appear to be making significant investments in this direction."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 79.

    10. "As a result of the serious health and social problems associated with crack cocaine use, there is more experience of developing services for this group, although activities are limited to those relatively few cities in Europe that have experienced a significant crack cocaine problem. In a number of cities crack cocaine users have been targeted by outreach schemes that attempt to engage with what is often viewed as a difficult group to work with. Although overall the evidence base remains relatively weak, some studies have suggested that benefits can accrue. For example, one study of an innovative outreach treatment programme in Rotterdam (Henskens, 2004, cited in the Dutch national report) identified factors that were observed to be important for treating this group of clients, who are often difficult to engage in conventional drug services."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 64.

    11. "A more controversial approach has been adopted in some cities in Europe, where the concept of safe consumption rooms, usually targeting drug injection, has been extended to drug inhalation. Rooms for supervised inhalation have been opened in several Dutch, German and Swiss cities (EMCDDA, 2004c). Although the supervision of consumption hygiene is a main objective of such services, there is some evidence that they could also act as a conduit to other care options; for example, monitoring of one service in Frankfurt, Germany, reported that, during a six-month evaluation period in 2004, more than 1 400 consumptions were supervised, while 332 contact talks, 40 counselling sessions and 99 referrals to other drugs services were documented."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 64.

    12. "Despite the overall expansion of treatment options, engaging with some groups of drug users, particularly those with long-term and chronic problems, remains a challenge for drug services. Outreach and low-threshold interventions are common approaches to attempting to make contact and engage with these hard-to-reach populations. A more controversial approach is the development in some countries of supervised drug consumption rooms mostly targeting drug injectors but now sometimes also extending provision to crack cocaine or heroin smoking (see EMCDDA, 2004c). Another controversial area of service development and experimentation is the use of heroin by a few countries as an agent for drug substitution treatment. Although, overall, activities in this area remain very limited compared with other treatment options, some studies have suggested that heroin prescribing may have potential benefits for clients where methadone maintenance treatment has failed. For example, a recent German randomised controlled trial of heroin-assisted treatment (Naber and Haasen, 2006) reported positive outcomes in terms of both health and reductions in use of illicit drugs. Nonetheless, no clear consensus currently exists across Europe on the cost and benefits of this approach and it remains an area where there is considerable political and scientific debate."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 33-34.

    13. "In the EU Member States, problem drug users can access social measures through facilities either exclusively dedicated to drug users or targeting socially deprived groups. Among these measures, housing is one of the key pillars. The service most commonly offered to homeless problem drug users is access to 'generic housing services' (in 21 countries), while 18 countries offer housing facilities solely for problem drug users and 13 countries combine the two systems. However, there are doubts about the effective access of homeless problem drug users to these facilities. Low availability, local resistance to providing drug users with new facilities, restricted criteria for access and difficulties for homeless problem drug users in sticking to the rules are among the problems reported."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 34.

  5. Treatment

    1. "Substitution therapy for opioid dependence (mainly treatment with methadone or buprenorphine) is in place in all EU Member States as well as Bulgaria, Romania and Norway, and there is now a substantial European consensus that it is a beneficial approach to the treatment of problem opioid users, although in some countries it remains a sensitive topic (see Chapter 2). The role of substitution treatment is becoming less controversial internationally; the UN system came to a joint position on substitution maintenance therapy in 2004 (WHO/UNODC/UNAIDS, 2004), and in June 2006 WHO included both methadone and buprenorphine in its model list of essential medicines."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 72.

    2. "While methadone continues to be the most commonly prescribed substitution treatment in Europe, treatment options are still expanding, and buprenorphine is now available in 19 EU countries, Bulgaria and Norway, although it is not clear whether it is officially approved for maintenance treatment in all countries where it is reported to be used. Considering that high-dosage buprenorphine treatment was introduced in Europe only 10 years ago, the drug's popularity as a therapeutic option has developed remarkably quickly (see Figure 1)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 72.

    3. "Some countries (Germany, Spain, the Netherlands and the United Kingdom) also have heroin prescription programmes, although the number of patients receiving this kind of treatment is very small compared with other forms of drug substitution (probably constituting less than 1% of the total). This form of treatment remains controversial and is generally provided on a scientific trial basis for long-term users in whom other therapeutic options have failed."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 72.

    4. "It is estimated that in the EU more than half a million opioid users received substitution treatment in 2003, which represents one third of the currently estimated 1.5 million problem opioid users (EMCDDA, 2005a). The new Member States and candidate countries account for only a small fraction of the clients in substitution treatment in the European region, which can partly be explained by lower levels of opioid use in these countries. Although the overall provision of substitution treatment remains low in these countries, there are some indications of increases in Estonia, Lithuania and Bulgaria."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 30.

    5. "Over the last decade, but even more so in the last five years, many European countries have 'opened the doors' to treatment by expanding their provision of substitution treatment and reducing access limitations. Never before have such large numbers of drug users been reached by the system of care. Many but not all require assistance beyond the treatment of their dependency, and many seem to need low-threshold care as well as substantial support for their reintegration."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 31.

    6. "A survey conducted among national focal points (NFPs) in 2005 assessed the general characteristics of treatment provision in Europe. National experts were asked whether the majority of opioid users were treated in drug-free or medically assisted programmes or whether both modalities were equally prevalent. "The results show a ratio largely in favour of medically assisted treatment, with the main substance used being methadone (except in the Czech Republic and France; for more details see Chapter 6). The results further show that drug-related treatment in most countries is predominantly provided in outpatient settings — only Latvia and Turkey provide most treatment in inpatient settings. Traditional psychotherapeutic treatment modalities (psychodynamic, cognitive-behavioural, systemic/family therapy or Gestalt therapy) are the most frequently used modalities in outpatient treatment in Ireland, Latvia, the United Kingdom, Bulgaria and Turkey. Nine countries report the provision of predominantly 'supportive' methods (which can include counselling, socio-educative and environmental therapy, motivational interviewing or relaxation techniques and acupuncture), and 10 countries combine the different methods in their outpatient work."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 31.

    7. "Concerning inpatient care, the 12-step Minnesota model is frequently used in residential care in Ireland, Lithuania, Hungary and Turkey, while six countries predominantly apply psychotherapeutic treatment modalities, five countries 'supportive' methods and 10 countries a combination of such approaches."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 31.

    8. "Treatment units or programmes that exclusively service one specified target group are a common phenomenon across the EU. Children and young people under the age of 18 are treated in specialised agencies in 23 countries; the treatment of drug users with psychiatric co-morbidity takes place in specialised agencies in 18 countries; and women-specific services are reported to exist in all countries except Cyprus, Latvia, Lithuania, Bulgaria and Turkey. Services designed to meet the needs of immigrant drug users or of groups with specific language requirements or religious or cultural backgrounds are less common but have been reported from Belgium, Germany, Greece, Spain, Lithuania, the Netherlands, Finland, Sweden and the United Kingdom."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 33.

    9. "The development of 'safer' substitution products (i.e. substances less likely to be diverted into the black market) makes it likely that drug dependency treatment will move even further towards the GP's surgery. This is also a process of normalisation, which allows drug dependency to be treated like a chronic disease such as diabetes."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 34.

    10. "Some countries report that the large groups of heroin users in substitution treatment create a corresponding demand for social reintegration support, especially for paid work. Under the current economic circumstances, many countries may find it difficult to meet the vocational reintegration needs of older heroin users, even if they are stabilised in drug maintenance treatment. This situation is aggravated by the high levels of morbidity among this group."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 34.

  6. Substance Use and the Justice System

    1. "Over the five-year period 1999–2004, the number of 'reports' of drug law offences increased overall in most EU countries (in fact in all reporting countries except Italy and Portugal, with particularly marked increases — twofold or more — in Estonia, Lithuania, Hungary and Poland). In 2004, this increasing trend was confirmed in most reporting countries, although a few countries reported a fall over the previous year — the Czech Republic, Greece, Latvia, Luxembourg, Portugal, Slovenia (since 2001), Slovakia, Finland and Bulgaria."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 23-24.

    2. "In most EU Member States the majority of reported drug law offences are related to drug use or possession for use, ranging in 2004 from 61% of all drug law offences in Poland to 90% in Austria. In the Czech Republic, Luxembourg, the Netherlands and Turkey, most reported drug law offences relate to dealing or trafficking, with the proportion varying from 48% of all drug offences in Luxembourg to 93% in the Czech Republic."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 24.

    3. "Over the same five-year period [1999-2004], the number of offences for use/possession for use increased overall in all reporting countries, except Italy, Portugal, Slovenia, Bulgaria and Turkey, which reported a declining trend. The share of all drug law offences accounted for by these offences also increased in most reporting countries over the period, although the rate of increase was generally low, except in Cyprus, Poland and Finland, where more marked upward trends were reported. However, in Luxembourg, Portugal, Bulgaria and Turkey, the proportion of drug offences related to use/possession for use fell overall."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 24.

    4. "In most of the Member States, cannabis is the illicit drug most often involved in reported drug law offences. In the countries where this is the case, cannabis-related offences in 2004 accounted for 34–87% of all drug law offences. In the Czech Republic and Lithuania, amphetamines-related offences predominated, accounting, respectively, for 50% and 31% of all drug law offences; while in Luxembourg cocaine is the most reported substance (in 43% of drug law offences)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 24.

    5. "In 1999–2004, the number of 'reports' of drug law offences involving cannabis increased overall in the majority of reporting countries, while decreases were evident in Italy and Slovenia. Over the same period, the proportion of drug offences involving cannabis increased in Germany, Spain, France, Lithuania, Luxembourg, Portugal, the United Kingdom and Bulgaria, while it remained stable overall in Ireland and the Netherlands, and decreased in Belgium, Italy, Austria, Slovenia and Sweden. Although in all reporting countries (except in the Czech Republic and Bulgaria and for a few years in Belgium) cannabis is more predominant in offences for use/possession than in other drug law offences, the proportion of use-related offences involving cannabis has decreased since 1999 in several countries -- namely Italy, Cyprus (2002–04), Austria, Slovenia and Turkey (2002–04) -- and has fallen over the last year (2003–04) in most reporting countries, possibly indicating a reduced targeting of cannabis users by law enforcement agencies in these countries."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 24.

    6. "Over the same five-year period, the number of 'reports' and/or the proportion of drug law offences involving heroin decreased in the majority of reporting countries, except Belgium, Austria, Slovenia and Sweden, which reported upward trends in the number of 'reports' involving heroin and/or the proportion of drug offences that involved heroin. "The opposite trend can be observed for cocaine-related offences: in terms of both number of 'reports' and the proportion of all drug offences, cocaine-related offences have increased since 1999 in most reporting countries. Bulgaria is the only country to report a downward trend in cocaine offences (both numbers and proportions of drug offences)."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 24.

    7. "In 2004, an estimated 60,000 seizures of 74 tonnes of cocaine were made in the EU. Most seizures of cocaine are reported in western European countries, especially Spain, which accounts for about half the seizures and amounts recovered in the EU in the last five years. Over the period 1999–2004, the number of cocaine seizures increased overall at EU level, while quantities seized fluctuated within an upward trend. However, based on reporting countries, quantities appear to have declined in 2004 -- perhaps in comparison with the exceptional amount recovered in Spain the year before."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 58.

    8. "In 2004, the average retail price of cocaine varied widely across the EU, from EUR 41 per gram in Belgium to over EUR 100 per gram in Cyprus, Romania and Norway. The average prices of cocaine, corrected for inflation, showed an overall downward trend over the period 1999–2004 in all reporting countries except Luxembourg, where it declined until 2002 and then increased, and Norway, where prices rose sharply in 2001 and then stabilised."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), pp. 58-59.

    9. "Compared with heroin, the average purity of cocaine at user level [in the EU] is high, varying in 2004 from 24% in Denmark to 80% in Poland, with most countries reporting purities of 40–65%. Data available for 1999–2004 indicate an overall decrease in the average purity of cocaine in most reporting countries, although it increased in Estonia (since 2003), France and Lithuania, and remained stable in Luxembourg and Austria."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 59.

    10. "In 2004, the average retail price of brown heroin varied widely across Europe, from EUR 12 per gram in Turkey to EUR 141 per gram in Sweden, while that of white heroin varied between EUR 31 per gram in Belgium and EUR 202 per gram in Sweden, and the price of heroin of type undistinguished ranged from EUR 35 per gram in Slovenia to EUR 82 per gram in the United Kingdom. Data available for 1999–2004 show a decrease in the average price of heroin, corrected for inflation, in most reporting countries."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 67.

    11. "The average purity of brown heroin at user level varied in 2004 from 10% in Bulgaria to 48% in Turkey, while that of white heroin varied between 20% in Germany and 63% in Denmark, and that of heroin of type undistinguished ranged from 16% in Hungary to 42–50% in the Netherlands. The average purity of heroin products has been fluctuating in most reporting countries since 1999, making it difficult to identify any overall trend."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 67.

    12. "Data on drug use among the prison population in the last five years (1999–2004) were provided by most European countries (1). They show that, compared with the general population, drug users are overrepresented in prison. The proportion of detainees who report ever having used an illicit drug varies among prisons and detention centres, but average rates range from one third or less in Hungary and Bulgaria to two thirds or more in the Netherlands, the United Kingdom and Norway, with most countries reporting lifetime prevalence rates of around 50% (Belgium, Greece, Latvia, Portugal, Finland). Cannabis remains the most frequently used illicit drug, with lifetime prevalence rates among prisoners ranging between 4% and 86%, compared with lifetime prevalence rates of 3–57% for cocaine, 2–59% for amphetamines and 4–60% for heroin."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 69.

    13. "Although the majority of drug users reduce or stop their drug use after incarceration, some detainees continue and others start using drugs (and/or injecting drugs) while in prison. According to available studies, 8–51% of inmates have used drugs within prison, 10–42% report regular drug use and 1–15% have injected drugs while in prison. This raises issues around the potential spread of infectious diseases, in particular in relation to access to sterile injection equipment and sharing practices among the prison population."

      Source: "Annual Report 2006: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2006), p. 69.

    14. On average per year from 1999 to 2001, the homicide rate in the European Union was 1.59 homicides per 100,000 population.

      Source: Barclay, Gordon & Cynthia Tavares, "International Comparisons of Criminal Justice Statistics 2001," Home Office Bulletin 12/03 (London, England, UK: Home Office Research, Development, and Statistics Directorate, October 24, 2003), p. 10, Table 1.1.

  1. Regarding drug use in candidate eastern European countries, the European Monitoring Centre for Drugs and Drug Addiction reported in 2003 that "Current trends are hard to assess, as very recent data are lacking in most countries. There are tentative indications from some studies that in some countries the increase in drug use may have started to stabilise in the early 2000s, especially in major cities, where prevalence levels are usually several times higher than in rural areas (e.g. in Warsaw as well as in cities in Hungary and the Czech Republic). In other countries, data are rare or only limited qualitative or impressionistic information suggesting continuing increases is available. In all countries, the pattern of use is dominated by experimental or occasional use, mainly of cannabis. At the same time, these studies suggest an increased intensity of use by those (the minority) who continue to use. In other reports, diffusion of drug use from cities to smaller towns and rural communities is described. The 2003 ESPAD study should help cast light on trends among 16-year-old schoolchildren, although the results will not be available until 2004 and, as noted above, will not reflect trends in older groups of young people, up to the age of 25 or so, in whom drug use prevalence is likely to be higher."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), pp. 18-19.

  2. "From available data, and subject to the reservations expressed above, it appears that the level of problem drug use in the CEECs [Central and Eastern European Countries] is approaching, and in some cases has surpassed, levels reported for EU Member States. The 2002 report on the drug situation in the candidate CEECs (EMCDDA, 2002a) estimated the proportion of problem drug users among the population aged 15 to 64 to be over 1% in Estonia and Latvia, around 0.5% (the EU average) in Bulgaria, the Czech Republic and Slovenia, and around 0.25% in Poland (lower than the EU average but based on older data). Rapid increases in new cases of heroin smoking reflected in treatment data over recent years suggest that the estimate for Poland would now be higher, while a new estimate for Slovenia implies a rate of problem drug use of over 1%. No estimates are available for Hungary, Lithuania, Romania or Slovakia."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 22.

  3. Regarding drug use in candidate eastern European countries, the European Monitoring Centre for Drugs and Drug Addiction reported in 2003 that "Substitution treatment, in particular with methadone, has been slow to develop. The first (experimental) methadone programme started in Slovenia in 1990, to be followed by others in the Czech Republic (1992) and Poland (1993). In other countries, the first methadone programmes date from 1995 or later, although by 2001 all countries had introduced at least one. However, except in Slovenia, the number of programmes is limited and coverage remains very low indeed. In Slovenia, a nationwide network provides methadone treatment to perhaps 20% of the estimated total heroin-dependent population. In all other countries, coverage is less than 5%, and in many countries under 1 to 2%. This contrasts with an average coverage of well over 30% in the EU Member States (Figure 2). Other pharmacological treatments are available to a limited extent in some countries, including naltrexone and buprenorphine, but systematic information is not available."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 24.

  4. Regarding drug use in candidate eastern European countries, the European Monitoring Centre for Drugs and Drug Addiction reported in 2003 that "While needle and syringe exchange programmes (SEPs) have been implemented in all countries, only the Czech Republic reaches a substantial proportion (estimated at over 50 %) of drug injectors through a national network of SEPs and low-threshold projects, although in some countries, such as Slovenia, a reasonable level of coverage is achieved in some cities."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 28.

  5. Regarding drug use in candidate eastern European countries, the European Monitoring Centre for Drugs and Drug Addiction reported in 2003 that "However, most 16-year-olds in the CEECs have never used illicit drugs and, among those who have, the vast majority have used only cannabis. On average, lifetime prevalence of illicit drug use by 16-year-olds in the CEECs is 19%, ranging from 12% in Romania to 35% in the Czech Republic. On average, the lifetime prevalence of cannabis use by 16-year-olds in the CEECs is 16%, ranging from 1% of the surveyed population in Romania (although 8% have tried smoking heroin at least once) to 34% in the Czech Republic. In contrast, in almost all of the CEECs, more than 90% of 16-year-olds have tried alcohol at least once, and nearly two thirds admit to having been drunk at least once in their life."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 35.

  6. "Relatively high national rates of HIV prevalence among different subgroups of IDUs tested during 2001 were reported from Estonia (13%) and Latvia (12%). However, in the capital of Estonia, Tallin, the local HIV prevalence rate in 2001 reached the alarmingly high value of 41%. In Latvia and Poland, HIV prevalence among IDUs rose above 5% in 1998 and has remained above 5% since. In Lithuania, HIV prevalence increased to more than 1% in 1997 but remained consistently below 5% until 2001. In contrast, between 1996 and 2001, HIV prevalence among IDUs remained consistently below 1% in Bulgaria, the Czech Republic, Hungary, Slovakia and Slovenia (European Centre for the Epidemiological Monitoring of AIDS, 2002). In these countries, HIV prevalence rates among IDUs are lower than those in any EU Member State, where levels of infection in different subgroups of IDUs vary from about 1% in the UK (surveys and unlinked anonymous screening) to 34% in Spain (routine diagnostic tests in drug treatment) (EMCDDA, 2002c)."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 48.

  7. "In all CEECs for which information is available, sterile injection equipment can be purchased from pharmacies without a prescription. In 2001, in most CEECs the price of syringes in pharmacies was EUR 0.1. The exceptions were Estonia, where the price was lower (EUR 0.06), and Slovenia and Romania, where it was higher (EUR 0.14 and up to EUR 0.2 respectively). Only in Slovenia and Latvia can syringes also be exchanged or distributed through pharmacies. Not a single CEEC reported the existence of a national programme to support the sale of syringes to IDUs in pharmacies, although Estonia and Latvia reported sporadic efforts to provide at least some training for pharmacists with the aim of raising awareness of the need to prevent drug-related infectious diseases among IDUs. With the exception of Lithuania, no CEEC reported the distribution of prevention information targeted specifically at IDUs through pharmacies. Information on the numbers of syringes sold to IDUs through pharmacies would be very valuable in assessing the overall access of IDUs. The Czech Republic reported that in 2001 approximately one million syringes were sold to IDUs through pharmacies (97.8 syringes per 1 000 total population). National estimates of the proportion of IDUs who purchase sterile injecting equipment through pharmacies are generally not available, except in Hungary, where the figure in 2001 was approximately 30-40%."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), pp. 52-53.

  8. "All CEECs have in place some community-based or outreach harm reduction programmes that provide access to sterile injecting equipment and information on safer drug use and often also promote safer sex, including the distribution of condoms."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 53.

  9. "Substitution treatment is available to IDUs in all CEECs; however, availability varies considerably. In 2001 in Slovenia, 679 IDUs per million total population were on methadone maintenance, but the corresponding rate in Estonia was only 3.6. Total estimated numbers of IDUs receiving methadone substitution treatment per million population in 2001 or the most recent year for which an estimate is available are shown in Figure 15. With the possible exception of Slovenia, access to methadone substitution is clearly insufficient. The next highest rates were in Slovakia and the Czech Republic, but here the numbers of drug users receiving methadone were approximately 10-20 times lower. Like coverage of SEPs, more meaningful rates would take account of the estimated numbers of IDUs."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 54.

  10. "It is interesting to note that a number of acceding and candidate countries have moved towards criminalising possession for personal use, or use itself, over the past 12 years, while the most recent drug law modifications within the European Union countries have addressed the same question in a different way (ELDD, 2002)."

    Source: European Monitoring Centre for Drugs and Drug Addiction, "Annual Report 2003: The State of the Drugs Problem in the Acceding and Candidate Countries to the European Union" (Lisboa, Portugal: EMCDDA, 2003), p. 60.

  1. "The National Drug Strategy (NDS), formerly the National Campaign Against Drug Abuse, was initiated in 1985 following a Special Premiers' Conference. From its inception the Strategy recognised the importance of a comprehensive, integrated approach to the harmful use of licit and illicit drugs and other substances. The aim is to achieve a balance between demand-reduction and supply-reduction measures to minimise the harmful effects of drugs in Australian society. The tangible social costs of drug use in Australia were estimated to be $18.3 billion or approximately 5.5% of gross domestic product in 1998–99 (Collins & Lapsley 2002)."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. 1.

  2. "Based on the results of the 2004 National Drug Strategy Household Survey (NDSHS), 17% of the Australian population aged 14 years and over were daily smokers. Approximately one in four Australians (26%) were ex-smokers and just over half the population (53%) had never smoked.
    "Overall, men were more likely than women to be smokers. In 2004, 19% of males were daily smokers, while 16% of females were daily smokers. People aged 20–29 years of age had the highest smoking rates, with 24% of this age group smoking daily.
    "Smoking rates declined over the period 1991 to 2004.
    "During the 2003–04 financial year, the Australian Government collected over $5.6 billion in revenue from the importation and sale of tobacco products in Australia."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. xv.

  3. "In 2004, around 84% of the population aged 14 years and over had consumed at least one full serve of alcohol in the last 12 months. People were most likely to drink either weekly (41%) or less than weekly (34%), and 9% of Australians consumed alcohol on a daily basis. People aged 60 years and over recorded the highest prevalence of daily drinking (17%).
    "Overall, males were more likely to consume alcohol daily (12%) or weekly (48%) compared with females (6% and 35%).
    "The pattern of alcohol consumption by the Australian population has remained relatively unchanged over the period 1991 to 2004.
    "Around one in three people (35%) aged 14 years and over consumed alcohol in a way that put themselves at increased risk of alcohol-related harm in the short term on at least one occasion in the last 12 months. One in ten Australians consumed alcohol at levels that are considered risky or high risk for alcohol-related harm in the long term."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. xv.

  4. "Based on responses to the 2004 NDSHS, 38% of Australians aged 14 years and over had used any illicit drug at least once in their lifetime, and 15% had used any illicit drug at least once in the last 12 months.
    "Marijuana/cannabis was the most common illicit drug used, with one in three persons having used it least once in their lifetime and 11% of the population having used it in the previous 12 months.
    "Recent illicit drug use was most prevalent among persons aged between 18 and 29 years in 2004, with almost one in three people (31%) in this age bracket having used at least one illicit drug in the last 12 months.
    "The proportion of the population who had used any illicit drug in the last 12 months fluctuated between 1991 and 2004, reaching a similar level in 2004 (15%) to the prevalence in 1993 (14%). While the proportion of people who had recently used marijuana/cannabis (11%) was the lowest seen in the 13-year period, the proportion using ecstasy (3%) was the highest prevalence for that substance in the same period.
    "Ecstasy and related drugs were commonly used by 12–24-year-old Australians in 2004. The most prevalent drugs from this group were ecstasy and meth/amphetamines, with 7% of persons in this age group having used each substance in the last 12 months. In particular, the highest recent use of ecstasy (13%) and meth/amphetamines (11%) were reported by 20–24-year-olds."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), pp. xv-xvi.

  5. "The decline in smoking rates in Australia over the past three decades has resulted in Australia being ranked lowest of all countries in the Organisation for Economic Co-operation and Development (OECD) in terms of the prevalence of daily smoking.
    "In 2002, Australia ranked 23rd highest in the world in terms of per capita consumption of alcohol, with approximately 7 litres equivalent of pure alcohol consumed per person. This corresponded to an annual per capita consumption of approximately 92 litres of beer, 21 litres of wine and 1 litre of pure alcohol from spirits."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. xvi.

  6. "According to the annual Needle and Syringe Program (NSP) Survey, hepatitis C prevalence among people attending needle and syringe programs remained high over the period 1997 to 2003, with 57% of males and 61% of females testing positive to the hepatitis C virus antibody in 2003."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. xvii.

  7. "High levels of ATS (Amphetamine-Type Stimulants) abuse in the Oceania region are mainly found in Australia, which reported a prevalence rate for amphetamines of 3.6% in 1998. Such high figures do point to high levels of consumption; but they may also have to do with the specific social and legal context in which studies take place. This results in the case of Australia (and some other countries with a long tradition of social research) in more readiness to admit to drug use, and thus far less under-reporting than in countries where drug users fear that such information could be used against them."

    Source: United Nations Drug Control Programme, "World Drug Report 2001" (New York, NY: UNDCP, January 2001, p. 74.

  8. "An extensive network of needle and syringe programs (NSPs) has been established in Australia; in the financial year 1994-95, around 700 NSPs distributed six million syringes nationally and an additional four million were distributed through pharmacies. Early and vigorous implementation of harm reduction measures, such as methadone maintenance, peer-based education and NSPs, has successfully maintained low seroprevalence of HIV infection among people who inject drugs in Australia."

    Source: MacDonald, Margaret A., et al., "Hepatitis C Virus Antibody Prevalence Among Injecting Drug Users At Selected Needle and Syringe Programs In Australia, 1995-1997," Medical Journal of Australia, 2000;172:57-61, from the web at http://www.mja.com.au/public/issues/172_02_170100/macdonald/macdonald.html last accessed December 21, 2001.

  9. "Nuns who run one of Australia's best known hospitals are to operate the country's first legal and medically supervised heroin injecting room after a radical overhaul of the drug laws in New South Wales. The 18 month trial will be administered by the Sisters of Charity, who also run Sydney's inner city St Vincent's Hospital. An estimated 50 000 visits a year by drug users are expected at the centre, which will be staffed by a medical supervisor, a registered nurse, and security staff. The controversial plan will include the provision of clean needles and syringes; users must supply their own drugs."

    Source: Zinn, Christopher, "Nuns To Run First Heroin Injecting Room," British Medical Journal, Vol. 319, Aug. 14, 1999.

  10. "Marijuana/cannabis accounted for 72% of illicit drug arrests in 2003–04, compared with 12% of arrests related to amphetamine-type stimulants.
    "In 2004, one in ten sentenced prisoners was imprisoned for drug-related offences. The most common drug-related offence for which people were imprisoned was dealing/trafficking drugs.
    "Results based on the 2003 Drug Use Careers of Offenders (DUCO) study show that twothirds of female sentenced prisoners used an illicit drug in the 6 months prior to their arrest, while around 27% were classified in the study as dependent on alcohol and 55% were classified as dependent on drugs. Around two-thirds of female prisoners responding to the 2003 DUCO survey who were classified in the study as alcohol and/or drug dependent reported that they 'often' experienced a mental health condition while growing up."

    Source: Australian Institute of Health and Welfare 2005. Statistics on drug use in Australia 2004. AIHW Cat. No. PHE 62. Canberra: AIHW (Drug Statistics Series No. 15), p. xviii.

  1. "In January 2001, the Government of Belgium released a Political Note in which it expressed the intention to modify the main drug law in order to make non-problematic use of cannabis non-punishable. The Note stated the intention that 'The criminal judge will no longer interfere in the lives of people who use cannabis on a personal basis and who do not create harm or do not show dependence.' a royal decree will be issued instructing prosecutors not to pursue people for possession of cannabis. The production, supply, sale and ownership of larger quantities will remain actively prosecuted, as will the use of cannabis which leads to 'unsociable behaviour'. Use and possession will still be prosecuted in cases involving minors, public nuisance, use in school premises, or in any place where the public order will be threatened."

    Source: "Decriminalisation in Europe? Recent Developments in Legal Approaches to Drug use" (Lisbon, Portugal: European Monitoring Centre on Drugs and Drug Addiction, November 2001), pp. 3-4, available on the web at http://wldd.emcdda.org/databases/eldd_comparative_analyses.cfm.

  2. According to the Belgian National Report on Drugs 2003, prepared for the European Union's drug monitoring agency:
    "Changes to the Narcotic Drug Act (24 February 1921)
    "The major existing change in the legal framework, and probably the one most spoken of by politicians, media and others, are the modifications to the Narcotic Drug Act. These changes have been mentioned in two laws (of 4 April and 3 May 2003) and one royal decree (16 May 2003). An overview of the most important topics:
    "Incorporation of a Council Regulation (n° 3677/90), regulating substances that can be used to produce illicit substances (so-called 'precursors') into police authorities;
    "Drug use in group is not seen as punishable in se any more; instead, this will be changed to drug use in the presence of minors;
    "Cannabis gets a separate statute (defined as another “category”): the possession of an amount of cannabis, meant for personal use, by an adult (i.e. 18 years or older), without the presence of nuisance or problematic use will only lead to a registration by the police. In the case of nuisance, however, a punishment can be imposed of minimum three months up to one year of prison sentence and / or a fine of 1.000 to 100.000 euro (to be multiplied by 5, the revaluation factor).
    "Commerce, production, export and importation of substances regulated by the Narcotic Drug Act remain forbidden, and maintain their original punishments."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Belgium, Scientific Institute of Public Health, Unit of Epidemiology, "Belgium Drug Situation 2003" (Brussels, Belgium: Scientific Institute of Public Health and EMCDDA, 2004), p. 6.

  3. "In 1998, according to the decision of the Federal Parliament, a directive/circular modified the action of judicial authorities: a distinction was established between the possession of cannabis and other illegal drugs with non acceptable risk for health, and the access to needle exchange was made possible (the drug law itself - even regarding cannabis - was not changed)."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Belgium, Scientific Institute of Public Health, Unit of Epidemiology, "Belgium Drug Situation 2000" (Brussels, Belgium: Scientific Institute of Public Health and EMCDDA, 2000), p. 15.

  4. On February 24, 2000, members of the Belgian Parliament made a proposal "modifying the law on drug of 24/02/1921 in order to partially decriminalize the possession of cannabis and its derivatives. The authors proposed that the positive right should be clarified. The prohibition policy against cannabis should be given up because a.o. its ineffectiveness. Nevertheless, the prosecutions against dealers should be continued and the drug use prevention efforts emphasized."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Belgium, Scientific Institute of Public Health, Unit of Epidemiology, "Belgium Drug Situation 2000" (Brussels, Belgium: Scientific Institute of Public Health and EMCDDA, 2000), p. 26.

  5. "A directive has been written by the Minister of Justice (16 May 2003) urging the Public Prosecutor to use a limit of 3 grams for cannabis possession or in case of plant a limit of 1 plant (or seed). In this case, on condition that there are no aggravating circumstances (like use in the presence of minors, public nuisance or problematic drug use), the police will only need to make a simple, anonymous registration of the facts."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Belgium, Scientific Institute of Public Health, Unit of Epidemiology, "Belgium Drug Situation 2003" (Brussels, Belgium: Scientific Institute of Public Health and EMCDDA, 2004), p. 7.

  6. "The lifetime experiences of cannabis and XTC/amphetamines were reported by respectively 10.8% and 2.3 % of population aged between 15 to 64 years old. The last month prevalence of cannabis use was reported by 2.8% of this population and the last month prevalence of XTC was lower than 1%.
    "Both prevalences of cannabis use are proportionally higher among men (respectively 13.3% and 4.1%) than women (respectively 8.3% and 1.6%). These gender differences appear also in the lifetime prevalence of ecstasy and/or amphetamines use (3.1% among men and 1.6% among women).
    "The lifetime prevalence and the last month prevalence of cannabis use as well as XTC/amphetamines decreases appreciably with the age. The critical groups relate to the age groups between 15-24 and 25-34 years.
    "The lifetime prevalence of cannabis use is more important among people with a high education diploma. The last month prevalence of cannabis and the lifetime prevalence of ecstasy and/or amphetamines uses are not influenced by the educational level."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Belgium, Scientific Institute of Public Health, Unit of Epidemiology, "Belgium Drug Situation 2003" (Brussels, Belgium: Scientific Institute of Public Health and EMCDDA, 2004), pp. 14-5.

  1. "In 1992 the government approved Canada's Drug Strategy, a co-ordinated effort to reduce the harm caused by alcohol and other drugs. The strategy calls for a balanced approach to reducing both the demand for drugs and their supply through such activities as control and enforcement, prevention, treatment and rehabilitation, and harm reduction."

    Source: Report of the Auditor General of Canada 2001, Chapter 11, "Illicit Drugs: The Federal Government's Role" (Ottawa, Canada: Office of the Auditor General, December 2001), p. 1.

  2. "Overall, 44.5% of Canadians report using cannabis at least once in their lifetime, and 14.1% report use during the 12 months before the survey. Males are more likely than females to have used cannabis in their lifetime (50.1% vs 39.2%) and during the past year (18.2% vs. 10.2%). Younger people are more likely to have ever used cannabis in their lifetime, with almost 70% of those between 18 and 24 having used it at least once. Younger people are also more likely to be past-year users. Almost 30% of 15-17 year olds and just over 47% of 18 and 19 year olds have used cannabis in the past year. Beyond age 45, less than 10% of the population has used cannabis in the past year."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 6.

  3. "Most Canadians drink in moderation. In the 12 months before the survey, 79.3% of Canadians aged 15 or older report consuming alcohol, 14% are former drinkers and 7% lifetime abstainers. Of the past-year drinkers, 44% report drinking weekly. The rate of past-year drinking is significantly higher among males than females (82.0% vs. 76.8%, respectively). Past-year drinking rates peak among youth 18 to 24 years of age, with about 90% of people in that age range consuming alcohol during the course of the year."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 4.

  4. According to the Canadian Addiction Survey, "Excluding cannabis, the illicit drug most commonly used during one’s lifetime is reported to be hallucinogens, used by 11.4% of respondents, followed closely by cocaine (10.6%), speed (6.4%) and ecstasy (4.1%). The lifetime use of drugs such as inhalants, heroin, steroids and drugs taken intravenously is about 1% or less of the population. The percentage reporting the use of any five drugs other than cannabis (cocaine or crack; hallucinogens, PCP or LSD; speed or amphetamines; heroin; ecstasy [MDMA]), is 16.5%, and the percentage reporting the use of any of the eight drugs, including cannabis, is 45.2%."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 7.

  5. According to the Canadian Addiction Survey, "The most commonly reported drug-related harm involves physical health, reported by 30.3% of lifetime and 23.9% of past-year users of drugs other than cannabis, and 15.1% of lifetime and 10.1% of past-year users of any drug. Following physical health, a cluster of harms, represented somewhat equally, includes harms to one’s friendship and social life (22.3% and 16.4% of users excluding cannabis, 10.7% and 6% of any drug users), home and marriage (18.9% and 14.1% excluding cannabis, 8.7% and 5.1% of any drug users), work (18.9% and 14.2% excluding cannabis, 9.2% and 5.1% of any drug users), and financial (19.6% and 18.9% excluding cannabis, 8.4% and 6.5% of any drug users)."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 7.

  6. "Self-reported rates of illicit drug use are increasing in Canada. The proportion of Canadians reporting any illicit drug use in their lifetime rose from 28.5% in 1994 to 45.0% in 2004, and in the past 12 months from 7.6% to 14.4%.
    "The lifetime use of cannabis increased from 23.2% in 1989, to 28.2% in 1994, and to 44.5% in 2004. For cocaine, use rose from 3.5% in 1989, to 3.8% in 1994, and to 10.6% in 2004. For LSD/speed/heroin, the rate rose from 4.1% in 1989 to 5.9% in 1994, and to 13.2% in 2004.
    "The past-year use of cannabis rose from 6.5% in 1989 to 7.4% in 1994, and to 14.1% in 2004. For cocaine and crack, rates declined from 1.4% in 1989 to 0.7% in 1994, and rose again to 1.9% in 2004. While past-year rates for the combined category of LSD/speed/heroin rose slightly from 0.4% in 1989, to 1.1% in 1994, and to 1.3% in 2004, these findings are not statistically significant."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 11.

  7. According to the Canadian Addiction Survey, "This overall trend of increasing rates of illicit drug use does not translate into changes in reported harms among most of the variables that can be compared across surveys."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 11.

  8. "The data indicate that the number of Canadians who report having used an injectable drug at some point in their life increased from 1.7 million in 1994 to a little over 4.1 million in 2004. Of those, 7.7% (132,000) reported having used a drug by injection in 1994 compared with 6.5% (269,000) in 2004."

    Source: "Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms," Canadian Executive Council on Addictions, Health Canada, November 2004, p. 11.

  9. "In 1999 about 50,000 people were charged with offences under the Controlled Drugs and Substances Act in cases where the most serious offence was drug-related.... In that same year, we estimated that Canadian criminal courts heard 34,000 drug cases that involved more than 400,000 court appearances. About 19 percent of offenders in the federal correctional system are serving sentences for serious drug offences.
    "For the roughly 50,000 persons charged, 90 percent of the charges related to cannabis and cocaine. Cannabis accounted for over two thirds of the charges, and about half of all charges were for possession."

    Source: Report of the Auditor General of Canada 2001, Chapter 11, "Illicit Drugs: The Federal Government's Role" (Ottawa, Canada: Office of the Auditor General, December 2001), p. 4.

  10. "An estimated 125,000 people in Canada inject drugs. Injection drug use is a major risk factor in the spread of HIV/AIDS and hepatitis. In 1999 it resulted in an estimated 34 percent of all new HIV infections."

    Source: Report of the Auditor General of Canada 2001, Chapter 11, "Illicit Drugs: The Federal Government's Role" (Ottawa, Canada: Office of the Auditor General, December 2001), p. 4.

  11. The Auditor General of Canada notes that Correctional Service Canada (CSC), which is responsible for offenders serving criminal sentences of over two years, provides substance abuse and harm reduction services to inmates:
    "Substance abuse is one of seven criminogenic factors contributing to criminal behaviour. Nearly two thirds of offenders entering the federal corrections system have drug abuse problems. An estimated 5 percent of offenders participate in substance abuse programs while serving their sentences.
    "In addition to substance abuse programs, CSC has provided methadone treatment to some opiate-addicted injection drug users. Injection drug users pose a serious problem for institutions as they can contribute to the spread of HIV/AIDS and hepatitis. As a harm reduction measure, CSC also makes bleach available in prisons to sterilize needles shared by inmates."

    Source: Report of the Auditor General of Canada 2001, Chapter 11, "Illicit Drugs: The Federal Government's Role" (Ottawa, Canada: Office of the Auditor General, December 2001), p. 13.

  12. The Canadian government in 2001 established regulations to expand the use of marijuana as a medicine. According to an editorial in the Canadian Medical Association Jurnal in May 2001, "The new regulations promise more transparency in the review of applications to grow or possess medicinal marijuana, a broader definition of medical necessity, and greater latitude for physicians in determining the needs of individual patients.... Health Canada's decision to legitimize the medicinal use of marijuana is a step in the right direction. But a bolder stride is needed. The possession of small quantities for personal use should be decriminalized."

    Source: "Marijuana: federal smoke clears, a little," Canadian Medical Association Journal, Vol. 164, No. 10, May 15, 2001, p. 1397.

  13. "The North American Opiate Medication Initiative (NAOMI) is a carefully controlled (clinical trial) that will test whether medically prescribed heroin can successfully attract and retain street-heroin users who have not benefited from previous repeated attempts at methadone maintenance and abstinence programs.
    "The NAOMI study will enrol 470 participants at three sites in Vancouver, Montreal and Toronto. The Toronto and Montreal sites are expected to begin recruitment this spring.
    "Each site will enroll about 157 participants. About half of these volunteers will be assigned to receive pharmaceutical-grade heroin (the experimental group) and half will receive methadone (the control group). The prescribed heroin will be self-administered under careful medical supervision within a specially designed clinic. Those in the heroin group will be treated for 12 months then transitioned, over three months, into either methadone-maintenance therapy or another treatment program. The researchers expect a 6-9 month recruitment period, so that the total time to complete the study will be 21 to 24 months."

    Source: Health Canada News Release, "North America's First Clinical Trial Of Prescribed Heroin Begins Today," Feb. 9, 2005, from the web at http://www.cihr-irsc.gc.ca/e/26516.html, last accessed Oct. 17, 2005.

  1. The Danish government says of its drug policy, "Danish drug policy is based on persistent and targeted prevention intervention, multi-pronged optional co-ordinated treatment and effective control. Drug prevention policy rests on the principle of prohibition of drugs, a high level of information as well as action to impact on social conditions. In this connection, it is especially a deprived childhood, too little contact with adults and marginalisation in relation to education and training which results in a small group of young people becoming vulnerab to the experimental use of drugs, which subsequently, in many cases, leads to actual addiction."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), p. 9.

  2. "In Denmark, a May 2004 amendment to the Euphoriant Substances Act, together with a public prosecutor’s circular, stated that the possession of drugs for own use will now normally be punishable by a fine rather than the warnings issued previously."

    Source: "Annual Report 2005: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2005), p. 24.

  3. "Where possession of drugs is meant for own consumption, such an offence is punishable by a fine provided that it is not repeated. For first offences, possession of very small quantities for own use normally results in the police issuing a warning to the person in question."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), pp. 15-16.

  4. "In Denmark possession of narcotics is a criminal offence. However a guideline of 1971, on legal process in drugs cases, stipulates that it was not the intention of the drug law to criminalize the use of drugs and corresponding possession of drugs for own consumption."

    Source: "Decriminalisation in Europe? Recent Developments in Legal Approaches to Drug use" (Lisbon, Portugal: European Monitoring Centre on Drugs and Drug Addiction, November 2001), p. 6, available on the web at http://wldd.emcdda.org/databases/eldd_comparative_analyses.cfm.

  5. The Danish government estimates that in 2000, approximately 3% of the population of Denmark aged 16-44 had tried cannabis in the previous month, while a total of 4% had tried cannabis within the previous year. This compares with estimates from 1994 of 2% having used in the previous month, and 5% in the previous year. The Danish National Board of Health reported in 2000 that "It is primarily the young segment of the population (16-24 years of age) who have smoked cannabis within the last year, both in 1994 and 2000. More men than women report in 1994 and in 2000 that they have experimented with cannabis within the last month and last year. The difference in consumption between the two genders is, however, least pronounced among the young segments of the population - among the 16-24-year-olds."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), p. 20.

  6. "While the use of cannabis has stabilised from 1994 to 2000, the use of 'hard' illegal drugs has increased significantly from 194 and up until today. Less than 1% of the 16-44 year-old reported in 194 that they had used hard drugs such as amphetamine, cocaine, heroin and hallucinogens within the last year, whereas even fewer had tried the hard drugs within the last month. As it appears from table 2.1.22, 2% of the 16-44-year-olds report in 2000 having experimented with one or several of the hard drugs within the last year, including 1% within the last month. The share of this group who report having tried hard drugs within the last month has thus increased approximately 5 times from 1994 to 2000, and the share of this group who report having tried hard drugs within the last year has gone up by more than 4 times as much during the same period."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), pp. 15-16.

  7. "In 1995, more than 17% of the 15-16 year-olds report ever having tried cannabis. There was a significant increase in 1999 where the share that state having ever tried cannabis is over 24%. 8% had used it within the last month; in 1995 this was 6%. There are great differences in experimental use between boys and girls in 1999 when 30% of boys and 19% of girls state having ever used cannabis. Twice as many boys as girls had used cannabis during the last month."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), pp. 24-25.

  8. "Syringes and needles distributed free of charge are still much in demand. Thus, since 1986 the city of Copenhagen has made syringes and needles available free of charge through pharmacists, dispensing machines, hostels and other outlets. In 1999, a total of 613,932 sets were distributed, which is a small decline compared to 1998. Furthermore, an increasing number of separate needles were dispensed."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), pp. 30-31.

  9. "In 1995, the proportion of first-time HIV-positive where the source of infection has been reported as being intravenous-injecting drug addiction is 11% (34 persons). The percentage dropped to 6% (13 persons) in 1998 and had again gone up to 9% (24 persons) in 1999. Based on the data provided by the HIV reporting system, 'Statens Sterum Institut' has estimated that the spread of the infection among drug addicts has dropped since the mid-80s. It is assumed that less than 4% of the drug addicts are HIV-infected. This estimate is based on the analysis, under which there are 11,000 injecting drug users in Denmark."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of Denmark, Sundhedsstyrelsen (National Board of Health), "Denmark Drug Situation 2000: National Report on the State of the Drugs Problem in Denmark" (Denmark: National Board of Health and EMCDDA, December 2000), p. 41.

  1. "In France, a law passed in August 2004 adopting the fiveyear public health policy plan incorporates the policy on harm reduction for drug users into the public health regulations, giving harm reduction an official definition and bringing it within the jurisdiction of the state."

    Source: "Annual Report 2005: The State of the Drugs Problem in Europe," European Monitoring Centre for Drugs and Drug Addiction (Luxembourg: Office for Official Publications of the European Communities, 2005), p. 23.

  2. According to "France Drug Situation 2000," a report prepared for the European Union's European Monitoring Centre on Drugs and Drug Addiction, "The Law of 1970 makes public or private use punishable by one year in prison and/or a fine, even if there has not been a perceptible negative impact upon those in the user's entourage. Another of the law's articles is out of the realm of practicality even if it attests to the ambiguous legal status of users (both delinquent and ill). Users may avoid proceedings by spontaneously seeking treatment. The provisions for anonymity guarantee that the Law will not ask for any explanations after treatment. It is also possible to escape proceedings if the prosecutor decides to close the matter or rules for a court-ordered treatment programme."

    Source: Report to the European Monitoring Center on Drugs and Drug Addiction by the Reitox National Focal Point of France, l'Observatoire francais des drogues et des toxicomanies (OFDT), "France Drug Situation 2000" (Paris, France: OFDT and EMCDDA, December 2000), p. 9.

  3. "In France prohibition and punishment of simple drug use has provoked a strong debate for decades. In June 1999 a Directive of the Ministry of Justice asked prosecutors to prioritise treatment approaches for petty offenders both related to drug use or to other small crimes. Particularly where problematic drug users are concerned, the recommendation of the Directive is to apply therapeutic alternatives to prisons to the largest extent possible, while 'the imprisonment of drug users, not having committed other related offences, must be the last resort.' (citing the French Minister of Justice NOR JUS A 9900148C, June 17, 1999)

    Source: "Decriminalisation in Europe? Recent Developments in Legal Approaches to Drug use" (Lisbon, Portugal: European Monitoring Centre on Drugs and Drug Addiction, November 2001), p. 6, available on the web at http://wldd.emcdda.org/databases/eldd_comparative_analyses.cfm.

  4. According to "France Drug Situation 2000," a report prepared for the European Union's European Monitoring Centre on Drugs and Drug Addiction, "In polls before 1999, the majority view which appeared to be defined is that prosecutions and legal penalties should be imposed on consumers of heroin and of cocaine (85% in favour), of cannabis (70%) or of alcohol (approx. 50%). However, polling of such opinions is very sensitive to the way in which questions are put: three quarters of interviewees in this way, were not in favour of the idea that drug addicts should be punished. Likewise, if the person and his individual freedom are emphasised rather than the legal aspects of the question of utilisation, then one third of interviewees, as in 1999, will be induced to express their consent for the proposal according to which the prohibition of smoking cannabis is an infringement of the right for free utilisation of one's own body."