Looking Back on 25 Years of Annual Reporting on the Drugs Problem in Europe

2020·1.9 MB·English

by  Griffiths, Paul

Looking back on 25 years of annual
reporting on the drugs problem in Europe
PAUL GRIFFITHS, EMCDDA SCIENTIFIC DIRECTOR
September 2020
In 1996, the EMCDDA released its first Looking back at these 25 years of annual
annual report on dr ug trends in Europe, reporting, two things stand out: first, Europe’s
entitled the Annual report on the state of the drugs problem has evolved considerably over
drugs problem in the European Union 1995. this period; and second, this evolution has
This introduced the work of the agency and been accompanied by a dramatic increase
presented the limited data then available in the quantity and quality of the information
from European countries on drug use. available on this topic.
EU aggregate estimates were largely absent
at that time. Since then, although the report’s While today our information systems
format and name have changed — it is now remain imperfect, they represent a major
known as the European Drug Report: achievement of the European approach
Trends and Developments — the EMCDDA to addressing drug issues, as they now
has continued to provide yearly assessments permit a far better understanding of the
of drug use in Europe over a quarter of a drug problems faced within the EU and the
century. measures taken to address them.
II LLooookkiinngg bbaacckk oonn 2255 yyeeaarrss ooff aannnnuuaall rreeppoorrttiinngg oonn tthhee ddrruuggss pprroobblleemm iinn EEuurrooppee
The Reitox network: key
partners for building the
European evidence base
In its review of the situation in 1995,
the EMCDDA report presented data on
last-year cannabis prevalence from five
countries with national surveys, although
more (11) were able to provide lifetime
estimates based on school survey data.
All of the then 15 EU Member States
could provide some data on drug-related
deaths and most had some data on
Photo: Envato Elements.
entrance to drug treatment. The only
other data widely available were on drug
seizures. However, as noted at the time, Meeting the challenges of period of time, the candidate countries
the quality of all of this information was a changing drug scene and were experiencing an ‘accelerated
often poor and the comparability at EU EU enlargement growth in problem drug use and
level was extremely limited. treatment responses similar to that
experienced by EU Member States over
The benefits of working together at
Today, methodological problems remain, the last 35 years.’
European level quickly showed, and
but they are far better understood
were evident in the EMCDDA’s Annual
and, overall, the quality, coverage and A major leap forward can therefore be
report on the state of the drugs problem
comparability of the data have improved found in the Annual report on the state
in the European Union 1999, which now
considerably. While EU aggregate of the drugs problem in the European
contained more elaborations of national
estimates based on such data must Union and Norway 2004, where data
data as well as EU-level estimates
always be used with caution, they from 26 countries were now included
and new data sources. New infectious
can now be made; and, perhaps more (all of the then 25 EU Member States
disease estimates linked to injecting
importantly, trends in drug use over time plus Norway).
were presented, along with a thematic
can be charted and used to inform policy
chapter on synthetic drugs, where pill
choices and actions. Although detailed statistical information
testing from the Netherlands illustrated
and time trends were not available for
the growing availability in the late 1990s
This progress would not have been many countries, and data sets were
of what was, at the time, a relatively new
possible without the existence of the often limited (especially for some of the
synthetic drug, ‘ecstasy’ (MDMA).
EMCDDA’s Reitox network of national new Member States), the yearly report
focal points. This network has allowed from this date began to have a wider
countries to learn from each other and The Annual report on the state of the focus and offered a more comprehensive
work together to produce common drugs problem in the European Union analysis of trends and developments
standards and methods. Focal points and Norway 2002 — Norway joined the across an enlarged EU, as well as more
not only facilitate a direct link to, and EMCDDA’s reporting system in 2001 by information on responses.
between, experts across EU countries special agreement — was accompanied
and provide the data presented in our by a supplement on drug use in the Interestingly, the 2004 annual report
reporting, but crucially they also allow candidate countries to the European noted that most countries, including
the EMCDDA’s annual analysis to be Union. Establishing a drug monitoring the new Member States, had put
informed by direct critical input from system was part of the preparatory in place national drug strategies.
those working on this topic at a national activities for those countries that would Over the next few years, the report
level. join the EU in 2004, and supporting contained both evidence of growing
this work was a major challenge for the drug problems, especially relating to
EMCDDA during that period. injecting drug use in some of the new
Member States, but also, at the same
The 2002 supplement notes that, while time, increased investment in evidence-
the information available was limited, based responses. Data from Turkey was
the data that did exist showed that drug included in the annual reporting after it
use patterns were changing rapidly. formally joined the EMCDDA network in
In particular, it was noted that, in a short 2014.
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I Looking back on 25 years of annual reporting on the drugs problem in Europe
A strong argument can be made that this issue remains important, especially complement the annual reporting on
the existence at the political level of after enlargement and because of the trends and recent developments.
a national strategy, supported by an localised problems experienced in some
established model for drug monitoring, countries.
and accompanied by a growing Keeping pace with a more
understanding of what constitutes Today, in 2020, however, while long-term
rapidly changing drug
effective responses, allowed many of problems associated with heroin use
landscape
the new members of the EU to both remain present, the current evidence
identify, and begin to respond to, the points to an ageing heroin-using
drug problems they were facing far population with overall rates of initiation The annual reporting from the EMCDDA
quicker than otherwise would have remaining low by historical standards. is based on data which often have a time
been the case. Again, this demonstrates Rates of new drug-related HIV infection lag. The analysis offered by the agency
the benefits of sharing experiences at have also fallen dramatically, and now each year is necessarily top-level, as it
European level to inform policy choices combatting drug-related HCV infections needs to address, in a summary form,
— the underlying principle for the among injectors has become a priority. developments taking place in a large
EMCDDA’s annual reporting exercise. number of countries.
While injecting heroin use remains
important in our European Drug Report Despite these limitations, the EMCDDA
The information needs 2020: Trends and Developments, it has managed to report, in a timely
does not play the central role it once did. manner, most of the important changes
for informed policies and
The opioid situation has become more occurring in the European drug situation
actions have evolved over
complex, with growing concerns about over the last 25 years. This has been
time
problems caused by synthetic opioids, achieved, in large part, by maintaining
and, overall, it is now recognised that a close dialogue with data providers
Reviewing the annual report from its the most problematic forms of drug use across the EU, monitoring global
earliest version reveals that, while many are usually characterised by complex developments and incorporating new
of the topics reappear, their relative patterns of multiple substance use. data sources and research findings.
importance changes over time. One of
the original policy drivers for the creation In 2020, the EMCDDA’s annual reporting This is illustrated by the fact that some
of a European drug information system must, therefore, address a wider of the most important current concerns
was the epidemic of injecting heroin set of drug issues and problematic for European drug policy first appeared
use in many European countries in the behaviours, if the report is to keep in the annual report a surprisingly long
late 1980s and early 1990s and the pace with contemporary information time ago. In 2006, for example, a review
associated concerns about HIV infection. needs. To meet this challenge, not on changing patterns of drug use in
only is there now a greater focus on recreational settings noted the growing
By 1998, the report was already non-opioid-related drug problems, but importance of the internet for the
observing that, for most countries, in-depth analysis of developments in the diffusion of new drug trends. In 2009,
HIV transmission among drug users drug market and responses have been the EMCDDA described the selling of
was ‘stable or decreasing’, although provided in supporting publications to ‘Spice products’, both online and in
specialist shops — one of the earliest
identifications of the emerging problem
caused by synthetic cannabinoids.
In 2013, in the newly named European
Drug Report: Trends and Developments,
the recent resurgence in the ecstasy
market was noted.
A review of 25 years of reporting reveals
that the agency has often been one of
the first to identify important new drug-
related threats. Sharing this information
has allowed European countries to be
better prepared for potential future
problems, even if they were first
observed elsewhere, and this is another
Photo: iStock.
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I Looking back on 25 years of annual reporting on the drugs problem in Europe
concrete example of the benefits of the more prominent role they now play in However, it is only in more recent years
European collaboration in this area. the European drug situation. that greater attention has been given
to cannabis-related problems and
This forward-looking perspective has, The amphetamines are an interesting cannabis-related policy issues.
in part, been achieved because the example here. Apart from regularly This reflects a greater recognition of the
EMCDDA has, whenever possible, tried noting that long-term problems with need to understand better the public
to complement its more established injecting amphetamine use have existed health implications of the widespread
data sources with new methods. for many years in some Nordic countries, use of this substance as well as a more
The reporting of city-level wastewater these drugs were rarely commented on dynamic situation in the cannabis
analysis of drug residues, for example, in detail until recently. In the last few market.
is now an established part of our annual years, however, it has become evident
data round-up, but was considered that greater reporting attention needs Strikingly, across the 25 years of
an innovative development when to be given to the production and use reporting, cannabis has gone from
introduced in 2014; and it took time of synthetic stimulants. A worrying being a drug relatively rarely reported
to convince some of the potential observation is that methamphetamine in data from drug treatment registries
value of this approach. This source availability is growing in some countries. to being the drug that is now most
is now proving particularly sensitive A drug that has global significance may commonly associated with new
to detecting emerging trends, as therefore have the potential to play treatment entries. The observation
demonstrated recently by the early a greater role in Europe’s future drug made on the 1995 data, that ‘typically
indication of increasing levels of cocaine problems, and the EMCDDA’s annual about 5 to 10 percent of clients report
consumption. reporting exercise therefore provides cannabis as their main problem drug’,
a valuable opportunity to stimulate sits therefore in stark contrast with
In recent reports, new data sources, such a debate on how this threat may be today’s figures. This change has been a
as web surveys, hospital emergency mitigated. long-term phenomenon however, with
data and the analysis of residues from an increase in new clients being treated
syringes, have all also been showcased. Cannabis use prevalence has always for cannabis problems being noted
This reflects the recognition that, as the featured prominently in the annual from 1999 onwards. A more critical
European drug landscape continues to report, reflecting the drug’s status as the observation is that, even in our most
evolve, we often need to find new ways most commonly used illicit substance recent reporting, the characteristics
to report on important developments and its high visibility in general of those being treated for problems
that may not be fully visible in our population and youth surveys compared with this drug, and the treatments
existing monitoring tools. It also fits with other substances. It is also the drug they receive, remain overall poorly
with the ethos of the annual report from that is most likely to bring young people understood. This point has been made
its inception, that, in an area such as into contact with the criminal justice repeatedly in the EMCDDA’s annual
drug use, where all information sources system in most countries. reporting exercises, and it represents an
are imperfect or incomplete, a multi- example of how identifying knowledge
indicator approach, informed by an gaps and documenting the limits of our
ongoing discussion with those working
on this issue nationally, is a necessity.
The growing importance
of stimulants, synthetic
drugs and cannabis
Data on the prevalence of the main
drugs used in Europe have always
been included in the EMCDDA’s annual
reporting exercise, as have data on drug
seizures. However, the attention given
to reporting on the use of stimulants
and synthetic drugs, and the problems
associated with these substances, has
changed over the last 25 years, reflecting
Photo: unsplash.
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I Looking back on 25 years of annual reporting on the drugs problem in Europe
current understanding have always been
important parts of the agency’s work
to support a more nuanced debate on
complex policy issues.
New psychoactive
substances become an
issue of concern
A particular challenge for European
drug policies over the last decade
has been the rapid emergence of new
psychoactive substances (NPS).
Europe was one of the regions in the Photo: unsplash.
world first affected by this problem.
the forms of cannabis available within
Europe is also recognised to have been
Supply side data have Europe. Supply side data have been
quick to identify and respond to the
particularly useful here although,
become more important
emergence of new drugs, due to the
as noted earlier, all information sources
existence since 1997 of its early-warning
have limitations that need to be carefully
and risk-assessment system. The multi-indicator model that the
considered in their analysis.
EMCDDA’s annual reporting is based
Reporting trends in newly identified on has always included supply side
and persistent NPS has therefore information, while noting the necessary Preparing to meet the
become an important theme for caveats that need to be considered
future challenges of
inclusion in the EMCDDA’s annual in its interpretation. Drug seizures, for
reporting on drug use in
reporting. NPS and the activities of the example, can reflect both underlying
Europe
EU Early Warning System (EWS) start trends in the drug market as well as the
taking prominence in the EMCDDA’s prioritisation and activity levels of law
annual reporting in 2007, where the enforcement. Historically, supply side Many of the issues first raised in the
emergence of piperazines, such as BZP information sources were not subject Annual report on the state of the drugs
and mCPP, was discussed, as was the to the same methodological investment problem in the European Union 1995
sale and aggressive marketing of these that demand side measures received. remain important today. Over the
substances through specialised shops intervening 25 years, however,
and the internet. Over the last decade, however, greater the agency’s reporting has had to adapt
efforts have been invested in extending to both the evolution of the European
BZP was reported by 14 European and improving the quality of information drug problem and policy priorities.
countries by 2007, and it is interesting in this area, and supply side data have It has also charted how responses to
to note that we were able to discuss become more visible in the EMCDDA drug problems have changed over this
the emergent trends in NPS use at reporting. In part, this reflects the time, informed by a better understanding
European level at a time when many need to report on a wider variety of of what can work.
parts of the world were unaware of this substances.
issue. A challenge here for the EMCDDA Some interventions that were once
was to integrate the cases-based data This can be seen in increased analysis regarded as controversial or innovative
emerging rapidly from the EWS with of synthetic drug production processes, have become mainstream; and some
the aggregated data sets the agency greater use and reliability of price and that were once considered essential
typically worked with in its reporting. purity/potency data in commenting on have been shown over time to be
By 2009, the number of new NPS trends in drug availability. Cannabis ineffective. To keep pace with these
being reported annually had increased is a good example here of how the changes, new data sets have been
dramatically, and correspondingly this EMCDDA’s annual reporting has needed developed and new topics introduced.
topic received increasing attention in the to keep pace with important changes in In its analysis, the EMCDDA has always
reports in the years to come. the situation. The agency has had to find tried to provide a European perspective,
ways to report on the growth of cannabis while acknowledging the heterogeneity
production within the EU, increasing that exists in Europe. In doing this,
potency and a greater heterogeneity in the reporting from the EMCDDA has
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I Looking back on 25 years of annual reporting on the drugs problem in Europe
especially those within our neighbouring
countries. This means that, in our future
reporting, more efforts will be needed to
locate European drug trends within the
wider global context.
Twenty-five years ago, when the
EMCDDA first reported on drug use at
the European level, a policy priority for
many countries was simply to better
describe the developments that were
taking place and the problems countries
faced. Today these objectives remain,
especially with respect to some of
the emerging threats we are facing,
Photo: unsplash.
but, overall, there is also far greater
understanding of drug issues and a
contributed to the recognition that
An important element of this is corresponding need to, not just describe
European countries share many
a reflection on how the agency the problem, but also to do more to
common problems with regard to
communicates with its audiences. identify and support the implementation
drug use and there is value in working
This reflection is ongoing but already of effective responses.
together to identify and implement
some conclusions are emerging that are
effective solutions.
likely to impact on our annual reporting The implications for the EMCDDA’s
of trends and developments. annual reporting are likely to be that we
The world is a very different place in Among these is the need to move need to exploit better the opportunities
2020 than it was in 1995. Globalisation, towards a more integrated digital that the digital environment provides
technological developments and, more publications model that can allow to link our analysis of drug trends to
recently, the COVID-19 pandemic have greater access to the underlying data, resources on the identification and
transformed all areas of modern life and, more multilingual content and greater sharing of best practice and to extend
not surprisingly, they have also impacted user interactivity. our work to support for the successful
on drug use and the drug market. implementation of proven approaches
The pace of change in this area shows We also recognise that, in addition to in the different contexts and settings
no signs of slowing down. Our reporting our core data sources, which allow us that exist across Europe. The challenges
must therefore keep pace with a world to comment on changes over time, for the next 25 years are therefore
where, for example, new drugs that we need more sensitive and timely considerable.
were unknown 25 years ago can now information that can detect emerging
be purchased online, using encrypted problems. Moreover, the growing A review of the first quarter century of
services or social media applications, importance of synthetic substances, the EMCDDA’s work suggests that, in a
can be paid for using digital currencies, as well as the need to better describe complex and politically sensitive area
and delivered rapidly across national patterns of polydrug use, especially like drug policy, there is enormous value
borders, exploiting commercial delivery with respect to how drug combinations to be drawn from sharing an objective
services and automated pick-up points. impact on overdose and death, requires and non-partisan approach to describing
If one thing is clear from a review of greater use of forensic and toxicological drug problems across Europe and
the last 25 years, it is that the changes data sources. This is because some matching this with discussion on what
in this area are likely to continue to people who use drugs may be unaware constitute effective actions.
accelerate and this requires us to or misinformed on the actual substance
continue to innovate in order to ensure they are consuming, and consequently
our reporting remains aligned to our self-report data, a mainstay of many
stakeholders’ needs. reporting tools, can be sometimes
unreliable.
This is why the EMCDDA is conducting
a futures exercise and reviewing its Within a more global and digitally
business model. enabled market, drug trends in Europe
are also increasingly impacted on
by developments outside of the EU,
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I Looking back on 25 years of annual reporting on the drugs problem in Europe
European Drug Report 2020
COVID-19
How is the COVID-19 pandemic affecting drug use, supply and services?
Drug use and harms
What are the health costs of drug use in Europe today?
Drug markets
What do the latest data tell us about drug production and trafficking trends?
Find out more in the European Drug Report 2020: Trends and Developments
and European Drug Report 2020: Key Issues
www.emcdda.europa.eu/edr2020
Legal notice: Neither the EMCDDA nor any person acting on behalf of the EMCDDA is responsible
for the use that might be made of the information presented.
Luxembourg: Publications Office of the European Union
PDF doi:10.2810/199193 I ISBN 978-92-9497-551-5 I TD-04-20-485-EN-N
© European Monitoring Centre for Drugs and Drug Addiction, 2020
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