The European Drug Report 2023 provides an analysis of the drug situation in Europe and presents the complex challenges associated with drugs
The EU agency on drugs, the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) compiles and analyses the data sent by EU member States, Türkiye and Norway on a yearly basis to produce the European Drug Report. This article presents some of the report’s excerpts that we find especially relevant to Dianova’s field of work. The complete report can be downloaded here.
One of the report’s key messages is that the impact of illegal drug use is now seen almost everywhere in our society. Almost everything with psychoactive properties has the potential to be used as a drug. This means that everyone, whether directly or indirectly, can be affected by illegal drug use and the problems associated with it.
Excerpts from the EMCDDA report:
Today, drug issues have an impact almost everywhere. Domestically, they are manifest in and exacerbate other complex policy problems, such as homelessness, the management of psychiatric disorders, and youth criminality. We are also observing greater levels of violence and corruption driven by the drug market in some countries. Internationally, drug problems are growing in many low- and middle-income countries, undermining governance and development and adding to the already considerable public health and security challenges many countries face.
Increasingly, we are observing that almost everything with psychoactive properties can appear on the drug market, often mislabelled or in mixtures, leaving consumers potentially unaware of what they are using, increasing health risks and creating new law enforcement and regulatory challenges.
The impact of the developments we are seeing means that everyone is in some way likely to be impacted by illicit drug use, the operation of the drug market and the problems associated with it. Directly, we see this in those who develop problems and need treatment or other services. Indirectly, we see it in the recruitment into criminality of vulnerable young people, the strain on health budgets and the social costs for communities that feel unsafe or where institutions or businesses are undermined by corruption or criminal practices.
The drug situation in Europe in 2023 – an overview
Greater diversity in drug availability and use is creating new health and policy challenges
High drug availability has been accompanied by a greater diversity in the substances on the illicit drug market, exposing consumers to a wider range of psychoactive substances. These include new synthetic drugs, for which knowledge about the health risks is often limited. This raises concerns about the potential for the greater use of illicit substances in general and the increased risks associated with some of them. People who use drugs may be at greater risk of adverse health outcomes, including poisonings and deaths, through consuming, possibly unknowingly, higher-potency or more-novel substances, or mixtures of substances where drug interactions may increase the potential health harms.
Evidence-based and joined-up responses can work, but they are often not sufficiently available
Although important knowledge gaps remain, research and investment in service development means that in the areas of drug prevention, treatment, harm reduction and support to recovery, we now have a better understanding of what interventions are likely to be effective. The interrelated nature of problems associated with drug use and other complex social policy issues also means that there is a greater recognition of the need for more integrated and comprehensive responses. Synergies are therefore needed with policy and practice in other important areas, including housing support, generic healthcare, youth and elderly services, mental health provision and the criminal justice system. However, both the availability of drug-specific responses and examples of well-developed, integrated models of care are extremely heterogeneous at the European level and, in many countries, there is a need to invest more in both of these areas.
Growing support for implementing evidence-based substance use prevention
Substance use prevention aims to stop or delay the use of psychoactive drugs. It also may help those who have started to use substances to avoid the development of drug use disorders. However, historically, not all approaches utilized in this area have been found to be effective, and interest in the identification and implementation of evidence-based prevention programmes has been increasing. Achieving this objective is now supported by the establishment of prevention programme registries, training initiatives and the development of quality standards. The European Prevention Curriculum is designed to improve the overall effectiveness of prevention efforts. More than 25 EU Member States and neighbouring countries now have national European Prevention Curriculum trainers. Prevention efforts are also supported by Xchange, a European online registry of evaluated prevention interventions.
Provision of harm reduction services needs to be further strengthened
The use of illicit drugs causes a range of acute and chronic harms and is a recognised contributor to the global burden of disease. Related harm reduction responses, such as opioid agonist treatment and the provision of sterile equipment to people who inject drugs, are now widely accepted as making an important contribution to healthcare provision. However, coverage and access to these types of interventions remain inadequate in some EU Member States compared with the estimated needs. Some countries have also invested in newer services, such as drug consumption rooms, take-home naloxone programmes and drug checking facilities. The availability of these services remains more limited. Moreover, there is generally less consensus among countries on the extent to which these measures are appropriate responses. A need exists, therefore, for further research and evaluation studies to strengthen the evidence base required for informing policy deliberations in this area.
Multidisciplinary support needed to treat an ageing cohort of opioid clients
Current estimates suggest that opioid agonist treatment was received by about half of those engaging in high-risk opioid use in the European Union in 2021, an estimated 511 000 (524 000 including Norway and Türkiye). The evidence available supports opioid agonist treatment, with positive health and social outcomes observed, which include reductions in the risk of mortality. Over 60 % of clients in opioid agonist treatment, however, are now aged 40 or older, while less than 10 % are under 30 years old. This means that services have to address a more complex set of healthcare needs in a population that is becoming ever more vulnerable. Effective referral pathways are required to more generic services offering treatment for conditions associated with the ageing process. The treatment of this often highly marginalized group also needs to respond to a complex set of problems related, not only to their drug use, but also to mental health issues, social isolation, employment and housing. An increased emphasis on establishing effective multi-agency partnerships with generic health and social support services is therefore required.