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.
Amphetamine and methamphetamine are central nervous system stimulants. Of the two drugs, amphetamine is by far the more commonly available in Europe. Worldwide, increasing levels of use of methamphetamine are a cause for considerable concern, as the drug is associated with a range of severe health problems. Within Europe, significant methamphetamine use appears to be restricted to the Czech Republic.
Ecstasy refers to synthetic substances that are chemically related to amphetamines but which differ to some extent in their effects. The best-known member of the ecstasy group of drugs is 3,4-methylenedioxy-methamphetamine (MDMA), but other analogues are also occasionally found in ecstasy tablets (MDA, MDEA, etc.). These drugs are sometimes known as entactogens, a reference to their very specific mood-altering effects. Sometimes they provoke effects more typically associated with hallucinogenic substances.
Historically, lysergic acid diethylamide (LSD) has been by far the best-known hallucinogenic drug, but overall consumption levels have been low and somewhat stable for a considerable time. Recently, evidence of increased availability and use of naturally occurring hallucinogenic substances, hallucinogenic mushrooms in particular, has emerged.
To detect new drugs emerging on the European drug scene, the EU has in place an early-warning system. This system also monitors potentially harmful new trends in the use of psychoactive substances.
The production of amphetamines and ecstasy is difficult to quantify because ‘it starts with readily available chemicals, in easily concealed laboratories’ (UNODC, 2003a). The most recent estimate of annual global production of amphetamines and ecstasy is about 520 tonnes (UNODC, 2003b). Global seizures of these substances peaked in 2000 at 46 tonnes. Following a decline in 2001 and 2002, seizures increased again to 34 tonnes in 2003, and declined slightly to 29 tonnes in 2004. In 2004, the share of global amphetamines and ecstasy seizures accounted for by methamphetamine fell to 38 % (from 66 % in 2003), with ecstasy accounting for 29 % and amphetamine 20 % (CND, 2006).
Worldwide, amphetamine production remains concentrated in Western and Central Europe, in particular in Belgium, the Netherlands and Poland. In this sub-region, Estonia, Lithuania and Bulgaria also play a significant role in the illicit manufacture of amphetamine, and to a lesser extent Germany, Spain and Norway, as shown by the dismantling of amphetamine laboratories in 2004 in these countries (UNODC, 2006) (82). Outside Europe, amphetamine is mainly manufactured in North America and Oceania (CND, 2006). Trafficking in amphetamine in 2004 remained mainly intraregional. Most amphetamine found on European illicit markets comes from Belgium, the Netherlands and Poland, and also from Estonia and Lithuania (in the Nordic Countries) (Reitox national reports, 2005; WCO, 2005).
Of the 6 tonnes of amphetamine seized worldwide in 2004, about 97 % was seized in Europe, mostly in Western/Central Europe and South-eastern Europe (accounting respectively for 67 % and 26 % of the global amount seized) (CND, 2006).
In 2004, an estimated 33 000 seizures of amphetamine, amounting to 5.2 tonnes and 9.6 million units, were made in the EU. In terms of number of seizures and weight of amphetamine seized, the United Kingdom has consistently been the main amphetamine-seizing country in the EU (83). Turkey reported the interception of 9.5 million units of amphetamine in 2004. Despite some fluctuations, at EU level both the overall number of amphetamine seizures (84) and quantities seized (85) have increased since 1999 and, based on the findings from reporting countries, this upward trend seems to have continued in 2004.
In 2004, the average retail price of amphetamine ranged from 4 euros per gram in Slovenia to 64 euros per gram in Malta (86). Over the period 1999–2004, amphetamine prices, corrected for inflation (87), decreased overall in Germany, Spain, Ireland, Latvia, Lithuania, Sweden, the United Kingdom, Bulgaria, Turkey and Norway (88).
The average purity of amphetamine in 2004 varied from 5–6 % in Bulgaria to 44 % in Norway (89). Available data (90) on average amphetamine purity for the period 1999–2004 reveal overall downward trends in Latvia, Lithuania, Luxembourg, Finland and Norway and upward trends in Belgium, Germany, France, Italy, Hungary and Austria.
Worldwide, in terms of quantities manufactured and trafficked, methamphetamine continues to be more important than amphetamine or ecstasy, although its share in global seizures fell in 2004. It continues to be mostly manufactured in East and South-east Asia (China, the Philippines, Myanmar, Thailand), followed by North and Central America (United States, Canada, Mexico). In 2004, 11 tonnes of methamphetamine was seized worldwide, of which 59 % was seized in East and South-east Asia and 37 % in North America (CND, 2006). In Europe, production of methamphetamine is largely limited to the Czech Republic, where it has been produced since the mid-1980s under the local name of ‘pervitin’. In 2004, however, manufacture was also reported in Slovakia and Bulgaria, where laboratories were dismantled (Reitox national reports, 2005; UNODC, 2006). Most of the Czech production of methamphetamine is destined for the local market, although some is smuggled to Germany, Austria and Slovakia (Reitox national reports, 2005). In 2004, methamphetamine seizures were reported in Belgium, the Czech Republic, Denmark, Estonia, Greece, France, Latvia, Lithuania, Hungary, Austria, Slovakia, Sweden, Romania and Norway, the last accounting for both the highest number of seizures and the greatest quantities recovered (91).
In 2004, the price (92) of methamphetamine at retail level in the Czech Republic was reported to vary between 12 and 63 euros per gram, while its average purity (93) ranged between 43 % in Slovakia and 50 % in the Czech Republic.
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).
Ecstasy trafficking is still strongly concentrated in Western Europe, although, like production, it has spread throughout the world in recent years. Of the 8.5 tonnes (weight equivalent) of ecstasy seized globally in 2004, 50 % was recovered in Western and Central Europe, 23 % in North America and 16 % in Oceania (CND, 2006).
An estimated 24 000 seizures led to the confiscation of about 28.3 million ecstasy tablets in the EU in 2004. Up to 2003, the largest quantities of ecstasy were seized by the United Kingdom, followed by Germany, France and the Netherlands (94).
After a rapid increase over the period 1999–2001, the number of ecstasy seizures (95) at EU level declined in 2002–03; but data from reporting countries indicate an increase again in 2004. Quantities of ecstasy (96) intercepted increased from 1999 to 2002; after a steep decline to a low point in 2003, the available data for 2004 suggest that they again reached the 2002 level.
In 2004, the average retail cost of ecstasy tablets ranged from less than 3 euros each in Lithuania and Poland to 15–25 euros in Greece and Italy (97). During 1999–2004, average retail prices of ecstasy, corrected for inflation (98), fell in most reporting countries (99).
Generally in Europe, most tablets sold as ecstasy contained MDMA or another ecstasy-like substance (MDEA, MDA), usually as the only psychoactive substance present. In the Czech Republic, Greece, Latvia, Lithuania, Hungary, the Netherlands, Slovakia, Finland, the United Kingdom and Norway, such tablets accounted for more than 95 % of the total number of tablets analysed in 2004. An exception to this finding occurred in Bulgaria, where a high percentage (61 %) of tablets analysed contained amphetamine and/or methamphetamine as the only psychoactive substances. The MDMA content of ecstasy tablets varies greatly between batches (even between those with the same logo) both between and within countries. In 2004, the average content of active substance (MDMA) per ecstasy tablet was reported to range from 30 to 82 mg (100) (Reitox national reports, 2005).
LSD is manufactured and trafficked to a much smaller extent than other synthetic drugs. In 2004, an estimated 700 seizures of 220 000 LSD units were made in the EU. Since 2002, Germany has been the country seizing the largest quantities of LSD per year, followed by the United Kingdom (101). Between 1999 and 2002, at EU level, both the number of LSD seizures (102) and quantities seized (103) decreased. However, in both 2003 and 2004, the available data suggest that numbers of LSD seizures and amounts intercepted increased for the first time in 9 years, with relatively large amounts of the drug seized in Germany, France, Lithuania, the Netherlands and Poland in 2004.
In 2004, the average cost to users of an LSD unit ranged from 2.5 euros in Portugal to 11.6 euros in Malta (104). Average prices of LSD, corrected for inflation (105), showed an overall downward trend (106) between 1999 and 2004 in the Czech Republic, Ireland, Poland, Slovenia and Sweden, but increased in Germany and France.
In the area of synthetic drugs, Europol has been running Project Synergy since December 2004 (107). It is supported by 20 EU Member States and some third states, and includes an analytical work file (AWF) with operational sub-projects carried out throughout the EU across several countries, as well as a number of instruments used for analytical and strategic purposes, such as the Europol ecstasy logo system (EELS) (including the ecstasy logo catalogue) and the Europol illicit laboratory comparison system (ELICS). Europol continues to support the CHAIN Project (108) on amphetamine profiling and the European Joint Unit on Precursors (EUJP). Besides on-the-spot expert assistance in dismantling illicit synthetic drug production, recent sub-projects have focused on comparing the laboratories dismantled, on uncovering chemical dump sites as starting points for investigations, on back-tracking tablet machines, and on investigating trafficking in precursor chemicals to the EU countries.
Project Prism is the international initiative set up to prevent the diversion of precursor chemicals used in the illicit manufacture of synthetic drugs, through a system of pre-export notifications for licit trade to the International Narcotics Control Board (INCB) and the reporting of shipments stopped and seizures made when suspicious transactions occur.
Ephedrine and pseudo-ephedrine are key precursors for methamphetamine, while 1-phenyl-2-propanone (P-2-P) is also used to manufacture amphetamine; 3,4-methylenedioxyphenyl-2-propanone (3,4-MDP-2-P), safrole and safrole-rich oils are used in the illicit manufacture of MDMA, while piperonal is also used to synthesise MDA (109).
Licit trade of ephedrine and pseudo-ephedrine amounted to a total of 526 and 1 207 tonnes respectively in 2004. The largest seizures of these chemicals were reported in North America and South-east Asia, but there is concern that seizures have spread to all regions. Smuggling of ephedrine and pseudo-ephedrine to Europe originates mainly in West Asia. In 2004, 2.6 tonnes of ephedrine and 1 kg of pseudo-ephedrine were seized in Europe (110); the seizures were mostly small seizures and came from many different laboratories, a majority in the Czech Republic, although there was a large seizure in Greece of ephedrine from Pakistan.
The activities of the Project Prism in Europe have focused on preventing the smuggling of 3,4-MDP-2-P and P-2-P into the EU for use in the illicit manufacture of MDMA and amphetamine respectively. In 2004, seizures of 3,4-MDP-2-P and P-2-P were the largest ever reported globally, Europe accounting for the greatest quantities of 3,4-MDP-2-P seized and the United States for the greatest quantities of P-2-P seized. In 2004, seizures in Europe totalled 10 161 litres of 3,4-MDP-2-P (mostly in the Netherlands and Belgium) and 9 297 litres of P-2-P (mostly in Poland and the Netherlands) (111).
Piperonal has many licit uses but may also be used as a precursor in the manufacture of 3,4-MDP-2-P, MDA or MDMA (INCB, 2006b). Between November 2004 and October 2005, over 150 shipments of 3 800 tonnes were reported to the INCB (2006b). In 2004, the greatest seizures of piperonal were reported by China (13 tonnes); 2.4 tonnes was seized in Europe, nearly all of it in Romania (112).
Seizures of safrole are reported from all regions worldwide but quantities remain small, except in China, which reports seizures over 100 kg. In Europe 122 litres of safrole was seized in 2004, mainly in Latvia but also in Lithuania.
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.
Among EU Member States, use of amphetamines (113) 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 is 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 (114).
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 (115). It is estimated that, on average, 1.4 % of young Europeans have used amphetamine in the last year (see also Figure 4).
Ecstasy has been tried by 0.2–7.1 % of all adults (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.
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.
Ecstasy use is predominantly a youth phenomenon. In the 15–24 years age group, lifetime use ranges from 0.4 % to 18.7 %, with the highest figures reported by the Czech Republic (18.7 %) (116) and the United Kingdom (10.7 %), and with higher rates among males (0.3–23.2 %) than among females (0.4–13.9 %). Use in the last year ranges from 0.3 % to 12 %, with the Czech Republic (12 %) and Estonia (6.1 %) reporting the highest figures (Figure 5). Last month prevalence rates lower than 3 % are reported by seven countries. Prevalence rates are typically higher in urban areas, and in particular among people frequenting discos, clubs or dancing events (see the selected issue on drug use in recreational settings).
Among 15- to 16-year-old school students, surveys show that overall lifetime prevalence of ecstasy use increased over the period 1995–2003, with the greatest increases occurring in the Czech Republic and most of the new EU Member States (117). In the 2003 ESPAD school surveys (Hibell et al., 2004), lifetime prevalence estimates for amphetamines remained between 1 % and 3 % higher than those for ecstasy in six Member states (Denmark, Germany, Estonia, Lithuania, Austria and Poland) (118).
For comparison, in the 2004 United States 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 (for comparison, 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) (119).
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.
Significant problems with methamphetamine use have been reported in many parts of the world, including the USA, South-east Asia and the Pacific, and Africa (UNODC, 2006). Methamphetamine use can lead to serious medical problems, including psychosis and dependence, and may be associated with risky behaviours, including some that could lead to HIV transmission.
Historically, methamphetamine use in Europe has been concentrated in the Czech Republic, where there are estimated to be twice as many problem methamphetamine (pervitin) users (20 300) as problem opioid users (9 700). In recent years, methamphetamine has become the most frequent primary drug among those demanding treatment for the first time in Slovakia, and high levels of methamphetamine use have also been found among some subpopulations in Hungary. In their 2005 Reitox reports, seven other countries (Denmark, France, Latvia, Slovenia, the United Kingdom, Bulgaria and Norway) reported an increase in seizures and/or use of this drug, mainly among frequent attendees at clubs and parties. Currently, the available information does not allow us to draw any firm conclusions on trends in methamphetamine use in these countries. Nevertheless, the spread of methamphetamine elsewhere in the world and the potential for this drug to cause significant health problems means that this is an area in which continued vigilance is required.
There is evidence from new population surveys that amphetamine and ecstasy consumption, which has shown an increasing trend in recent years, may be stabilising or even decreasing. In the United Kingdom, as well as in two other Member States where consumption of these drugs has been relatively high (the Czech Republic and Spain), last year use of amphetamines among young adults is now reported to be stabilising or even decreasing (120). And, similarly, ecstasy use appears to be levelling off or even declining in two high-prevalence countries, Spain and the United Kingdom, although not in the Czech Republic (121).
Although the number of demands for treatment relating to the use of amphetamines and ecstasy is increasing, in general, this form of drug use is rarely the primary reason for attending drug treatment in most countries (123). An important exception is that a few countries do report a substantial proportion of treatment requests related to amphetamine or methamphetamine use. In the Czech Republic, Slovakia, Finland and Sweden these drugs account for anything from a quarter to around a half of all treatment demands (124). In the Czech Republic and Slovakia, a large proportion of reported treatment demands relate to a primary methamphetamine problem (see box on methamphetamine). In those countries where amphetamines users account for a substantial portion of treatment requests, between one-third and two-thirds of amphetamines clients inject the drug (125).
Demands for treatment related to ecstasy use are reported to account for less than 1 % of all treatment demands in most countries, with the exception of Cyprus, Hungary, Ireland and Turkey, where ecstasy clients constitute between 4 % and 6 % of all clients seeking treatment.
Prevalence estimates for the use of new or emerging as drugs are much lower than those for the use of more established illicit drugs. New forms of drug use are likely to be adopted initially by a few individuals, among small subpopulations or in limited geographical locations or settings. Consequently, the identification and monitoring of emerging trends demands a different type of approach from that used for monitoring the main types of drug use.
Until recently, LSD was the most commonly used hallucinogenic substance. This may now be changing as the use of hallucinogenic mushrooms (126) has become increasingly reported. The availability of hallucinogenic mushrooms appears to have increased since the late 1990s, when they began to be marketed alongside other ‘natural’ products in 'smart shops' in the Netherlands and elsewhere (127). For example, in the United Kingdom, during the early 2000s, the number of shops selling hallucinogenic mushrooms increased, and by 2005 it was estimated that they were being sold in about 300 shops and market stalls across the country. The sale of hallucinogenic mushrooms through the Internet also emerged, with sites, mainly Dutch based, selling fresh mushrooms, growing kits and spore prints. Online marketing of hallucinogenic mushrooms is conducted in a variety of languages, mainly English, French and German, implying a wide international consumer base.
Recent adult and school population surveys in the EU indicate that, among young people aged 15–24 years, lifetime use of hallucinogenic mushrooms ranges from less than 1 % to 8 % (128). Lifetime prevalence estimates for use of hallucinogenic mushrooms among school students aged 15–16 years are equal to, or higher than, lifetime prevalence estimates for ecstasy use in nine of the EU Member States (Hibell et al., 2004). However, there are indications that continuation rates are lower for hallucinogenic mushrooms than for most other drugs. This is a common feature of hallucinogenic drug use and reflects the fact that young people generally choose to confine this type of drug use to experimenting and rarely go on to develop patterns of regular use.
Reports about acute or chronic health problems requiring medical interventions relating to the use of hallucinogenic mushrooms are rare. However, some countries changed their laws in response to the use of such hallucinogenic substances by young people. Although the active ingredients of mushrooms, psilocybin and psilocin, are already controlled at international level by the 1971 UN Convention on Psychotropic Substances, until recently it has often been left to prosecutors to interpret whether and when these substances are prohibited when inside a mushroom, to avoid penalising the owners of land on which such mushrooms grow naturally. Six countries have tightened up their legislation on mushrooms in the last 5 years (Denmark, Germany, Estonia, Ireland, the Netherlands and the United Kingdom). The changes made by these countries extend prohibition to include hallucinogenic mushrooms, although legal controls do not always apply to exactly the same mushrooms or states of preparation.
In 2004, seizures of hallucinogenic mushrooms were reported in the Czech Republic, Germany, Estonia, Greece, Lithuania, Hungary, the Netherlands, Poland, Portugal, Slovenia, Slovakia, Sweden and Norway (129). The number and quantity of law enforcement seizures of hallucinogenic mushrooms are generally low and no clear trends emerge from these data.
Both gamma-hydroxybutyrate (GHB) and ketamine are being monitored following EU concerns arising in 2000 about the misuse of these drugs for recreational purposes (130). In March 2001 the UN drugs control system added GHB to the list of internationally controlled drugs, and as a result all EU Member States have been updating their legislation on this substance. More recently, in March 2006, the INCB recommended that the WHO expedite its review to determine whether ketamine should be placed under international control (INCB, 2006a). At national level, ketamine is controlled under drugs legislation, as opposed to medicine regulations, in almost half of the EU Member States.
The limited prevalence data available on GHB and ketamine suggest that use of these substances has stabilised at low levels in most countries. Studies of high-prevalence populations suggest that even among regular recreational drug users both of these drugs may be less commonly used than other substances such as amphetamines, ecstasy, LSD and hallucinogenic mushrooms.
Council Decision 2005/387/JHA of 10 May 2005 on the information exchange, risk assessment and control of new psychoactive substances (1) establishes a mechanism for the rapid exchange of information on new psychoactive substances that may pose public health and social threat, thus allowing the EU institutions and Member States to act on both new narcotic and new psychotropic drugs that appear on the European drug scene. The EMCDDA and Europol, in close cooperation with their networks – the Reitox national focal points (NFPs) and Europol national units (ENUs) respectively – have been assigned a central role in detecting and notifying new psychoactive substances. The decision also provides for an assessment of the risks associated with these new substances so that measures applicable in the Member States for the control of narcotic and psychotropic substances (2) can also be applied to new psychoactive substances if appropriate. The decision broadens the scope of, and replaces, the 1997 joint action (3), which was devoted exclusively to new synthetic drugs. The decision, however, maintains the three-step approach piloted by the joint action: information exchange/early warning, risk assessment and decision-making.
(1) Council Decision 2005/387/JHA on information exchange, risk assessment and control of new psychoactive substances was published in the Official Journal of the European Union on 20 May 2005 (L 127/32–37) and took effect on 21 May 2005. The decision applies to substances currently not listed in any of the schedules to the 1961 and 1971 UN drug control conventions.
(2) In compliance with the provisions of the 1961 UN Single Convention on Narcotic Drugs and the 1971 UN Convention on Psychotropic Substances.
(3) Joint action of 16 June 1997 concerning the information exchange, risk assessment and control of new synthetic drugs (OJ L 167, 25.06.1997).
Deaths and non-fatal emergencies reported to be associated with the use of GHB and ketamine are very rare. However, the absence of accurate and comparable systems for recording deaths and non-fatal emergencies related to the use of these substances limits the data available in this area. Two countries have reported deaths related to GHB, usually in association with other drugs. The Municipal Health Service in Amsterdam recorded an increase in the annual number of non-fatal emergencies attributable to the use of GHB from 25 in 2000 to 98 in 2004, more than the number of medical emergencies attributed to use of ecstasy, amphetamine, LSD or hallucinogenic mushrooms. In Sweden, detections of GHB (or its precursors GBL and 1,4-BD) in body fluid specimens increased from 24 in 1997 to 367 in 2004. Deaths associated with GHB have also been reported in Sweden: between 1996 and 2004 the drug was detected in 36 drug-related deaths, with nine of these occurring in 2004. In England and Wales in 2003, GHB was mentioned in the coroner’s report of three deaths, in one of which GHB was the only drug mentioned (ONS, 2006). However, toxicological information from one hospital in the United Kingdom, covering a large region, indicates that GHB was detected in five deaths between May and December 2005 (131).
As GHB is water/alcohol-soluble, and because of its potentially incapacitating effects, often followed by amnesia, there have been concerns that it is being used in drug-facilitated sexual assaults (so-called ‘date rapes’). However, as cases may remain unreported, and because forensic evidence is scarce and such crimes are difficult to prove, there is no sound evidence on the extent of this phenomenon. Further research is therefore needed to determine the nature and extent of this potentially worrying development.
There was a smooth transition, with no disruption in information exchange, in 2005 when the 1997 joint action was superseded by the new Council Decision (2005/387/JHA). A total of 14 new psychoactive substances were officially notified for the first time to the EMCDDA and Europol. They are all psychotropic (synthetic) drugs, similar to those listed in Schedules I and II of the 1971 UN Convention on Psychotropic Substances. The newly notified substances belonged to three major chemical groups – phenethylamines, tryptamines and piperazines. Various substances from these groups have been previously notified through, and are currently being monitored by, the early-warning system (EWS) (132).
Drug use and the recreational activities of young people are often linked. In particular, studies targeted at young people attending music and dance events consistently report much higher prevalence estimates for drug use than those found in general population surveys, with particularly high levels of stimulant drug use often being reported. Can differences between countries be explained in terms of the variety of commercial nightlife settings available, music culture, drug availability and disposable incomes? These questions are explored in this selected issue.
New developments in the promotion of recreational drugs via the Internet and in recreational drug use itself bring with them new challenges in the fields of policy, prevention and risk reduction. These are explored in this selected issue, which also reviews in detail the innovative drug prevention and risk reduction initiatives that have been introduced in the EU over the past decade in response to the complex problem of the interaction of leisure activities and drug use by young people.
This selected issue is available in print and on the Internet in English only (http://issues06.emcdda.europa.eu).
The most significant new development in 2005 was the appearance and rapid spread of the new psychoactive substance 1-(3-chlorophenyl)piperazine (mCPP). mCPP is an aryl-substituted piperazine, as is benzylpiperazine (BZP), a substance monitored by the EWS since 1999. The first official notifications of the detection of mCPP were received by the EMCDDA and Europol in February/March 2005, concerning samples collected in France and Sweden. By the end of 2005, mCPP-containing tablets had been seized by the law enforcement authorities or found in the context of various recreational activities (open-air dance/music festivals, dance clubs, etc.) in almost all Member States. They are almost always designed to look like, and presumably marketed as, ecstasy. The drug is chiefly available in tablet form, and the subjective effects of mCPP and MDMA are partially comparable (Bossong et al., 2005). In addition, mCPP is often found in combination with MDMA. Since this is unlikely to be the result of accidental contamination, it suggests that the deliberate addition of mCPP may be intended to potentiate or modify the effects of MDMA. There seems to be little specific demand or market for mCPP in its own right in the EU.
mCPP has been more widely identified by Member States than any other new psychoactive substance since the EWS started to monitor new (synthetic) drugs in 1997. It has been identified within the space of a year in 20 Member States as well as in Romania and Norway.
In a joint report, the EMCDDA and Europol recommended, in line with the provisions of the Council decision, that no formal risk assessment be carried out as there is evidence that mCPP is used in the manufacture of at least one medicinal product. However, it was also noted that, despite the fact that at present there is little evidence of significant public health or social risks related to mCPP, this question must remain open in the absence of a thorough scientific risk assessment.
(82) The number of laboratories dismantled reported in different countries reflects, in addition to the number of production sites, law enforcement activities and priorities as well as reporting practices.
(83) This situation should be checked against 2004 data for the United Kingdom when available. Data on both number of amphetamine seizures and quantities of amphetamine seized in 2004 were not available for Ireland and the United Kingdom; data on quantities of amphetamine seized were not available for Slovenia in 2004; data on number of amphetamine seizures were not available for the Netherlands in 2004. For estimating purposes, 2004 missing data were replaced by 2003 data. Data on quantities seized in 2004 provided by the Netherlands were only estimates, which could not be included in the analysis of trends to 2004.
(87) Taking 1999 as the base year for the value of money in all countries.
(88) Over the period 1999–2004, data on amphetamine prices were available for at least three consecutive years in Belgium, Germany, Spain, France, Ireland, Latvia, Lithuania, Poland, Sweden, the United Kingdom, Bulgaria, Turkey and Norway.
(90) Over the period 1999–2004, data on amphetamine purity were available for at least three consecutive years in Belgium, Germany, Estonia, France, Italy, Latvia, Lithuania, Luxembourg, Hungary, the Netherlands, Poland, Portugal, Finland, the United Kingdom, Turkey and Norway.
(91) Data for 2004 provided by Germany, Italy, Luxembourg and the Netherlands do not allow methamphetamine and amphetamine seizures to be distinguished, while Ireland and the United Kingdom did not provide 2004 data on drug seizures, making it difficult to know whether any methamphetamine seizures occurred in these five countries in 2004.
(94) This situation should be checked against 2004 data for the United Kingdom when available. Data on both number of ecstasy seizures and quantities of ecstasy seized in 2004 were not available for Ireland and the United Kingdom; data on number of ecstasy seizures were not available for the Netherlands in 2004. For estimating purposes, 2004 missing data were replaced by 2003 data. Data on quantities seized in 2004 provided by the Netherlands were only estimates, which could not be included in the analysis of trends to 2004.
(98) Taking 1999 as the base year for the value of money in all countries.
(99) Over the period 1999–2004, data on ecstasy prices were available for at least three consecutive years in Belgium, Czech Republic, Germany, Spain, France, Ireland, Cyprus, Latvia, Lithuania, Luxembourg, Poland, Portugal, Slovenia, Sweden, the United Kingdom, Bulgaria, Turkey and Norway.
(100) This range is based on data from a few countries only, namely Denmark, Germany, France, Luxembourg and the Netherlands.
(101) This situation should be checked against 2004 data for the United Kingdom when available. Data on both the number of LSD seizures and quantities of LSD seized in 2004 were not available for Ireland and the United Kingdom; data on the number of LSD seizures seized were not available for Cyprus, the Netherlands, Poland and Bulgaria. For estimating purposes, 2004 missing data were replaced by 2003 data. Data on quantities seized in 2004 provided by the Netherlands were only estimates, which could not be included in the analysis of trends to 2004.
(105) Taking 1999 as the base year for the value of money in all countries.
(106) Over the period 1999–2004, data on LSD prices were available for at least three consecutive years in the Czech Republic, Germany, Spain, France, Ireland, Lithuania, Poland, Portugal, Slovenia, Sweden, the United Kingdom, Romania and Norway.
(107) Project Synergy merged Projects CASE and Genesis, which commenced in 2002.
(108) The Collaborative Harmonised Amphetamine INitiative (CHAIN) is a forensic profiling initiative which has superseded the CASE pilot project.
(109) All scheduled under Table I of the 1988 Convention.
(110) Seizure data do not include quantities involved in stopped shipments.
(111) Seizure data do not include quantities involved in stopped shipments.
(112) Seizure data do not include quantities involved in stopped shipments.
(113) Within the framework of population surveys, data on ‘amphetamine use’ include use of both ‘amphetamine’ and ‘methamphetamine’ under one category.
(114) For the method of computation see footnote (53).
(116) In the Czech Republic, the age group surveyed was 18–24 years.
(119) Source: SAMHSA, Office of Applied Studies, 2004 National Survey on Drug Use and Health (http://oas.samhsa.gov/nsduh.htm#nsduhinfo). Note that the age range in the US survey (12 years and over) is wider than the age range reported by the EMCDDA for EU surveys (15–64 years). The figures for ‘young adults’ (16–34 years) for the US survey were recomputed by the EMCDDA.
(122) See footnote (70).
(126) In this report, the term hallucinogenic mushrooms refers only to fungi containing the psychoactive substances psilocybin and psilocin. Species of fungi containing other psychoactive substances are more rarely used. See the EMCDDA thematic paper on hallucinogenic mushrooms for more information (http://www.emcdda.europa.eu/?nnodeid=400).
(127) These shops sell legal and predominantly natural products, including hallucinogenic mushrooms.
(128) EMCDDA data from European Model Questionnaire. Eleven Member States provide data on hallucinogenic mushrooms (Czech Republic, Denmark, Germany, France, Ireland, Lithuania, Hungary, Netherlands, Poland, Finland, United Kingdom).
(129) Reitox national reports (Germany, Estonia, the Netherlands, Norway) and EMCDDA early-warning system network questionnaire (Czech Republic, Greece, Hungary, Poland, Portugal, Slovenia, Slovakia, Sweden).
(130) Joint action risk assessment report 2000.
(131) Information from the EWS. The relatively high number of deaths related to GHB in this report is likely to reflect the research interest in GHB by the hospital laboratory.
(132) Of the nine new synthetic drugs that underwent risk assessment between 1997 and 2004 under the joint action, all six substances that were subsequently controlled at EU level were phenethylamines.