World Drug Report: Health & Social Consequences

"The prison population should have access to services equivalent to those available to the general public"

Source: World Drug Report (UNODC) – In Europe, the financial crisis seems to have had an impact on drug use modalities, with related health and social consequences. While there are no comprehensive data available yet, two phenomena seem to have emerged in parts of Europe that have appeared in parallel to the financial crisis. First, there appears to be a shift in the pattern of drug use which sometimes results in a higher risk of harm; and secondly, there has been a reduction in coverage of harm reduction services, which, according to recently published research, has increased the likelihood of unsafe injecting practices, thus influencing the spread of infections such as HIV and Hepatitis C. 

Prevalence of Drug Use

  •   The extent of problem drug use remains stable at between 16 million and 39 million people. However, as in recent years there continues to be a gap in service provision since only one in six problem drug users globally have had access to or received drug dependence treatment services each year.
  •   The number of persons seeking treatment for cannabis use disorders has increased over the past decade, particularly in the Americas, Oceania and Europe. Nonetheless, opiates remained the most prevalent primary drug of abuse among those seeking treatment in Asia and in Europe, as did cocaine in the Americas.
  •   It is estimated that the number of people who inject drugs is 12.7 million (range: 8.9 million-22.4 million), which corresponds to a prevalence f 0.27 per cent (range: 0.19-0.48 per cent) of the population aged 15-64.The problem is particularly stark in Eastern and South-Eastern Europe, where the rate of injecting drug use is 4.6 times higher than the global average. 

HIV/AIDS

It is estimated that an average of 13.1 per cent of the total number of people who inject drugs are living with HIV or f 1.7 million persons (range: 0.9-4.8 million). That situation is particularly pronounced in South-West Asia and Eastern/South-Eastern Europe, where it is estimated that HIV prevalence among IV drug users is 28.8 and 23.0 per cent, respectively. In addition, more than half of the people who inject drugs are estimated to be living with hepatitis C.

Addressing HIV among people who inject drugs is a key component of the global response to stop the spread of HIV through harm reduction services. Of them, the four most effective include needle and syringe programs, opioid substitution therapy, HIV testing and counseling and antiretroviral therapy. 

The coverage of these interventions is greatest in Western and Central Europe where harm reductions strategies have been scaled up for more than a decade, leading to a decline in the number of newly diagnosed cases of HIV among IV drug users. However, recent outbreaks of HIV among people who inject drugs in some parts of Europe demonstrate how the HIV epidemic situation can change rapidly in areas where interventions are scaled down.

Prison

A very high percentage of people who inject drugs have already been held in prison where both drug use and injecting drug use are rampant. The situation has become a major concern due to the lack of access to and availability of health care, especially drug dependence treatment programs and HIV prevention and treatment services. The prison population should, at a minimum, have access to services equivalent to those available to the general public. For instance, in Europe, the proportion of prisoners who had used an illicit substance during incarceration ranged from 4-56 per cent 56 %