Treatment demand data


Box 5: Treatment demand indicator

Information on the number of people seeking treatment for a drug problem provides a useful insight into general trends in problem drug use and also offers a perspective on the organisation and uptake of treatment facilities in Europe. The EMCDDA’s treatment demand indicator (TDI) (1) (2) provides a uniform structure for reporting the number and characteristics of clients referred to drug treatment facilities. Although TDI data can be regarded as providing a reasonably robust and useful representation of the characteristics of clients referred to specialised drug services, for a number of technical reasons caution should be exercised in extrapolating findings to the clientele across the overall provision of services. In particular, the number of countries reporting each year varies and therefore trends identified at the European level need to be interpreted with caution. In addition, it should be considered that data coverage may change by country (data on units covered are reported in the statistical bulletin) and treatment demand data partly reflect the availability of drug treatment in the countries.

To facilitate interpretation and comparison of treatment demand data, the following points should be borne in mind:

  • Clients starting treatment for drug use for the first time are referred to as ‘new clients’. This group is considered analytically more important as an indicator of trends in drug use. Analyses are also reported for all clients. This group includes new clients as well as those who, having interrupted or ended treatment in a previous year, resumed it in the reporting year. Data on clients who during the reporting period continued, without interruption, treatment that had been begun in previous years are not recorded.

  • Two types of data are collected: summary data on all types of treatment centres and detailed data by centre type (outpatient treatment centres, inpatient treatment centres, low-threshold agencies, general practitioners, treatment units in prison, other types of centres). However, for most countries, data are sparse for centre types other than outpatient and inpatient treatment centres. For this reason, analysis is often restricted to outpatient treatment centres, for which data coverage is best.

  • Qualitative and contextual information extracted from the 2004 Reitox national reports is also included to aid in the interpretation of TDI data.

(1) For further details, see the EMCDDA’s web page on treatment demand and the Joint Pompidou Group–EMCDDA Treatment demand indicator protocol version 2.0.

(2) For details on data sources by country, see Table TDI-1 in the 2005 statistical bulletin.


Among the approximately 480 000 treatment demands reported in total, cannabis is reported as the primary drug in about 12 % of cases, making it the second drug after heroin. Over the eight-year period 1996–2003, the proportion of cannabis clients among new clients seeking treatment for all drugs increased by at least two-fold in many countries (44), with a similar rise in numbers of clients. However, this analysis should be treated with caution as it is based on a restricted number of countries that can provide the data necessary for a time-trend comparison.

Overall, after heroin, cannabis is also the second most frequently cited drug in reports on clients entering treatment for the first time (45). There are considerable variations between countries, with cannabis being cited by 2–3 % of all clients in Bulgaria and Poland but by more than 20 % of all clients in Denmark, Germany, Hungary and Finland (46). In all countries from which data are available, the proportion of clients seeking treatment for cannabis use is higher among new clients than among all clients, with only a few exceptions, where the proportions are roughly equal (47). Nonetheless, over the eight-year period 1996–2003, the proportion of cannabis clients among clients seeking treatment for all drugs increased from 9.4 % to 21.9 % (48). However, this analysis should be treated with caution as it is based on a restricted number of countries that can provide the data necessary for a time-trend comparison.

Among drug users in treatment, males far outnumber females. The highest male to female ratios are found among new clients demanding treatment for cannabis use (4.8 to 1). Higher male to female ratios are found in Germany, Cyprus, Hungary and Slovakia and lower ratios in the Czech Republic, Slovenia, Finland and Sweden. These differences between countries may reflect cultural factors or possibly differences in the organisation of treatment services (49).

Those being treated for cannabis problems tend to be relatively young; virtually all cannabis clients new to treatment are under 30 years old. Teenagers in specialised drug treatment are more likely to be recorded as having a primary cannabis problem than are clients in other age groups, with cannabis accounting for 65 % of treatment demands among those younger than 15 years and 59 % among those aged 15–19 years (50).

There are marked differences between countries in the frequency of cannabis use among new clients. The highest proportions of daily cannabis users are in Denmark and the Netherlands among new cannabis clients, and the highest proportions of occasional users or persons who have not used cannabis in the last month prior to treatment are found in Germany and Greece (51), probably reflecting differences in referral to treatment. In Germany, about one-third of new cannabis clients use the drug occasionally or have not used it in the month prior to treatment, but elsewhere this group is about 11 % of clients, and about 60 % use it daily.


(44) See Tables TDI-2 (part i) and TDI-3 (part iii) in the 2005 statistical bulletin.

(45) See also the selected issue on cannabis treatment demand in the EMCDDA 2004 annual report. Data analysis is based on clients demanding treatment in all treatment centres for the general distribution and the trends, and on outpatient treatment centres for profile of clients and patterns of use.

(46) See Tables TDI-2 (part ii) and TDI-5 (part ii) in the 2005 statistical bulletin.

(47) See Tables TDI-4 (part ii) and TDI-5 (part ii) in the 2005 statistical bulletin.

(48) See Table TDI-3 (part iii) in the 2005 statistical bulletin.

(49) See Table TDI-22 in the 2005 statistical bulletin.

(50) See Table TDI-10 (part ii) in the 2005 statistical bulletin.

(51) See Table TDI-18 (part iv) in the 2005 statistical bulletin.