Problem drug use

Problem drug use (PDU) is defined operationally as ‘injecting drug use or long duration/regular use of opiates, cocaine and/or amphetamines’ (104). Variations in definitions and methodological uncertainties mean that obtaining reliable estimates in this area is difficult, and caution should be used when interpreting differences between countries or over time.

Problem drug use can be subdivided into important groupings. A general distinction can be made between heroin use, which has historically accounted for most PDU in the majority of EU countries, and problem use of stimulants, which predominates in Finland and Sweden, where the majority of problem drug users are primary amphetamine users. Similarly, in the Czech Republic, methamphetamine users have traditionally formed a significant proportion of problem drug users.

Problem drug use is becoming more diverse. For example, polydrug use problems have become progressively more important in most countries, whereas some countries where opiate problems have historically predominated now report changes towards other drugs. In Spain, estimates of problem opiate users are declining, and an increase has been observed in cocaine-related drug problems; however, reliable time trends of PDU that include problematic cocaine use are not available. Germany and the Netherlands report an increasing proportion of crack cocaine users among their problem drug populations, although the overall estimate of problem drug users in the Netherlands remains unchanged.

(104) For more detail, see the methodological notes on problem drug use in the 2005 statistical bulletin.