Trends in acute drug-related deaths


Figure 19 Trends in mean age of acute drug-related deaths victims in some of the EU-15 Member States, 1990–2001/03

Notes

The figure represents data from countries that reported mean age of victims in most years during the reporting period.

Information based on ‘national definitions’ as presented in Table DRD-6 in the 2005 statistical bulletin. In England and Wales, the ‘drug strategy definition’ is used.

Source: Reitox national reports (2004), taken from national mortality registries or special registries (forensic or police).

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Trends in drug-related deaths vary from country to country (151), and even from region to region, as a result of differences in the course of the heroin epidemic, in the prevalence of its use, in risk behaviours (e.g. proportion of injectors, polydrug use), in provision of treatment and support services for drug users and, perhaps, in the availability and characteristics of heroin. Differences in the organisation and policies of the medical emergency services can also play an important role.

With these limits in mind, some general trends can be identified for the EU, in particular for the EU-15 Member States, where longer and more systematic series of data are available. Overall, a marked increase in drug-related deaths was observed during the 1980s and early 1990s. During the period 1990–2000, and despite decreases in some countries, the overall increasing trend continued in Europe, although at a lower rate. In 2000, 8 930 deaths were reported, compared with 6 426 in 1990 (a 40 % increase) (152). In most of the longer-standing Member States, an ageing trend can be observed among overdose victims, suggesting an ‘ageing cohort effect’, which could be related to a decline in the recruitment of young addicts (Figure 19).

Since 2000, however, many EU countries have reported a decline in the numbers of drug-related deaths. Among the EU-15 Member States and Norway, the total number fell from 8 930 in 2000 to 8 394 in 2001 (a 6 % decrease) and 7 122 cases in 2002 (153) (a further 15 % decrease). Only 10 countries reported information for 2003, and so inferences for trends in the EU should be made with caution. However, on the basis of those 10 countries, a 5 % decrease was observed in 2003, or only one third of the decrease that occurred in 2002. Of the 10 countries supplying information for 2003, three reported increases, one reported no change, and six reported decreases, of which those in Greece (22 %) and Italy (17 %) could be considered significant (154). These developments should raise serious concerns, as it is possible that the factors responsible for the decline in drug-related deaths between 2000 and 2002 (a reduction of almost 20 %) were abrogated in 2003; this is particularly important as drug-related deaths are still at historically high levels – approximately the same as in the early 1990s (Figure 20).


Figure 20: Overall trend in acute drug-related deaths in the EU-15 Member States and trend in the proportion of drug-related death victims under 25 years old, 1990–2003


Overall, drug-related deaths among people younger than 25 years old have been decreasing relatively steadily since 1996, indicating a possible decrease in the number of young injectors (Figures 19 and 20), the result of a decreasing or stable trend in most of the EU-15 Member States, except France, Sweden and Norway. However, in several new Member States, a clear increase in the proportion of victims younger than 25 years was observed between the mid-1990s and 2000–02, suggesting increasing recruitment of young users (155). In addition, the decrease observed at EU-15 level since 2000 has taken place mainly among men (a 21.9 % decrease). Women have exhibited a much smaller decrease (14.5 %), and in 2003, in contrast to men, the decreasing trend among women appears to have been reversed (156).

Identification of trends in the new Member States is difficult because of the limited information available. Although there are differences from country to country, the available information suggests that drug-related deaths started to increase more clearly in the early to mid-1990s. This is also supported by the increase in the proportion of victims younger than 25 years old that occurred between the mid-1990s and 1999–2000 in most of the countries supplying information (157). In the new Member States from which data are available, the number of victims younger than 25 increased substantially more than the total number from 1996 until very recently (Figure 21), supporting the view of a more recent epidemic. Since 2000, deaths due to illegal substances have stabilised or decreased in Bulgaria, the Czech Republic (158), Latvia (in 2003) and Hungary. Overall, a degree of stabilisation appears to have occurred in recent years, but this finding has to be considered with caution as the quality and coverage of reporting are still limited in many countries. The probable increase in heroin use that took place during the 1990s in many of the new Member States might have been compensated for by increases in the provision of treatment services in more recent years, or other factors, but it is difficult to predict the future trend (Figure 21).


Figure 21: Overall trend in acute drug-related deaths in new Member States and candidate countries and trend in proportion of victims under 25 years old, 1996–2003


It can be concluded that, despite positive developments from 2000 until 2002, possibly related to factors such as a shift away from injection among opiate users in a number of countries and increased treatment provision, and the possible stabilisation or decline in the number of opiate users, the current figures remain high from a longer-term perspective, and there are indications that the improvement may not continue.


(151) See Figure DRD-7 in the 2005 statistical bulletin.

(152) See Figure DRD-8 in the 2005 statistical bulletin.

(153) Figures for Belgium and Ireland in 2002 are not included (there were 88 cases in Ireland in 2001).

(154) On the basis of a simple statistical Poisson model. Police data from Norway also suggest a clear decrease in 2003.

(155) See Figure DRD-9 in the 2005 statistical bulletin.

(156)  See Figure DRD-6 in the 2005 statistical bulletin.

(157) See Figure DRD-9 in the 2005 statistical bulletin.

(158) Considering only cases under EMCDDA ‘Selection D’, which includes illegal drugs. The national definition includes many cases resulting from psychoactive medicines (75%).