Drug
use in the general population
An estimation of the proportion of
the population that uses drugs, or that has experimented
with them, is basic information to assess the drug situation,
to develop policies and to evaluate them. It is necessary
to know in which groups drug use is concentrated and
the patterns of use.
| Methods
employed to estimate drug use in the general population
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General
population surveys are employed to estimate drug
use. Twelve Member States have conducted national
surveys during recent years on drug use in the
general population (although in Luxembourg the
sample was small) and the remaining ones (Italy,
Portugal and Austria) are currently organising
them. Several countries have already established
series of repeated national surveys using the
same methodology (for example Germany, Spain,
Sweden and the United Kingdom) and in Greece,
France and the Netherlands series have been initiated.
Some countries have successive ad hoc surveys
which are comparable to some extent (for example
Denmark, Finland and France).
There are
differences across countries in methods of data
collection, sampling sizes and frames, which could
influence the precision and validity of estimates.
Until these issues are solved, direct comparisons
between levels of use in Member States should
be made with caution, especially where differences
are small.
The EMCDDA
has developed guidelines to improve quality and
comparability of population surveys in the EU.
These guidelines include a set of common core
items that can be used to report data from existing
surveys or that can be inserted into broader questionnaires
and basic methodological guidelines, and they
are gradually being implemented in the Member
States.
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Patterns
of drug use
In all EU countries, cannabis
is the illegal substance most commonly used, both in
terms of lifetime experience (any use during a person's
lifetime) and in recent use. Use of other illegal substances
is less common.
Cannabis lifetime experience in the
adult population (15 to 64 years according to the EMCDDA
standard, although with some national differences) ranges
from about 10 % in Finland to about 20 to 25 % in Denmark,
France, Ireland, the Netherlands, Spain and the United
Kingdom.Other substances have been experienced by far
fewer persons. Experience with amphetamines is reported
by 1 to 4 % of adults, but by up to 10 % in the United
Kingdom. Ecstasy has been tried by 0.5 to 4 % of European
adults and cocaine by 0.5 to 3 %. Heroin experience
is reported generally by less than 1 % of adults, which
contrasts with its high presence in drug-problem indicators.
Illegal drug use is concentrated in
some groups of the population -in particular young adults,
males and urban inhabitants. Young adults (aged 15 to
34 according to the EMCDDA standard with some national
differences) present rates up to double or more than
those of the whole adult population for most drugs.
For example, cannabis has been tried
by about 15 % of young adults in Finland and Sweden,
up to about 28 to 40 % in Denmark, France, Ireland,
the Netherlands, Spain and the United Kingdom, while
amphetamines, ecstasy and cocaine have been tried by
about 1 to 6 % of young adults (although in the United
Kingdom figures for amphetamine and ecstasy are around
16 and 8 % respectively). Higher rates of drug use are
evident among males, although this varies across countries
and differences tend to decrease over time.
Inhabitants of urban areas report
higher rates of drug use than those of rural areas,
and differences in overall national figures could be
largely conditioned by the proportion of urban population.
Although widely used, lifetime experience
is insufficient to estimate recent drug use since it
includes all those who have ever tried drugs, whether
once or years ago. Recent use is usually estimated as
any use during the previous year (last-12-months prevalence).
Recent use (expressed as last-12-months use) of cannabis
is reported by 1 to 9 % of European adults. Recent use
of other illegal substances rarely exceeds 1 % among
adults. Young adults report higher prevalence figures,
roughly double that for all adults. In Ireland, Spain
(for cocaine) and the United Kingdom figures tend to
be somewhat higher than in other countries.
Trends
Information on drug trends
can be more informative than a fixed picture. However,
until now only Germany, Spain, Sweden and the United
Kingdom have carried out series of comparable, national
surveys. Other countries conducted several different
surveys and trends have to be analysed with caution.
Lifetime experience of cannabis increased
over the 1990s in most countries where information is
available. In recent surveys, many countries report
relatively similar prevalence figures — roughly 20 to
25 %. Where prevalence was low early in the 1990s (for
example, in Greece, Finland and Sweden), increases seem
to have been proportionally greater than where initial
prevalence was higher (for example, in Denmark, Germany
and the United Kingdom).
Increased lifetime experience of cannabis
does not necessarily imply a parallel growth in recent
use. Last-12-months prevalence has generally risen less
than lifetime experience.
Trends in the use of other substances
are more difficult to track. These developments tend
to involve relatively limited groups of the population,
but nevertheless they can have important implications
on public health and drug policy. For example, the much-discussed
possible increase in cocaine use still needs to be analysed
in more detail in most countries. Also, recent increase
in ecstasy use — well documented among groups of
young people — does not show up clearly in population
surveys covering the whole population. Samples have
to be large enough and the analysis focused on appropriate
age groups. Oversampling of young people should also
be considered.
| Drug
use in the school population |
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For
under-18-year-olds, the EMCDDA draws on information
from a comparable schools survey which includes
data from 30 participating countries in Europe
and also data from the United States. Eleven EU
Member States participated in the most recent
1999 European School survey project (ESPAD)(1),
which describes tobacco, alcohol and other drug
use among 15 to 16-year-old students. Belgium,
Luxembourg, and Spain also conducted school surveys
in 1998 or 1999 independently from the ESPAD survey
and the results from these are consistent with
those from ESPAD.
Situation
and patterns
These surveys
show that cannabis continues to be the most widely
used illegal substance among school students.
Lifetime experience among 15 to 16-year-old students
ranges from 8 % in Sweden and Portugal to 35 %
in France and the United Kingdom. In two Member
States (Greece and Sweden), lifetime use of inhalants
(volatile substances) is higher than, or equals,
that of cannabis. School surveys report lifetime
use of amphetamine by 1 to 8 % of 15 to 16-year-old
school students, ecstasy use by 1 to 5 %, and
figures for lifetime use of cocaine are between
1 and 4 %, with Spain and the Netherlands at the
higher end of cocaine use.
A different
pattern occurs in illicit lifetime use of tranquillisers
and sedatives (without a doctor's prescription)
where the United Kingdom and Norway, at 4 %, are
at the lowest end of illicit lifetime experience
and France at the highest (12 %). Illicit lifetime
use of tranquillisers and sedatives is higher
amongst girls than boys in France, Portugal, Italy,
Finland, and Sweden. In contrast, lifetime prevalence
for illegal drugs is higher amongst boys than
girls in all Member States.
It is worth
noting that comparable data from the United States
show that figures for lifetime use of a number
of illegal drugs are higher than in any of the
EU Member States: cannabis (41 %), amphetamine
(16 %), ecstasy (6 %) and cocaine (8 %).
There is
a negative relationship between the prevalence
rate of illegal drug use in a country and the
perceived risk attributed to that particular drug,
and girls are generally more apt than boys to
consider illegal drug use a risk. Disapproval
of illegal drug use is consistently high among
boys and girls in all the EU Member States at
around 80 % on average, excluding disapproval
of cannabis, which is lower at 70 % average.
Trends
In all
except two of the Member States (United Kingdom
and Ireland) that participated in both the early
and later ESPAD surveys, the lifetime prevalence
of all illegal drug use increased between 1995
and 1999.
Lifetime
use of cannabis
Figures of illegal
drug taking in general by 15 to 16-year-old school
students are largely determined by cannabis figures.
In the majority of countries the prevalence of
lifetime cannabis has increased.
In Finland
and Norway, lifetime use of cannabis figures doubled
between 1995 and 1999. Increases also occurred
in Sweden, Portugal, Denmark and Italy. However,
there was a decrease in the two Member States
which had the highest lifetime prevalence of cannabis
in 1995. In the United Kingdom, between 1995 and
1999 it decreased from 41 to 35 % and in Ireland
from 37 to 32 %.
Perceived
availability of cannabis increased substantially
in Denmark, Finland, Italy and Norway between
1995 and 1999. In Ireland and the United Kingdom,
there were decreases in the perceived availability
of cannabis but the decrease is less than the
decrease in lifetime prevalence.
Lifetime
use of 'other illicit drugs' (amphetamine, LSD/hallucinogen,
crack, cocaine, ecstasy and heroin) The ESPAD
survey also shows an increase in lifetime use
of collapsed categories of 'other illicit drugs'
in the majority of Member States but a sharp decline
in the United Kingdom and Ireland, where it fell
from 22 to 12 % and from 16 to 9 % respectively.
Increases in the majority of Member States and
declines in the United Kingdom and Ireland confirm
the trend towards convergence in patterns of drug
use among the Member States. The substantial decrease
in Ireland and the United Kingdom may imply that
in advanced stages of drug diffusion the pool
of 15 to 16-year-olds willing to experiment with
illegal drugs is becoming saturated.
Lifetime
use of tranquillisers or sedatives without a doctor's
prescription
Traditionally, use
of tranquillisers or sedatives without a doctor's
prescription has been considerably higher amongst
girls than boys. Between 1995 and 1999, girls
in Denmark, Italy, Ireland, and the United Kingdom
showed substantial decreases of around a half
in the figures for lifetime prevalence of tranquillisers
and sedatives without a doctor's prescription.
In contrast, girls in Finland and Portugal showed
increases (3 % and 2 % respectively), whilst boys
in these two countries showed decreases.
Lifetime
use of inhalants
There
was little change in lifetime use of inhalants
except in Sweden and the United Kingdom where
there was a decrease between 1995 and 1999.
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