EMCDDA logo Annual report on the state of the drugs problem in the European Union 2001

Home of the Annual Report
Introduction to the annual report
Chapter 1: Drug demand and drug supply
Drug use
Health consequences
Law-enforcement indicators
Drug-market indicators
Chapter 2: Responses to drug use
Chapter 3: Selected issues
Chapter 4: The drugs problem in central and eastern European countries
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CHAPTER 1

Health consequences of drug use

Health consequences: Demand for treatment | Drug-related infectious diseases | Drug-related deaths and mortality of drug users
 

Drug-related infectious diseases

A more detailed insight into this issue is provided in Chapter 3, Selected issues - Drug-related infectious diseases.

Figure 9

Figure 9

NB

n.a. = data not available. Data in brackets are local.
Differences between countries have to be interpreted with caution due to different sources and in some cases local data. Colour for a country indicates the midpoint of the range in prevalence from the different data sources. Data for Germany, Italy and Spain are limited to HCV prevalence among IDUs who are in treatment and may thus not be representative of HCV prevalence among IDUs who are not in treatment. The Luxembourg data are limited to IDUs in prison. UK and Luxembourg data and the high figures for Ireland and Finland are based on saliva tests. The data for France and the high figure for Belgium are based on self-reported test results, which may be unreliable. The German data are for 1995, the Swedish data for 1994. For more detail For more detail see complementary statistical table and sources.

Prevalence and trends
As available data are from different sources (sometimes local), only a general impression of HIV prevalence in injecting drug users (IDUs) can be given. However, large differences are apparent between, as well as within, countries. Available data indicate levels of infection among different subgroups of IDUs that roughly vary from about 1 % in the United Kingdom to 32 % in Spain. This overall picture has not changed in recent years. However, there are indications of new increases of HIV transmission in (subgroups of) IDUs in some countries (see box).

Data on prevalence of infection with hepatitis C virus (HCV) are less available and, where available, are subject to the same limitations as the HIV data. However, the overall picture is clear — HCV prevalence is extremely high in the data from all countries of the EU, with infection rates of between 40 and 90 % in different subgroups of IDUs (Figure 9). As far as they are available, data on prevalence in IDUs aged under 25 indicate levels of HCV infection from 20 % (Belgium, treatment, 1998) to over 74 % (Portugal, Coimbra treatment, 2000) (see Figure 27, in Chapter 3, Selected issues, Drug-related infectious diseases). This suggests that HCV transmission continues at high levels in several countries, although some studies indicate that introducing prevention measures might have reduced transmission (United Kingdom).

 
Possible increases in HIV transmission among IDUs in some EU countries

Figure 8

Figure 8

NB

Data in brackets are local.
Differences between countries have to be interpreted with caution due to different sources and in some cases local data. Colour for a country indicates the midpoint of the range in prevalence from the different data sources. Data for France, Germany, Italy and Spain are limited to HIV prevalence among IDUs in treatment and may thus not be representative of HIV prevalence among IDUs who are not in treatment. For more detail, see the complementary statistical table
and details of sources.

Preliminary data suggest that increases in HIV infection may have occurred among subgroups of IDUs in some EU countries. The limitations of using routine data for detecting changes in transmission should be taken into account (see Chapter 3). For example, the increase in Ireland may partly be due to increased testing of IDUs. However, it is important to carefully monitor these possible increases and take appropriate action if necessary. Increases in HIV transmission may have occurred in Austria, Luxembourg, Ireland, the Netherlands, Portugal and Finland.

In Austria, HIV prevalence among opiate overdoses increased to 5 % in 1999 (from 3 % in 1996, 2 % in 1997 and 1 % in 1998).

In Luxembourg, notified HIV infections in IDUs rose, from 2-3 per year in 1995-97 to 67 per year in 1998 and 1999.

In Ireland, the number of IDU-related HIV positive tests tripled to 69 in 1999 (from 20-26 per year in the period 1994-98).

In Portugal data are from local sources. In Coimbra, prevalence among IDUs in treatment increased from 9 to 13% between 1999 and 2000, while this was mainly among females and from 9.5 to 18 % in the age group 25-34. A street-based study among 250 homeless heroin users in a very problematic area in Lisbon found a prevalence of 48 % in 1998-99.

In Finland, a large increase in IDU-related HIV notifications occurred from 0-5 yearly cases during 1990-97, to 20 cases in 1998 and 84 cases in 1999. Prevalence among needle exchange attendees asking for an HIV test also increased, from 0 % in 1997 to 3 % in 1998, 8 % in 1999 and decreased back to 3 % in 2000.

In the Netherlands, HIV infection rose from 11 to 22 % between 1994 and 1998/99 among IDUs in the city of Heerlen, southern Netherlands.


NB

Sample sizes: Austria 1996 - 184, 1997 - 131, 1998 - 108, 1999 - 126; Netherlands Heerlen 1994 - 161, 1998/1999 - 116; Portugal Coimbra 1999 - 227, 2000 - 106, Lisbon 1998/1999 - 252; Finland 1997 - 131, 1998 - 135, 1999 - 63, 2000 - 356.
Sources

National focal points. For Lisbon data: H. Valle, L. Rodrigues, R. Coutinho, et al., HIV, HCV and HBV infection in a group of drug addicts from Lisbon, Seventh European Conference on Clinical Aspects of HIV infection, 23-27 October 1999, Lisbon, Portugal (abstract 866).


Health consequences: Demand for treatment | Drug-related infectious diseases | Drug-related deaths and mortality of drug users

Drug use | Health consequences | Law-enforcement indicators | Drug-market indicators
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