Drug Abuse in the Global Village
Denmark
EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE
Extent of Drug Abuse
According to survey results, the estimated number of annual abusers for cannabis type drugs is 250,000, for amphetamine type 50,000, for volatile solvents 20,000 and for cocaine type 10,000 (U.N. 1991).
A 1990 national survey on drug abuse in the general population aged 16 years and over, indicates that 4 per cent of the sampled population annually abused cannabis. The drugs next most abused annually were amphetamines (1 per cent) followed by cocaine and hallucinogens (0.1 per cent each)(see table 1).
Table 1. Illicit drug abuse in Denmark by type of drug, for persons 16 or over, 1990 in percentages.
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Opi- Coc- Cann- Hallu- Amp- Seda- Vol-
ate aine abis cino- het- tive atile
gens amine
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Never used 100 99 78 99 97 70-78 99
Ever used - 1 22 1 3 30-22 0.1
Any use
last year - 0.1 4 0.1 1 13-7 -
Any use
last month - - 2 - 0.1 7-5 -
Use in 20
of past 30
days or
daily abuse - - - - - 4-3 -
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Sample size 2,400
Source: Use of intoxicants in Denmark. Prevention and hygiene 1991, no.15. National Board of Health.
Apart from sedatives and tranquilizers which were reported abused at least once by 22 to 30 per cent of the sample, mainly by women over 60 years of age, cannabis was the drug the most "ever" abused (22 per cent). Abuse of cocaine, heroin and amphetamines, in comparison, is insignificant. The survey also found that multiple drug use is common among drug abusers (NBH 1991).
A school survey conducted in 1990 among students 14 to 16 of age (sample size 1,183), indicates that cannabis is the most abused drug (16 per cent lifetime prevalence). Abuse of other drugs is insignificant. Abuse of volatile solvents is reported to be episodic and experimental among younger youth. More than half of those surveyed had done so more than a year before the survey was carried out but only 1 per cent in the month prior to the survey. About 12 per cent reported using sleeping pills, which were mainly provided by their parents (see table 2). The same survey indicates that youth believe that moderate abuse of cannabis is harmless and that it is perceived as a semi-legal substance (U.N. 1991).
Table 2. Use of illicit drugs among persons 14 to 16 years old, 1990 in percentages.
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Copen- Rest of Female Male All
hagen the
area country
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Cannabis
ever use 24 14 15 17 16
Cannabis
use in
the last
month 9 6 6 7 7
Volatile
solvent
ever use 5 3 5 4 4
Amphetamine
ever use 5 6 5 6 5
Cocaine
ever use 0 0.3 0 0.3 0.3
Opiate
ever use 0 0.2 0.1 0.1 0.2
Ever use
of sleeping
pills 15 11 14 10 12
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Sample size 243 940 618 565 1,183
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Source: Reply to UNDCP Annual Reports Questionnaire for the year 1991.
Abuser Characteristics
In general, drug abuse is more prevalent among males than females. Abuse among women is, however, significant. Thirty three per cent of the drug addicts in treatment centres are women (Denmark 1991). Abuse of sedatives and volatile solvents is higher among women (75 per cent and 50 per cent respectively) (U.N. 1991).
The average age of drug abusers in treatment centres is 28. However, the age range of daily abusers differ according to the drug: 12 to 18 years old for volatile solvents, 20 to 35 years for hallucinogens, amphetamines and cocaine, 20 to 40 for opiates and sedatives from 20 onwards. Cannabis abuse was reported in the 14 to 40 age group (U.N. 1991).
Regional Variations
Drug abuse is more widespread among youth 14 to 16 years of age in the capital compared to the rest of the country. However volatile solvents and amphetamines abuse did not vary significantly from region to region (U.N. 1991).
Trends
The abuse of opiates, cannabis, volatile solvents and MDMA (Ecstasy) increased in 1991, whereas a decrease in the abuse of sedatives and amphetamines was reported for the same year. Cocaine and hallucinogens abuse were reported stable. Abuse of cannabis among students 14 to 16 year of age decreased from 28 per cent in 1970 to 16 per cent in 1990 . Ecstasy (MDMA) is a new fad among youth associated with music and dance sub-cultures (U.N. 1991).
Multiple drug abuse has been on the increase among second generation immigrants to Denmark. Unemployment is associated with the increase in the number of cannabis and amphetamine abusers (U.N. 1991).
Mode of intake
Heroin is mainly injected, but its smoking is becoming increasingly common. Heroin is often abused in combination with other drugs (Denmark 1991). Amphetamines are sniffed, ingested as well as injected. Multiple drug abuse is very common and alcohol is consumed with all drugs abused (U.N. 1991).
COSTS AND CONSEQUENCES OF ABUSE
Drug related deaths. A total of 208 drug related deaths were reported for 1992 (162 males, 46 females) (150 for 1989 and 188 for 1991) (Narkotika-Statistik 1992).
AIDS/HIV seroprevalence. The percentage of drug abusers among the total AIDS case in March 1990 was 4 per cent (WHO 1991). The prevalence of HIV among intravenous drug abusers in treatment in Copenhagen in 1990 is estimated to be about 5 to 13 per cent. One study of HIV seroprevalence among selected group of intravenous drug abusers indicated a seroprevalence of 18 per cent (WHO 1992).
NATIONAL RESPONSES TO DRUG ABUSE
National Strategy
Denmark has adopted a supply orientated approach to the drug abuse problem by fighting drug trafficking and adopting at the same time an easy line towards drug abusers (WHO 1992).
Structure of National Drug Control Organs
The central government unit responsible for liaison and coordination of national drug control policy is the Ministry of Health.
LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**
Treaty adherence
Denmark is party to the 1961 Convention as amended by the 1972 Protocol, the 1971 Convention and the 1988 Convention.
Measures taken with respect to Drug Control
Recently enacted laws and regulations:
None reported.
Licensing system for manufacture, trade and distribution:
There is a government-controlled licensing system for both narcotic drugs and psychotropic substances. Narcotic drugs (ketobemidone) and the following psychotropic substances: alprazolam, chlordiazepoxide, triazolam, allobarbital, amobarbital, barbital, butalbital, butobarbital, meprobamate, pentobarbital, secbutabarbital, secobarbital were manufactured in 1991.
Control system:
(i) Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances.
(ii) Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances.
(iii) Control of non-treaty substances, if any: None reported.
(iv) Other administrative measures: None reported.
Social Measures
Penal Sanctions related to social measures: Courts apply measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence to varying degrees. Conditions relating to treatment are often laid down in suspended sentences, sentences to community services and as terms on which conditional release may be granted.
Other social measures: None reported.
DEMAND REDUCTION ACTIVITIES
Primary Prevention
Drug prevention takes place within the context of broad health promotion programmes to ensure that children grow up in healthy environment. Drug prevention targets children in the 13 to 16 year age range to inform them of alcohol and other drug related consequences as part of their general health education. Preventive education is based on "a situation orientated approach" and is strongly influenced by active participation. Parents are increasingly targeted for prevention and especially in relation to the abuse of amphetamines (U.N. 1989).
Prevention of HIV infection among drug abusers has been given increased importance. Prevention activities include easy access to needle and syringes, free distribution of condoms and information to drug abusers (pamphlets, personal counselling, out reach Casework) (WHO 1992).
Treatment and Rehabilitation
Drug abuse is seen as a psycho-social problem. Treatment is voluntary. Until 1985, all treatment was drug free and based on social therapy. During the 1980s the aims and methods of treatment were revised. The primary principle is of a treatment programme based on the needs of individual abusers. Greater emphasis has been placed on out-patient treatment (U.N. 1989, 1990).
In view of the growing AIDS problem, prescription of methadone is now an option and is offered by treatment centres to maintain clients in treatment and stabilize their drug consumption. The number of persons in methadone programmes has greatly increased to 1,943 in 1989 from 897 in 1985. An out-patient treatment programme for patient receiving methadone is operating since 1989. It combines medical treatment with education. An evaluation of this programme concluded that it is effective (U.N. 1989, 1990).
Regional out patient programmes offer both drug free and methadone maintenance out patient treatment. Cross-sectional teams have been set up to take care of pregnant drug abusers and their children. In major cities, there are special units working with drug abusers who have children. In Copenhagen, a clinic for HIV positive drug abusers was set up. Reception centres and shelters are also available to drug abusers. Psychiatric hospitals are playing an increasing role in treatment of drug abusers, mainly those with psychological problems (U.N. 1989, 1990).
About 1,050 treatment centres treated 3,326 abusers in 1989 nationwide, including 29 per cent requesting treatment for the first time. Sixty eight per cent of the drug abusers in treatment were intravenous drug abusers (for the new abusers in treatment this proportion was 52 per cent). Males make up two thirds of those in treatment (Denmark 1991).
SUPPLY REDUCTION ACTIVITIES
Arrests, convictions and type of Offences
A total of 17,316 drug related offences were reported for 1991. Of these case, 9,535 persons were arrested (8,294 Danes, 1,241 foreigners) (U.N. 1991). In 1989 of the total number of drug related offences (14,810), 8 per cent related to selling drugs, 4 per cent to smuggling and 88 per cent to buying and possessing drugs, (an increase of 62 per cent since 1986 for the last category. The number of drug abusers imprisoned has been increasing during the 1980s. The number of drug abusers imprisoned on a randomly selected day in 1988 was 953. This represents about 27 per cent of all prisoners (Denmark 1991).
Seizures
Cannabis resin make up the largest number of seizures. Cannabis seizures are on the increase (9,222 making up 1.7 tonnes in 1991 compared to 3,857 (1.3 tonnes in 1988). The next most important seizures are for heroin (1,735 in 1991 or 31 kgs compared to 1,139 seizures or 29 kgs in 1988). Stimulant seizures come in third place with a total of 1,345 seizures totaling 24 kgs in 1991 (compared to 1,360 seizures or 29 kgs). Other seizures reported for 1991 were cocaine (about 40 kgs) and some opium, synthetic drugs, LSD.
Since the 1980s, an increase in the supply of all drugs and in particular cannabis has been noted. Amphetamines, which had not previously been regarded as a problem, have become widely used since the mid eighties. An increase in the supply of heroin appear to be associated with the strong rise in the number of prescriptions for methadone in substitution programmes (Denmark 1991). Methadone seizures have also increased at street level. Cocaine seizures are believed to be intended for transit. Illegal sales of opiates and benzodiazepines play an increasing role in the supply of drugs (U.N. 1991).
Supply Source of Drugs
Heroin originates from South West Asia (75 per cent of the traffic) through the Balkan route and South East Asia (25 per cent) directly from Pakistan or Africa by air. All of the cocaine originates from Latin America. Seized cannabis resin originates from Morocco and from Holland, via Germany, mostly by ground transportation or from Lebanon via the Balkan route through Holland. Eighty per cent of the amphetamines originate from Holland and 10 to 15 per cent from Poland (U.N. 1991).
References and Notes
The National Board of Health collects every year data from all the counties and municipalities on the numbers of drug abusers in treatment, sex, age, route of drug administration and first demand of treatment. The Institute of Psychiatric Demography also collects data on drug abusers admitted to psychiatric wards. The police collects data on drug related offences and deaths (U.N. 1989).
** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years 1988-91.
U.N. 1989,1990,1991. Replies to UNDCP Annual Reports Questionnaires for the years 1989, 1990 and 1991.
Denmark 1991. National Report of Denmark to the First Pan-European Ministerial Conference on Co-operation on Illicit drug abuse problems. Oslo, 9-19 May 1991.
NBH 1991. Use of intoxicants in Denmark. Prevention and hygiene 1991, no.15. National Board of Health.
Narkotika-Statistik, 1992. Rigspolitichefen-Afdeling a Narkotikainformationen.
WHO 1991. AIDS among drug abusers in Europe. Review of recent developments. H. Brenner, P. Hernando-Briongos and C. Goos. WHO, 1991.
WHO 1992. European Summary on Drug Abuse. First Report 1985-1990. H. Klingemann, et al. WHO 1992.