Drug Abuse in the Global Village

Drug Abuse in Western Europe

                                     COSTS AND CONSEQUENCES OF ABUSE

AUSTRIA
Drug related deaths. After a stable period between 1988 and 1990, drug related deaths increased 39 per cent between 1990 (83) and 1991 (116) and almost tripled compared to 1986 (46). About 66 per cent of these deaths are attributed to overdose of drugs or medical preparations (77), followed by AIDS (22.5 per cent), suicide (5 per cent), other drug related diseases (4 per cent) and 4 per cent by some form of accident. In comparison with 1990, the proportion of deaths due to overdose has increased in 1991 (43 per cent in 1990), that due to suicide decreased (8 per cent in 1990) and deaths due to AIDS have decreased (27 per cent in 1990) (Jahresbericht 1991).

            The largest proportion of drug related deaths in 1991 were in the 30 to 34 age group (39), followed by the 25 to 29 age range (31). Only 2 deaths of persons 19 and under and 3 in the over 40 years old age group were reported. Among the deaths from overdose, the largest number were in the 25 to 29 age group (25) whereas the number of deaths due to AIDS was the highest in the 30 to 34 age range (12).

            Seventy nine percent of drug related deaths were of males in 1991 (83 per cent in 1990).

            Fifty three per cent of the drug related deaths were in the Vienna area, 16 per cent in Vorarlberg, 14 per cent in Oberosterreich, 9 per cent in Tirol, 3 per cent in each Karnten and Niederosterreich and 1 per cent each in Salzburg and Steiermark (Jahresbericht 1991).

            AIDS/HIV seroprevalence. Of the total 961 AIDS cases reported in Austria in June 1993, 28 per cent are injecting drug abusers. This proportion is higher than in France (23 per cent) and almost twice as high as in Germany (European Centre 1993).

            An increase of HIV infection among drug abusers has been noted since 1987, although no exact figure is available. HIV infected drug abusers account for 44.5 per cent of all seropositives in 1991 (WHO 1991).

BELGIUM
No studies regarding the costs and consequences of drug abuse, have been carried out. However, an increase in delinquency, violence, schooling problems and cost of prevention, treatment and social services have been reported (U.N. 1991).

            AIDS/HIV seroprevalence. Ten per cent of the total 2,010 AIDS cases in 1991, were drug abusers. The proportion of those seropositive and infected with AIDS is 12 per cent among drug abusers in the French speaking population and in Bruxelles, while it is 4.5 per cent in the Flemish community (Belgium 1991).

            Drug related deaths. A total of 41 drug related deaths in 1989 were reported (U.N. 1991).

FRANCE
Drug related deaths. Three hundred and fifty drug related deaths were recorded in 1990, an increase of 10 per cent over the previous year. Ignorance or differences in the purity of the drugs is thought to be partly responsible for this progression. As has been the case in the past, the vast majority of these deaths (86 per cent in 1990) are linked with the use of heroin. Medical preparations are the second most frequent cause of death (7 per cent in 1990) (Statistiques 1990).

            In general, drug related deaths are more prevalent among males (82 per cent of cases in 1990) and the 21 to 30 years old group which account for almost 72 per cent of the total. However, in 1990, for the first time since 1980, the 26 to 30 years old group was more larger than that of 21 to 25.

            AIDS/HIV seroprevalence. Nineteen per cent of all AIDS case recorded in March 1990 were drug abusers (18.3 per cent in 1989 and 7.5 per cent in 1985). HIV prevalence among intravenous drug abusers was up to 58 per cent in 1990 (WHO 1991).

GERMANY
Drug related deaths. In 1990 a total of 1,478 drug related deaths were reported, compared to 670 in 1988 and 991 in 1989 (Germany 1991).

HIV seroprevalence/AIDS.  A study in 1988-1989 found a prevalence rate of 20 per cent seropositives in over 1,000 drug abusers. For West Berlin the figure is 26 per cent. A study in drug treatment centres revealed a 15 per cent prevalence (WHO 1991). Of 5,612 cases of AIDS in 1990, 13.44 per cent were intravenous drug abusers, 9.27 per cent males and 4.17 per cent females (Germany 1991).

            No other information reported in Annual Reports Questionnaire by 31st December 1993.

LUXEMBOURG
Drug related deaths. A total of 17 drug related deaths were reported for 1992 (U.N. 1992) (15 in 1990, 9 due to overdose). An increase in deaths due to drug overdose has been noted (Luxembourg 1991).

HIV/AIDS. Of the total 67 cases of AIDS reported for 1993, 17.9 per cent injected drugs (European Centre 1993). HIV seroprevalence among drug abusers tested is approximately 3 per cent. This proportion has not changed in the last five years (Luxembourg 1991).

NETHERLANDS
Fifty two drug related deaths were reported in 1989. Drugs were either the primary or secondary cause of deaths. Amsterdam reported 13 drug related deaths in 1990 (Ministry of Welfare et al. 1991).

             Some 1,736 AIDS cases were reported in 1991, of which 8.8 per cent are intravenous drug abusers. The proportion of injecting drug abusers among AIDS patients increased slowly. AIDS transmission among those who inject drugs is higher than average. There is, however, no evidence of an explosive growth. In 1990, safer drug abuse practices is believed to have led to a slow down in new HIV infections among drug abusers who inject. However, HIV incidence rates in Amsterdam are believed to be high (5.6 per cent in 1988, 5.5 per cent in 1989) (Ministry of Welfare et al. 1991).

SAN MARINO
Drug related deaths. Between 1990 and 1992 a total of 4 deaths due to heroin abuse were reported, 3 of men and 1 women, all between 20 and 24 years old (U.N. 1992).

AIDS among injecting drug users. Only one AIDS case has been reported in San Marino as of June 1993, an injecting drug abuser (AIDS surveillance in Europe, 1993).

SWITZERLAND
The economic costs of illicit drug consumption in Switzerland in 1989 is estimated between 490 and 535 million swiss francs . Approximately half is attributed to loss of earning and productivity relating to mortality and morbidity, one third of the cost to supply control, 17 per cent to medical care and only 3 per cent to prevention and research (including documentation and coordination) (table 2).

Table 2.  Estimated cost of consumption of illicit drugs, 1989.
                                                                               
Millions of swiss francs Minimum          Maximum

Medical Cost                         73.3                 100.4

Morbidity and                        240.0               256.0
mortality

Cost of repression                  159.4               162.2

Cost of prevention                 8.9                   10.0

Cost of research                       4.7                   6.2
                                                                               
 Total                                      486.3               534.8
                                                                               
Source: Le problטme de la drogue - en particulier en Suisse - considיrי sous son aspect social et preventif. Rapport יtabli א la demande de l'Office fיdיral de la santי publique. 1990

            Drug related deaths. Some 419 drug related deaths were reported for 1992, compared to 405 in 1991 and 280 in 1990. Of these, 82 per cent were males and about half older than 27 years. Approximately 88 per cent of the deaths were by overdose, mainly of heroin. In most other cases, multiple drug abuse was the cause of deaths (Police 1990, 1991, 1992).