Drug Abuse in the Global Village

Italy

                        Extent of Drug Abuse

Estimates of the number of annual abusers of cannabis in 1989 is about 1.4 per cent (between 600,000 and 800,000). About 6 per cent of drug addicts receiving treatment are cannabis abusers (U.N. 1990). Annual prevalence of heroin abuse is estimated at 0.3 per cent (between 130,000 and 170,000) (U.N. 1991). Heroin is the most prevalent drug among of abuse among addicts in treatment (91 per cent of the total 50,000). Heroin is the predominant cause of death among known drug abuse cases (Italy 1991). Annual prevalence of other drugs abused are 0.06 per thousand for cocaine, 0.18 per thousand other coca based product, 0.13 per thousand hallucinogens and 0.02 per thousand benzodiazepines (U.N. 1991).

                       Abuser Characteristics

Most drug abusers in treatment (84 per cent) are men (U.N. 1991). Most drug abusers in treatment are between 26 and 29 years of age (Italy 1991). Most abuse heroin and sample surveys point out that the majority have primary or no education (UNICRI 1990).

                         Regional  Variations

Drug abuse is more prevalent in the North of Italy than in the South (U.N. 1991).

                                    Trends

Data indicate that abuse of heroin remains the greatest problem in Italy. Deaths associated with its abuse increased 19 per cent from 1,161 in 1990 to 1,382 in 1991. Abuse of cocaine, alone or in combination with heroin, is increasing. The availability of both drugs has also increased. Abuse of cannabis appears to be stable (U.N. 1991).

                             Mode of intake

Heroin is injected intravenously and taken in combination with benzodiazepines (U.N. 1991). Cocaine is not reported injected. In 1988, 70.5 per cent of all drug addicts in treatment were multiple drug abusers (46.5 per cent in 1986, 56.6 per cent in 1987). Among these multiple drug abusers, 36.6 per cent use cannabis and 27 per cent pharmaceutical preparations as a secondary drug (UNICRI 1990).

    COSTS AND CONSEQUENCES OF ABUSE

An increase of road accidents due to the use of Ecstasy (MDMA) has been noted (U.N. 1991).

            The estimated prevalence of AIDS/HIV among drug addicts treated in public health centres is 40 per cent. This figure varies a great deal from region to region: 10 per cent in Naples, 30-35 per cent in Rome and over 60 per cent in Milan and Cagliari. Sample surveys confirm the finding above (CND Report 1990). Estimates, however, may be higher: among the 8,227 AIDS cases reported in 1990, 66 per cent were attributed to drug abuse (Italy 1991).

            Drug related deaths. In 1990, a total of 1,152 drug related deaths were reported, an increase of about 18 per cent from 1989. This figure does not include deaths due to prolonged abuse of drugs, infections or drug related accidents. The death rate among drug addicts undergoing treatment was 1.5 per cent in 1989 and 1.7 per cent in 1990. Eighty nine per cent of the drug related deaths in 1990 were of males, most 26 to 29 years of age (Italy 1991).

   NATIONAL RESPONSES TO DRUG ABUSE

                           National Strategy

Legislation brought about in 1990 made a significant change  in regard to the problem of drug abuse at the cultural and political level. Earlier laws were based on the principle that the possession of small amounts of drugs and their consumption should not be punished but elicit treatment and rehabilitation intervention. The 1990 law, introduced punishment of abusers of controlled drugs as well as administrative and penal measures designed to foster treatment and rehabilitation of drug addicts (Italy 1991).

      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

Italy 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. Codeine, dextropropoxyphene, dihydrocodeine, morphine and oxycodone (narcotic drugs) and alprazolam, triazolam (psychotropic substances) 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: In 1991, it was introduced that all parties involved in international transactions with benzodiazepines had to notify (the competent authorities) before exportation and after importation.

                            Social Measures

Penal Sanctions related to social measures: In 1991, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence both as an alternative and in addition to conviction or punishment.

Other social measures: Treatment, education and social rehabilitation measures are carried out in accordance with national regulations.

        DEMAND REDUCTION ACTIVITIES

                          Primary Prevention

Health education. Information and counselling centres were established in high schools. The Education Department has spent about 5 million dollars in 1991 for the training of 4 000 high school teachers; in addition, 16 million dollars were allocated to activities in the field of health education and prevention of drug abuse. The Ministry of Defense also provides information and courses on health education to soldiers. About 8 million dollars a year are allocated to develop information campaigns to be diffused through public and private radio and television networks, newspapers, magazines and posters. Training programmes for out reach workers have been developed (Italy 1991).

            About 27 million dollars were allocated to HIV/AIDS Information Campaign in 1990. HIV testing, health information, counselling, pharmacological treatment (AZT) and immunological checks on seropositive persons are available at the local level. At the national level, campaigns target drug addicts and training is provided to drug addiction treatment staff. About 8 million dollars were allocated in 1990 for the marketing of selfblocking syringes (CND Report 1990).

                 Treatment and Rehabilitation

New legislation allocated 192 million dollars per year as of 1991, to increase the number of Public Health Centres (500 in 1991). Each centre consist of a multidisciplinary team (a medical doctor, a psychologist, a social worker, a nurse and a vocational teacher).  and provides counselling, treatment as well as methadone maintenance when other forms of treatment fail. In 1990, 53,341 drug abusers received treatment in public (40,928) and private health facilities (12,413). In 1990 about 50,000 drug abusers received treatment, a 25 per cent increase from 1989 Treatment is provided to drug addicts in prisons (CND Report 1991).

          SUPPLY REDUCTION ACTIVITIES

      Arrests, Convictions and types of Offences

A total of 30,622 persons were arrested in 1991 for drug related offences (24,647 for trafficking and 7,894 for possession in 1990). Slightly more than half (53 per cent) are heroin related, 32 per cent cannabis related and about 10 per cent cocaine related.

            Most 1991 arrests reported are for possession of drugs for personal consumption (75 per cent) (Article 75 of the new legislation) and among the 18 to 28 years of age (U.N. 1991).

                                   Seizures

A total of 22,988 seizures were made in 1991 (22,374 in 1990). Almost half of these seizures were of heroin, 40 per cent of cannabis and 10 per cent of cocaine. About 2,327 seizures of cocaine were reported in 1991, compared to 1,704 in 1990. However, the quantity seized increased by 489 kg to reach more than one tonne in 1991. Cannabis seized almost tripled and that of heroin increased by 637 kg to amount to 1.5 tonnes in 1991. Other seized drugs in 1991 were morphine (0.379 kg), opium (1.135 kg), opiates (0.29 kg), synthetic drugs (2.553 kg), depressants (0.787 kg), hallucinogens (0.90 kg), LSD (0.171 kg) and stimulants (0.762 kg) (U.N. 1991).

                      Supply Source of Drugs

Cocaine seized in 1991 originated from Latin America (Colombia 38 per cent, Bolivia 13 per cent, Venezuela 10 per cent and Brazil 8 per cent). Seized heroin originated mainly (89 per cent) from Turkey and Syria through the Balkan route but also from South East Asia, mainly Thailand. Cannabis seized originates from the middle east (mainly Lebanon) and Morocco (U.N. 1991).

                       References and Notes

** 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. 1990,1991. Responses to UNDCP Annual Reports Questionnaire for the years 1990 and 1991.

Italy 1991. Report of Italy to the First Pan-European Ministerial Conference on Co-operation on Illicit Drug Abuse Problems, Oslo, 9-10 May 1991).

UNICRI 1990. Towards Scientifically based Prevention, UNICRI, Publ. no 41.

CND Report 1990. Report of the Italian Delegation to the UN Commission on Narcotic Drugs, 1990.

CND Report 1991. Activities carried out in Italy for the prevention and suppression of drug abuse and illicit trafficking. 34th Session of the Commission on Narcotic Drugs, May 1991.