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Slovakia buying Heroin

October 21st, A A A A. EN Search keywords, tags Mon 21 October Sun Mon Tue Wed Thu 14 15 17 14 Sun Mon Tue Wed Thu 17 16 17 15 Sun Mon Tue Wed Thu 16 16 16 14 Sun Mon Tue Wed Thu 16 16 17 17 Visegrad Declarations. Presidency Programs. Annual Reports. Visegrad Parlour : State and Church. Ideal Tax System? Drugs and Law. Other articles. Students' Section. Today we have chosen a very current topic, which must be interesting to a wide public. These days, we are faced with this problem very often. So, we are going to talk about drugs. We will not discuss the effects of drugs on the human body, but instead of a health approach, we'll focus on the relationship between drugs and laws, legislative changes in the recent past, attempts to solve the drug problem as well as the Visegrad states' opinion on drug problems through liberalism or repressiveness. Allow me to introduce the discussants. Ivan Douda represents 'Drop In', the Czech centre for prevention and treatment of drug dependence. I will describe the situation in Slovakia. The first person in the discussion is from the Czech Republic. During the past few decades, in the Czech Republic there have been many discussions about drugs. In the beginning the discussion was mostly about being either liberal or rather more repressive. The core of the discussion was the question of whether it is necessary to change the law concerning drugs. Until , the law in the Czech Republic allowed the possession of drugs for personal consumption, but not for selling and distribution. Under the pressure of the Christian Democrats, the law was changed in Possessing drugs for personal consumption was forbidden, and the penalty was also increased. A special Drug Squad was established. It has relatively strong authority and influence on drug policy. Even before the transition, we started to carry out the first programmes focused on drug users. It was a programme of hypodermic needles. Later, we applied the first programme of substitution, thus the controlled feeding of alternative legal drugs instead of illegal ones. However, the drug policy works on the basis of political decisions all over the world. Therefore, the solution of the drug problem is more or less based on a personal point of view and not on rational and professional arguments. Experts protested against the law which determined that keeping drugs for personal consumption is a criminal act. But the police argued that this situation would be a cradle for dealers who claim they keep drugs just for their own consumption. In the case of more liberal laws, the dealers could not be prosecuted, either. Recently, because of the acceptance of the new law on drugs, the European Union enabled a two-year programme for the Czech Republic. This programme should verify the effectiveness of the new law in terms of acquisitions and deficits. The out put of the research demonstrated that this amendment cost a few ten million crowns more concerning the proximate system but in fact, it did not have any impact on the drug scene at all. However, I have to say that the police and state authorities all the while behaved relatively fairly and the atmosphere is relatively liberal. Many school campaigns focused on drug prevention have been organised during the past twelve years with approximately 1 million, mostly young participants. After ten years of work it seems that the situation has stabilised. The population of drug users is getting older and most of them is on file in one of the contact centres. The chain of these centres works thanks to people such as, for example, the mayor of the capital city, Mr. Today's approach to drugs is very rational and we get support also from the current government. The chain of contact centres was built gradually. At first, professional coordinators started to work at district authorities. Later, where the territorial units of districts were cancelled, the regional anti-drug coordinators took over their tasks. In big cities, there are also town municipal coordinators. These experts look over their region and make sure that the chain does not have too many holes in it. Regarding the use of different types of drugs, the position of amphetamines black beauty is getting weaker because of other trendy influences. Lately, the price of cocaine has decreased, so the Drug Squad is afraid of a new wave of this drug. The drug strategy of the Czech Republic relies upon prevention as well as repression. The most part of governmental expenses for anti-drug policy is still paid for criminal investigation. Besides governmental aid, the non-profit sector also plays an important role in the anti-drug strategy. However, we are still waiting for those reforms which were accomplished in Slovakia. The programmes of syringes and substitution have already been running for a long time, the level as well as the number of physicians is continually increasing. Physicians provide private substitution and use different preparations. There were heated discussions about taking drugs under medical control but this debate was rather on a political basis. However, it is interesting that at first, doctors, politicians and the police were very critical concerning controlled drug taking. But finally the results were convincing and the atmosphere is now more tolerant, the police do not focus on 'small fry' and let young people smoke marijuana. According to statistics, the Czech Republic ranks at the very top of the list in the number of people who have ever tried some kind of drug, namely marijuana. The positive thing in it is that the number of cases is not increasing and young people experiment with illegal but less risky drugs. The law on drugs, similar to that which was refused 18 months before the election, is being discussed again. Then the Minister of Health asked for the full legalisation of drugs in his election campaign for the liberal party. He was the first health minister in history who wanted to win over young people in this way, since he knew that this exact issue was very important for them. At that time there were failed attempts to legalise marijuana even for medical purposes, but only one vote was missing to accept the proposal. The new draft bill, compared to the unsuccessful one, will be slightly modified. It will consist of sections on marijuana, drug use and sanctions. It will be submitted to the parliament this autumn. As a lawyer and a leader of a legal aid service, I gained both theoretical and practical experience on the legislation of drug problems in Hungary. This legislation has changed many times during the past fifteen years. At first, the criminal statute was amended in It was necessary because the number of drug users increased. Until then, drugs were used mostly by groups belonging to the art sphere, or socially disadvantaged groups. From the beginning of the 90s, drugs spread also among other groups of society. Young people at first started to use a decoction made from poppies. Later they discovered classic drugs like heroin, cocaine, amphetamines and marijuana. However, I would like to emphasise that we can call only those who are drug dependent, 'druggies'. The most frequently used drugs are heroin and cocaine. However, most drug users are not addicted to drugs. Younger generations typically smoke marijuana. In most cases, it does not cause any health problems if young people occasionally smoke marijuana when partying. Also amphetamines belong in this group because most of the young people can control their use. These users do not get in touch with health care service, since the drug does not cause problems for them. There is only one sphere where they can have contact with the state because of their drug use and it is the sphere of criminal law. In Hungary, practice concerning drugs is steady: it is a criminal act to keep drugs even for personal consumption purposes. If a policeman finds a drug while checking somebody's identity, a criminal procedure immediately starts. I would like to give some information about the development of legislation during the last fifteen years in Hungary. In , the most important amendment was introduced, that is the term of diversion. In the case of the user, the criminal procedure starts but it also can be cancelled if the person concerned confirms that he participated in a 6-month treatment or public work. In the case of addiction, it is mandatory to take part in rehabilitation. In the case of occasional users who do not have health problems, it is useful to participate in preventive and community activity. This deflection is in function these days as well. However, one change has occurred. After the elections in , the first task of the right wing government was to tighten the rules regarding drugs in the criminal legislation. The diversion was allowed only for addicted users. Their number is much smaller than the number of occasional users. Occasional users had to face legal proceedings. In most cases they were not sentenced to prison, but the proceeding itself took years and they had to reimburse legal charges. After the next elections in , the left wing government came into power. The criminal statute was amended again and the diversion for occasional users was given back. As you see, the drug issue in Hungary is a very popular topic among politicians, especially at the time of elections. Right wing politicians struggle to enforce repressive measures, while left wing politicians are more liberal. Regarding drugs, Mr. This saying determined the attitude toward drugs in the Criminal Statute for a fouryear period starting in In the very strict penalties were liberalised. In the case of drug dealers, the very strict punishment still holds, that is, the possibility of imprisonment for life. Generally, no judge applies this punishment, as it is not possible to compare selling drugs with brutally committed robbery or murder. The judicial practice accurately resolves the criminal act of drug trade, but the senate dares not touch this part of the legislation, because of the political sensitivity of this issue. Recently, keeping drugs even in small quantities is a felony and the diversion is possible for everyone. In , there were 6, proceedings regarding drug abuse, which is a slight decrease compared to the year , when the number of proceedings was 7, In the number of opened legal proceedings is even fewer. It is worth mentioning the number of proceedings started against those who kept drugs for personal consumption. In , from 6, proceedings 5, were against those who kept drugs for their own consumption and only the rest were against drug dealers. To solve the issue of drug dealing is not so simple, because we have to differentiate between the real drug trade and the so-called 'distribution just among friends'. Within drug distribution there also exists a so-called 'distribution among friends' which is not a real distribution. The number of legal proceedings which are directed towards wholesale trade in quantities of kilograms, is only about a hundred cases annually. The activity of police is mostly directed towards the group that can be caught in the easiest way, that is the users. The police are often under the illusion that capturing users has a preventive effect. In the attitude of police has changed a little. It means that there are a few more proceedings against dealers compared to the past few years. That is probably because there are more young people among the leaders of the police who have already conducted an investigation of drug issues. I would like to say something about the diversion. The diversion is for young people who sometimes try or occasionally use drugs but do not have any health problems. According to my opinion, these diversions appear to be folly. If young people have problems due to drug use, they can visit other medical institutions. The diversion is not even a school prevention. The diversion actually ensures a back door for users not to be punished. It is basically a farcical attitude of lawmakers to the drug issue: we do not want to punish users but we do not have the courage to modify the legislation and say openly that drug taking is not a criminal act. In many states, drug taking is considered to be a violation and not a criminal act, and only in cases where drug consumption is in a public place and in a group. Nobody should care about the things we do in our house or flat, it is a completely private thing. In my opinion it would be the first step to the optimisation of the situation in Hungary. Also from an economic aspect it would be more effective budget-wise to send those who need it to rehabilitation, and start criminal procedures against those who commit a dangerous crime. Due to recent legislation, the source distribution is very unequal. I think that the given amount of money could be used in a more effective way. Thank you very much for the interesting presentation about the situation in Hungary. Now, I ask our next guest, Dr. Marek Zygadlo to describe the situation in Poland. We have almost all kinds of drugs in our country. It think it is an important information that Poland, Belarus and the Ukraine are the biggest producers of the highest quality amphetamine in the world. It is a dangerous drug, more dangerous than heroin. We have many institutions in Poland which are responsible for solving the drug problems. We are very proud that we can cover the treatment of the non-insured drug users. We have also had a national programme of health since which talks about drug demand reduction and limitation of accessibility to drugs. We started to think on the level of ministry and government about the approach to the drug problem, and we have a national bureau for drug prevention established in as a response to the worrying trends in the Polish drug scene. The aim of this organisation is to reduce the use of narcotics, drugs, psychotropic substances, and implement a co-ordinated national strategy against drug addiction. We have a national board of health, this institution covers the costs of treatment of patients. In July a new law was adopted to counter drug addiction. In my opinion this document is unacceptable because for any dose of drugs people can get into prison. So instead of helping them we put drug users into jails. But this act of law also has a useful part, which is introducing obligation to adapt provincial acts to avoid drug addiction. So not only the government is responsible for solving the problem but also the regional governments in the cities and villages. We have had many 'shamans' in Poland-so-called experts-who tried to help the users but many of them did not have any experience and practice. We hope that this system will bring quality into this activity. The national programme for counteracting drug addiction from to focuses on five fields, which are prevention, treatment, rehabilitation, supply reduction and international co-operation. We also have public health services like special inpatient and outpatient clinics, we offer counselling, individual and group therapy, detoxification and care. And now a few words about what kind of role the non-government organisations play in solving the problems connected to drug users and drugs. The non-government organisations in Poland can set up non-public services for drug users. Most of them offer very good health programmes for their clients, like drug education, needle-exchange, harm reduction, psychotherapy or substitution treatment. Community prevention is also implemented through community clubs, education and training as well as through social campaigns. In MONAR we run low-threshold assistance programmes for active drug addicts which are aimed at improving their health and social conditions. Drug related harm is also addressed and through this work we aim to counteract the spread of HIV and other infectious diseases and reduce crime connected with drug use. Drug education is a very important part of harm reduction, because many people are using drugs without knowing anything about them, or believing several myths which are not true. Our needle-exchange programme in Krakow was the first professional of its kind in Poland. We started it in , and now we have several exchange-centres all over the country. As far as the substitution treatment is concerned, two years ago it became possible to provide substitution by non-government organisations, and nonpublic health services could establish such projects. Now we have about ten substitution programmes in Poland, last year we introduced two new projects made by NGOs. So at the moment we have about a thousand clients attending these programmes. Nobody knows how many heroin addicts we have in Poland, it is not easy to count users in any country. According to the national health programme there was about 25 heroin users who needed some kind of treatment in the health system. The NGO services provide consulting for outpatients and detoxication and rehabilitation for inpatients. They also provide postrehabilitation programmes, housing programmes, hostels for clients who finished treatment and try to find their way back to society. I would like to end with two questions which are very important for this discussion. The first one is: What results can we expect from prohibition? The second one is: Why do we create narcofobia? Narcofobia in my opinion is the main problem of the last few years, and it exists because of ignorance and laziness. There is a great fear of drugs and drug addicts. People simply do not want to hear about these problems, while for example alcoholfobia does not really exists among them. Marek Zygadlo, thank you for the interesting presentation. I would like to make a brief description of the situation in Slovakia. Regarding the drug issue, in Central Europe we have a lot of features in common and we also have dissimilarities. After the transition in , when the iron curtain fell down, access to drugs became much easier. Contrary to in Poland, heroin became popular only after , especially in Bratislava. In Poland it was earlier, in Hungary and in the Czech Republic approximately at the same time. Contrary to the Czech Republic, in Slovakia heroin was dominating compared to pervitin, which was available in small quantities even before the transition and it was practically pushed back to the periphery by the police and dealers. So during the 90s we had a huge epidemic of heroin, especially in Bratislava and later in the whole of Slovakia. Ninety percent of treated persons had a problem with heroin. At the turn of the millennium, the situation had gradually changed and the use of pervitin gained ground, which is less addictive than heroin. Nonetheless, since we have noted a sudden increase in demand for pervitin, i. The situation has become stable during the last three years, the number of treated people has not increased. Obviously we always have new patients. At the same time, the request for cannabis addiction therapy has also increased. Regarding cannabis, there are lot of discussions. This substance is not as addictive as some other drugs. Only a smaller percent of occasional marijuana users--or people who use other forms of cannabis-become addicted. Although, besides the growth in demands for pervitin addiction therapy, between we noted an increased number of demands for cannabis addiction treatment. Taking into consideration the number of users, of course, it is just a small part but in terms of therapy it is a significant growth. In Slovakia, approximately 2, people seek medical help because of drugs every year. Out of that, approximately people use heroin, which has the highest addictive power. Moreover, it is usually used intravenously, so it poses the highest risk to public health. Concerning criminality, heroin is one of the most serious drugs. We started early with prevention and harmreduction. In we had less than a hundred intravenous users in Bratislava who requested medical help, and already at that time we started to change the spikes and needles. Recently sterile needles and syringes are available in drug-stores. Of course, not every drug-store is willing to help the users, it mostly depends on the pharmacist. In most cases users can buy syringes for a low price and there is no legal ground to forbid their sale to users, so the harm-reduction is ensured mainly through drug-stores. Syringe exchange programmes operate in the biggest drug centres. Regarding the political solution of the drug problem, there are two strategies to approaching drugs. The first is a repressive force-police, customs officers0-which is aimed at supply reduction, while the second is a non-repressive way, that is, prevention and demand reduction. We who work in the non-repressive sphere divide users according to if they have health problems or not. The health problem category, besides drug addiction, consists of drug overdose and infections. The repressive approach takes a different view of it. They take into consideration the relationship between users and the law. Print article. Send link.

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Slovakia buying Heroin

These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. Key findings and threat assessment. Global context. Trafficking and supply. Criminal networks. Prices, purities and offences. Retail markets. Actions to address current threats and increase preparedness. In most countries in the EU, it appears that the number of people who use heroin is relatively stable. In , the prevalence of high-risk opioid use among adults aged 15 to 64 is estimated to be around 1 million. The countries estimated to have the highest number of users per 1 inhabitants aged 15 to 64 are Finland at 7. Conceptually, there are two main strategies for assessing the size of the drug market, namely a demand-based or bottom-up approach and a supply-side or a top-down approach. The strengths and limitations of these strategies are reviewed in a background paper Udrisard et al. Using the methodology established by the EMCDDA , it is possible to estimate the size of the heroin retail market based on the number of users and their use patterns, including how much they use per year and the average price paid at retail level. While the overall prevalence of high-risk opioid use among adults aged 15 to 64 in was estimated to be around 1 million people in the EU, there was considerable variation between countries, and whereas some countries specified the main opioid used, others did not. As such, for some countries an estimate is available for high-risk heroin users rather than for high-risk opioid users. Where there is no estimate of high-risk heroin users available, this is imputed, based on high-risk opioid user estimates in combination with treatment data. Using the latest available data, the minimum estimated annual retail value of the heroin market is EUR 5. Estimates of amounts used suggest that about tonnes of heroin at retail-level purity range While this approach has a sound scientific basis, demand-based estimates are prone to underestimation due to misreporting and underreporting of prevalence and use, as self-reported data rarely reflect reality Udrisard et al. Obtaining information on the number of users and the amount of heroin they use is challenging. This is primarily because a large number of people who use heroin are dependent on the drug and may be living on the margins of society, and are thus unlikely to be included in surveys of the general population. Wastewater analysis, another source of information on drug use, cannot be performed for heroin because morphine, the most abundant metabolite of heroin, which can be used as a target residue to estimate heroin consumption, may also be an indicator of the commonly used medicines morphine and codeine. Many other potential indicators of heroin use have some time lag. For example, treatment indicators will detect opioid users only after approximately 13 years of use, and the number of opioid users entering treatment could be influenced by financial priorities and the availability and accessibility of services. Based on previous research, a ratio of 3. Further limitations include the lack of coverage of specific subgroups, such as prisoners, homeless people and other marginalised populations, in the current EU heroin market size estimate. This is due to a lack of data on the prevalence of drug use and the quantities used by these populations, which may be considerable. It would therefore be appropriate to consider these subpopulations specifically in demand-based estimates in the future Udrisard et al. It is also possible to produce an estimate of the size of the heroin market using a top-down approach. There are two main models that can be used for this, namely a production-based approach and a seizure-based approach. The first involves assessing the amount of heroin available for consumption in a given country or region by taking global production estimates, subtracting the amount seized by law enforcement authorities or otherwise lost spoiled, etc. The amount available can then be multiplied by the local price adjusted for purity, to account for adulteration to arrive at the retail market value. There are several challenges with this approach, such as the accuracy of global production estimates and global seizure data, and how the national and EU market share can be assessed. The seizure-based approach simply uses the amount of drug seizures and an estimated seizure rate to assess the quantities of drugs available on the market. However, no data are available that would allow an assessment of the seizure rate. An alternative supply-side approach is based on estimates of the number of dealers and the average number of doses they sell Rossi, Making such assessments may be possible. However, further studies are needed, initially at city level, to test this method and assess its suitability for use at national and EU level. In Europe, the opioid market is becoming increasingly complex, incorporating new potent synthetic opioids, prescription opioid medicines and mixtures see Section Synthetic opioid trafficking. While heroin remains by far the most common illicit opioid on the market at the EU level, this is not the case for all Member States. Ongoing monitoring and law enforcement action is needed to prevent further spread of synthetic opioids, some of which are relatively inexpensive and easy to manufacture or to divert from legitimate sources. While fentanyl and its derivatives, along with potent benzimidazole nitazene opioids, are still relatively niche in most places, they are increasingly available as part of the EU opioid market. Information on their use in Europe is limited, although existing evidence points to diverse national situations where there are signs of clusters of use limited to particular geographical locations. Historically, fentanyl and fentanyl derivatives have been the most common form of opioids used in Estonia. An increase in the availability of these substances was also observed in neighbouring markets, including Latvia, Lithuania and Sweden see Section Synthetic opioid trafficking. An important caveat is that current monitoring systems may not accurately document trends in synthetic opioid use, and this is therefore an area that needs improvement. Composite products, including heroin-fentanyl mixtures, have also been reported, as has the adulteration of illicit opioids with a range of potentially dangerous substances see Box Adulteration of illicit opioids with xylazine and new benzodiazepines. The availability of these products represents a significant change in the risk environment for users of opioids and people who inject drugs, posing additional challenges for health responses. While individual studies and monitoring data indicate that the misuse of prescription opioid medicines in the EU is limited, there is insufficient information to allow a more thorough assessment. For example, the diversion of methadone and buprenorphine from opioid agonist treatment is reported to be a significant problem in some countries see Section Synthetic opioid trafficking. There is also some evidence to suggest that the number of prescriptions for opioids used for pain management has been increasing. The same study assessed several proxies for misuse and identified a similar increasing trend. The number of opioid-related hospital admissions tripled from 2. Further, while opioid-related mortality remained stable between and , at 0. An increase in the use of prescription opioids affects the illicit market in a number of ways. For example, people who become dependent on opioid medications may turn to the illicit market to top up their medications or when their prescriptions expire. Also, an increase in the number of prescription opioids in circulation may provide new opportunities for diversion into the illicit market. Similar dynamics have been seen in the United States, where prescription opioids have fuelled the ongoing opioid epidemic. In addition to the diversion of opioids from legitimate sources, falsified and counterfeit opioid medicines are available, raising issues of their own. Reports and public notices have emerged in a number of EU Member States in recent years, alerting users about new opioids mis-sold as fake medicines, such as oxycodone tablets containing nitazenes. The EU is currently far from experiencing the opioid epidemic faced by the United States. Heroin is a central nervous system depressant. The immediate effects of heroin use include a rush of euphoria, a warm flushing of the skin, dry mouth and a heavy feeling in the limbs. However, these effects are short-lived, and the drug quickly leads to a state of drowsiness, slowed breathing and clouded mental function. It can also cause nausea, vomiting and severe itching. The long-term effects of heroin use are numerous and can be severe. These include physical and psychological dependence, overdose and death. Chronic heroin use can cause a range of physical and mental health problems, including liver disease, kidney disease, collapsed veins, chronic pneumonia, and infections of the heart lining and valves. In addition to the physical and mental health effects of heroin use, there are also a number of social and economic harms associated with the drug. These include increased crime rates, lost productivity, healthcare costs, and strained family and community relations. In particular, the broader social costs associated with long-term dependence on heroin include higher rates of homelessness and criminality, particularly acquisitive crime. The use of heroin is associated with a disproportionate amount of acute and chronic harm, and this is compounded by factors that include the properties of the drug, the route of administration, individual vulnerability and the social context in which heroin is consumed. Although the number of people reporting use of heroin in the EU is low compared with drugs such as cannabis and cocaine, a large proportion of people who use heroin are dependent on the drug. This means that they use it more frequently and in larger amounts than is the case for other drugs. In Europe, heroin is predominantly sold in the base form as brown powder, while white powder hydrochloride salt and black tar are rare. While the availability of various preparations of heroin may influence the mode of use, the drug is most frequently smoked or injected. Heroin that is smoked is usually in the base form, which is appreciably more volatile than the salt i. For injecting use, citric acid solution is added to prepare heroin base as it is poorly soluble in water. Injecting heroin is associated with many local and systemic complications, including increased risk of overdose, increased risk of infectious disease transmission such as HIV and hepatitis C via needle sharing , vein damage, skin abscesses and infections. Although heroin has historically been the main drug associated with injecting in Europe, this has been changing in recent years. Opioids are reported as the main injected drugs in 19 out of 24 countries for which data are available for clients entering treatment in While these data are not nationally representative, they can be viewed as indicative of local-level drug use dynamics. In this sample of used syringes, heroin was the most commonly detected drug in five out of the 12 participating cities. Overall, a third of syringes contained residues of two or more drug categories, often including both opioid and stimulant drugs. This indicates frequent polydrug use or reuse of injecting equipment. Recognising the increasing complexity of injecting practices in Europe and the prominence of polydrug consumption in this context is therefore likely to have important implications for both understanding the harms associated with this mode of administration and the interventions designed to reduce such harms. The most serious risk from overdose with opioids is rapid respiratory depression slow and shallow breathing , which can lead to death. With heroin, this risk may be increased by a number of individual as well as contextual, especially social, factors, including the following:. While the data available have limitations in respect of quality and coverage, the information available suggests that opioids, usually in combination with other substances, remain the group of substances that are most commonly implicated in drug-related deaths. Overall, trends in deaths where opioids are implicated appear stable. Meanwhile, in the north of Europe, less than one in six overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin in As such, while it remains the case that heroin is involved in a large proportion of opioid-related deaths, the data available increasingly suggest that other opioids are playing a more important role. Available data suggest that polydrug toxicity is the norm and that opioids other than heroin, including methadone and, to a much lesser extent, buprenorphine, with the exception of Finland and France , oxycodone and fentanyl, are associated with a substantial share of overdose deaths in some countries. In half of the 22 countries with post-mortem toxicological data available for , at least one in five drug-induced deaths involved methadone. In countries with available data, oxycodone was reported as being involved in drug-induced deaths between and , mainly in Denmark, Estonia, France and Finland EMCDDA, a. While available data indicate that fentanyl and fentanyl derivatives were linked to 49 deaths in Europe in , this excludes figures from Germany. With the inclusion of data from Germany, this number appears to be much higher, rising to a minimum estimate of deaths. Preliminary analysis, however, suggests that many of these fatalities might be associated with diverted fentanyl medicines rather than illicit fentanyl. Potent synthetic opioids, such as the fentanyl derivative carfentanil and benzimidazole nitazene opioids, consumed in the context of polydrug use, do not currently feature prominently in the data available at EU level but are observed to be causing an increasing number of deaths in the Baltic countries, including in Estonia and Lithuania in Preliminary data indicate that in , Estonia experienced an increase in drug overdose deaths involving isotonitazene, metonitazene and protonitazene. In Latvia, both the national statistics and the forensic registers have reported a three-fold increase in the number of drug-induced deaths in compared with Part of this reported increase relates to improved laboratory capacity in As such, the increase should be interpreted cautiously, although recent shifts in the opioid market are also likely to have played a role. Nitazenes appeared to be involved in a number of fatalities in and xylazine was identified in one case. Preliminary first-quarter data for from Latvia also suggest that benzimidazole opioids were involved in a number of drug-related deaths. The adulteration of heroin with fentanyl and isotonitazene, leading to fatal overdoses among users, has been reported to Europol by UK authorities since mid The UK Home Office is aiming to tighten controls on two other synthetic opioids, namely brorphine and metonitazene. Opioids were found in 20 of the 24 European hospitals participating in In contrast, small proportions of the presentations involved heroin in the hospitals in Belgium, the Netherlands, Estonia, Latvia and Lithuania and in the centres in Paris France and Barcelona Spain. Most presentations with heroin were among middle-aged men, and in 12 of the 20 centres no cases were aged less than 25 years. The use of heroin and other opioids during pregnancy has been linked to a number of neonatal complications, including opioid withdrawal, postnatal growth deficiency, neurobehavioural problems and a fold increase in sudden infant death syndrome Minozzi et al. Repeated use of heroin and withdrawal symptoms are associated with increased neonatal mortality Jansson et al. High rates of intrauterine growth retardation have also been reported in heroin-dependent mothers Binder and Vavrinkova, , in addition to elevated risk of low-birthweight infants from maternal heroin use compared to those from non-drug-using mothers, and prematurity and small-for-gestational-age babies Bell and Harvey-Dodds, ; Madgula et al. Among pregnant women who continue illicit intravenous heroin consumption, the risks of medical complications such as infectious diseases, endocarditis, abscesses and sexually transmitted diseases are also increased Winklbaur et al. There is a well-established, albeit complex, relationship between illicit opioid use and crime. Although high-risk opioid users are much more prevalent in the criminal justice system than in the general population, the relationship between opioid use and crime differs between individuals, and for the same individual over time. There is strong evidence that problem heroin use can amplify offending behaviour, particularly related to economic-compulsive crime, whereby users of heroin or other opioids engage in economically oriented crime to support a compulsive pattern of use Goldstein, A meta-analysis of studies on the relationship between drugs and crime concluded that the likelihood of committing crimes that were not drug possession offences is up to eight times greater for people who use drugs than for those who do not Bennett et al. Few opioid users resort to violence to acquire money for drugs, though some may engage in violent crime, such as assault, homicide or robbery. However, the extent to which opioid dependence is associated with these more serious forms of crime is less apparent White and Gorman, There is limited research examining the prevalence of drugs other than alcohol in penetrating injuries such as gunshots, explosive devices and stab wounds , and most of the published research originates from the United States Lau et al. Although heroin-using offenders have high rates of offending, they also have high rates of a range of other problems, such as homelessness, unemployment, low educational attainment and disrupted family backgrounds, making the relationship between drugs and crime more complex. The association between opioid use and crime highlights the importance of addressing use as a means of reducing criminal behaviour and improving public safety. Treatment for opioid-dependent individuals can help to reduce the demand for illicit drugs and decrease associated crime. Heroin can also be associated with an increased risk of being a victim of violence, due to altered perceptions and impaired judgement Gilbert et al. It is important to note that the risk of experiencing heroin-related violence is likely to be influenced by a range of situational factors, such as setting, socioeconomic status, other drug use, and a history of mental illness and trauma. Women involved in the sex trade have been identified as a sub-group who are particularly at risk of experiencing gender-based violence in the context of drug use, through engagement in the sex trade or in their intimate relationships EMCDDA, b. Many women who trade sex for drugs have limited power to practise safe sex or follow safe injecting practices and are at risk of experiencing violence and imprisonment. These women also face a greater degree of stigma, through both their drug use and their involvement in the sex trade EMCDDA, b. The available evidence strongly supports enrolment in opioid agonist treatment as a protective factor against opioid overdose and some other causes of death, with positive outcomes also found with regard to the use of illicit opioids and other drugs, reported risk behaviours, offending and drug-related harms EMCDDA, d, a; Mayet et al. In the EU, opioid users represent the largest group undergoing specialised drug treatment, mainly in the form of opioid agonist treatment, typically combined with psychosocial interventions EMCDDA, a. Overall, opioid agonist treatment was received by about half of all high-risk opioid users in the EU in , an estimated individuals. However, there are differences between countries. Trends from countries that consistently report data on clients receiving opioid agonist treatment between and show an overall stable trend of treatment levels during this period, with little fluctuation in the number of clients. This has important implications for service delivery, with services having to address a more complex set of healthcare needs in a population that is becoming more vulnerable due to other age-related health and social issues. Alongside opioid agonist treatment, needle and syringe exchange programmes and other harm reduction interventions were in place in all EU Member States and Norway in However, coverage and access to these programmes remains a challenge, with only five of the 17 EU countries with available data reaching the World Health Organization service provision targets in Currently, 15 countries report the provision of take-home naloxone to prevent overdose deaths and 10 countries report having at least one supervised drug consumption room. Naloxone works as a safe and effective antidote to reverse the respiratory depression caused by opioids Boyer, ; Britch and Walsh, ; Strang et al. However, coverage of these interventions remains uneven within and across countries in the EU. In addition, 12 countries have some type of drug checking service, which can help prevent harms by allowing users to find out what substances are present in the drug they have acquired and intend to consume. However, as with other drugs, opioids are also distributed across the EU via a range of digital channels, including darknet markets. The quantities offered online are typically small, and purchases are usually delivered using post and parcel services see Section Fluidity of routes, methods of transportation and modi operandi. In addition to parcel delivery, user-level distribution takes place by means of personal handover or by agreeing on a location where the drugs are left for pick-up. Although online retail distribution of heroin appears to remain marginal compared with other supply methods, it is important to understand its scope. A total of 2 listings sale offers of opioids excluding new opioids were identified based on data from eight major darknet markets, namely Versus , World , Dark0de Reborn , ASAP , Hermes 71 , Alphabay-v3 66 , Cypher 51 and Royal 23 ; these were reported as being shipped from an EU country. To put this in context, although not directly comparable, a similar scanning exercise conducted in found 13 listings for cannabis and 6 for amphetamine products For more information on the data source, see Section Overview of data and methods. The source data for this graphic is available in the source table on this page. Caution is needed in interpreting these data, as neither the number of individual sellers offering heroin on these marketplaces nor the number of transactions can be extrapolated from the number of listings alone. Nonetheless, the number of listings has been used as a valid indicator of the scope of activity on darknet markets. However, these findings should be viewed with caution due to an absence of forensic testing and evidence on the actual substances sold in these listings. In addition, heroin-fentanyl combinations appear to be available on darknet markets. An example of this can be found in a listing reportedly shipping from the Netherlands see Screenshot Fentanyl-heroin mixture listed on a darknet market, shipping from the Netherlands. The availability of such products represents a significant change in the risk environment for people who inject drugs. New benzimidazole nitazene opioids, including isotonitazene, etazene, etomethazene, metonitazene and protonitazene, also appear to be available on darknet drug markets. Listings for these substances have been associated with several EU Member States Czechia, France, Germany, Hungary, Poland and Sweden , which were noted as shipping origins on major darknet markets in Of particular concern is the online marketing of new opioids mis-sold as falsified fake medicines. In recent years, reports and public notices have been issued in a number of EU Member States to alert people about new opioids mis-sold as fake medicines, such as oxycodone tablets containing new opioids. The criminal use of the online environment to trade synthetic opioids, or medicines containing or adulterated with such compounds, could further increase in the EU as criminals act upon new opportunities, such as an increased demand for these products see Box Operation Earphones disrupts the trafficking of fentanyl into Italy. In addition to falsified medicines, there is also an online market for opioid medicines diverted from legitimate pharmacy supplies and sold on the surface web see Box Poland-based online market supplying illegally diverted opioid medicines to the United States and the United Kingdom. Consult the list of references used in this module. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. This make take up to a minute. Once the PDF is ready it will appear in this tab. Sorry, the download of the PDF failed. Table of contents Search within the book. Introduction Introduction Key findings and threat assessment Key findings and threat assessment Global context Global context Production Production Trafficking and supply Trafficking and supply Criminal networks Criminal networks Prices, purities and offences Prices, purities and offences Retail markets Retail markets Actions to address current threats and increase preparedness Actions to address current threats and increase preparedness. Search within the book Operator Any match. Exact term match only. Main subject. Target audience. Publication type. EU Drug Market: Heroin and other opioids — main page. On this page.

Slovakia buying Heroin