This paper explores European and national trends in specialised drug treatment entry for cannabis-related problems. The analysis is based on data for the years 2003-2014 from 22 European countries. Between 2003 and 2014, the overall number and proportion of primary cannabis-related first-time entrants increased significantly. A joinpoint regression analysis indicates that the overall increase of cannabis treatment entries is continuous, although country-related differences are observed. Possible explanations for the increase and different time trends are discussed including an increase in cannabis prevalence and cannabis-related problems, changes in risk perception, increases in cannabis potency, changes in referral practices and increased availability and accessibility of treatment services.
Objective:The article describes an epidemiological indicator called Treatment Demand Indicator (TDI). The TDI aims to provide professionals and researchers with a common European methodology for collecting and reporting core data on drug users in contact with treatment services. The article discusses the implementation of the TDI in the European countries and describes the main results, limitations, and future perspectives.Method:The TDI provides a common format for reporting data on clients entering treatment as a result of their drug use and related problems during each calendar year. Its technical protocol defines which clients should be reported at European level and represents the minimum common set of items each national monitoring system should be able to report to the European Monitoring Centre for Drugs and Drug Addiction.Results:In 2015, 29 European countries reported data on 467,811 clients entering drug treatment from 6,846 drug treatment units. Most clients were men in their 30s and had problems related to heroin or cannabis use; patterns of drug use differed geographically. Over the past decade, clients’ profiles and drug use patterns changed from young heroin injectors seeking treatment to drug clients with diversified drug use patterns and profiles.Conclusions:The TDI is the largest drug dataset in Europe, and its data is increasingly used in European and national data analysis. The use of a common drug-treatment-monitoring tool across a group of countries provides a useful instrument for policymakers, professionals, and managers working in the drug treatment field.Objectif :Cet article décrit l’indicateur épidémiologique appelé « Indicateur de la demande de traitement (TDI) ». L’TDI a pour but de fournir aux professionnels et aux chercheurs une méthodologie commune à l’ensemble des pays européens pour collecter et rapporter les principales données à propos des consommateurs de drogues fréquentant les traitements. Cet article traite de l’implantation du TDI dans les pays européens et décrit les principaux résultats, les limites et ainsi que les perceptives futures.Méthode :L’TDI propose un format commun de transmission des données pour chaque année civile à propos des clients qui entrent en traitement pour usage de substances et les problèmes qui y sont associés. Son protocole spécifique détermine quels clients devraient être signalés au niveau européen et décrit les points communs minimaux que chaque système de suivi national devrait être en mesure de transmettre à l’Observatoire européen des drogues et des toxicomanies (OEDT).Résultats :En 2015, 29 pays européens rapportaient des données à propos de 467 811 clients entrant en traitement pour leur consommation de drogues dans 6 846 centres de traitement en toxicomanie. La plupart des clients sont des hommes dans la trentaine et vivent des problèmes liés à leur consommation d’héroïne ou de cannabis; les habitudes de consommation varient selon la géographie. Durant la dernière décennie, le profil des clients et leurs habitudes de consommation ont ch...
Background People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes. Aim We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe. Methods Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n = 52,368 HIV+/−; n = 47,268 HCV+/−). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR. Results Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giving a PAR of 25.8% (95% CI 16.7–34.0). Univariable anti-HCV OR ranged between 1.06 and 5.04 (median: 2.70; pooled OR: 2.51; 95% CI: 2.17–2.91). Pooled PR was 1.42 (95% CI: 1.28–1.58) and PAR 16.7% (95% CI: 11.8–21.7). Subgroup analyses showed differences in the OR for HCV by geographical region, with lower estimates in southern Europe. Conclusion In univariable analysis, a history of incarceration was associated with positive HIV and HCV serostatus among PWID in Europe. Applying the precautionary principle would suggest finding alternatives to incarceration of PWID and strengthening health and social services in prison and after release (‘throughcare’).
Hepatitis C virus (HCV) infection is a serious public health problem in Europe, and it is estimated that a large number of people are unaware of their infection [1-3]. HCV infection may lead to symptomatic chronic liver disease after many years of asymptomatic infection. Effective treatment is available for HCV infection; however, the efficacy for many genotypes remains low and therapy is prolonged, involving both weekly injections and daily oral medication, and can be associated with significant adverse effects [4,5]. Where documented, injecting drug use is a major transmission route for HCV infections [1,6,7]. In many European countries, national surveillance of HCV infections has been established relatively recently.
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