HIV/AIDS Think Tank meeting: EMCDDA report. Roland Simon, Klaudia Palczak, EMCDDA Luxembourg, 7 July 2015

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1 HIV/AIDS Think Tank meeting: EMCDDA report Roland Simon, Klaudia Palczak, EMCDDA Luxembourg, 7 July 2015

2 European Drug Report 2015 Drop o Trends in seizures by substance from 2009 o Drug and related long-term harm decline o Interventions in quantities, but increases for Turkey DRID Meeting Recent o Topics upturn discussed in heroin purity o Follow up 2 2

3 European Drug Report (EDR) package 3 3

Overview on trends Overall decrease in heroin problems and related harms, although supply indicators raise new concerns Treatment systems and law enforcement efforts cannabis increasingly important

4 Overview on trends Overall decrease in heroin problems and related harms, although supply indicators raise new concerns Treatment systems and law enforcement efforts cannabis increasingly important Emergence of new drugs continues and monitoring of use, harms and responses needs to keep pace Market competition and innovation drive purity and potency increases, with new virtual marketplaces emerging. 4 4

5 Heroin market Heroin seizures by number and quantity Drop in in seizures from 2009 from and long term decline in quantities, 2009 but increases and long-term for Turkey decline in quantities, Recent upturn heroin purity but increases for Turkey Recent upturn in heroin purity 5 5

treatment (estimate) Trends in number of clients in OST 737

6 Over 50 % of problem opioid users receive treatment Percentage of problem opioid users receiving substitution treatment (estimate) Trends in number of clients in OST receive opioid substitution treatment, but numbers decreasing 6 6

7 Trends in treatment of opioid problems New New heroin heroin clients clients more more than than halved halved from New heroin clients more from to to than halved from 2007 to

8 Opioid users in treatment 8 8

9 Cocaine Quantity of cocaine seized Last year use of cocaine General population surveys Number of seizures Treatment requests 9 9

10 Amphetamines Amphetamines: Seizures Methamphetamines: Seizures 10 10

11 NPS reported 101 New psychoactive substances detected in 2014 synthetic cannabinoids (N=30) synthetic cathinones (N=31) 25 % increase compared with substances monitored by EWS 11 11

HIV diagnoses fall after outbreaks Newly diagnosed HIV cases related to injecting drug use 1

12 HIV diagnoses fall after outbreaks Newly diagnosed HIV cases related to injecting drug use new cases among injecting drug users in 2013 Responses to outbreak in Greece and Romania 12 12

13 Hepatitis C HCV antibody prevalence among injecting drug users HCV antibody levels among drug injectors vary between 14 % and 84 % New diagnostic tools and medications available High treatment costs 1 13

Overdose deaths Over 6 100 deaths in 2013 Over 6

14 Overdose deaths Over deaths in 2013 Over deaths in 2013 Recent increases a concern Drug-induced mortality rates among adults Highest overdose mortality rates in Northern countries 1 14

15 Preventing drug overdoses and deaths Opioid substitution treatment evidence Naloxone schemes increase Drug consumption rooms debated 1 15

16 Drug consumption rooms 70+ supervised facilities Local response to reduce harms, deaths and connect users with services Types: integrated, specialised and mobile facilities 16 16

17 Evidence is core: Best Practice Portal 17 17

18 Major EMCDDA activities in 2015 European Drugs Report package 2014 Lisbon launch National launches EMCDDA publications Insight publication on HCV treatment Insight publication on Naloxone Key EMCDDA experts meetings June DRID Expert meeting September 20 Years Monitoring September Lisbon Addiction 2015 (incl. sponsored session on HCV) Joint ECDC-EMCDDA: Latvia Common Mission report Dublin monitoring Botulism outbreak Other collaborations JA on HIV JA on Harm reduction 18 18

19 DRID meeting draft report General discussion Dropping budgets make testing and surveillance more problematic News France starts 6 years experiment on consumption rooms Studies NPS injection in Wales: old and new user groups Hungary: HepC doubled for Mephedrone users and Cocaine users Wound botulism Case fatality for PWID 15% Limited investment in diagnostics Mechanism of transmission not well understood Glasgow (Dec 2014/Jan 2015) 47 suspected/17 confirmed UK: 250 over 10 years suspected cases Lab network would help to understand mechanism of infection HIV Possible outbreaks in Ireland and Scotland Cocaine related outbreaks in Luxembourg 19 19

20 DRID meeting draft report Hepatitis C Spanish findings HIV 8%, HepC 20% amongst all prison inmates, Handbook NSP implementation in prisons Irish findings Self report + oral fluid sample amongst treatment clients (N=765) LYP: 29% cocaine, 30% heroine PWID in prison: 42% HepC, 6% HIV Risk factors: shared needles Improve reactions to threats Financial threats, less testing, risk of outbreaks Build common platforms for exchange New drugs change risk situation Seroprevalence studies needed Health in prison HIPP to help countries develop Special problem: short term prisoners Further aspects Modelling Costs 20 20

21 21 www. Thank you!

EMCDDA-update HIV/HCV among people who inject drugs: situation and response

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