NEW TRENDS IN USE, CONSEQUENCES / DAMAGES AND MARKETS. 2nd Annual Meeting of National Drug Observatories COPOLAD II Lisbon, November 2017

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NEW TRENDS IN USE, CONSEQUENCES / DAMAGES AND MARKETS 2nd Annual Meeting of National Drug Observatories COPOLAD II Lisbon, 13-17 November 217

THE QUESTIONS In the last two years What recent changes and new trends have been observed in the prevalence of use? What recent changes and new trends have been observed in the drug market? What recent changes have been observed regarding the social and health consequences related to drugs? Has there been any recent change in your country's drug policy?

SOURCES OF INFORMATION Epidemiological- 214 Epidemiological studies Household survey Survey on adolescent school population Survey on university population Treatment 214- NPS/ADULTERATIONS- EWS 214 - Supply control 23- Special studies (multimethod) 214 Law 19172 - Regulation of cannabis. (213) Permanent records People in treatment Mortality indicators / hospital discharges Supply control Early Warning System Special studies (multimethod) Local diagnostics RDS methodology for hidden populations Hospital emergencies Indirect estimates Groups of experts Studies in population deprived of freedom Have a plurality of tools to choose the most appropriate one(s) to respond to the approach of the problem / research question.

EPIDEMIOLOGICAL INFORMATION INDICATOR: use in last 12 months 7 71,1 6 5 4 33,9 3 2 1 12,1 9,3 5, 1,6,4,2,1 Source: VI National Household Survey on Drug Use - 214

EPIDEMIOLOGICAL INFORMATION SOURCE: VI NATIONAL HOUSEHOLD SURVEY ON DRUG USE - 214 ALCOHOL TOBACCO 39 1 9 8 7 6 5 4 3 82,8 81,3 71,4 66,5 53,2 52,4 92,4 9,6 74, 71,1 55,3 52,1 Prevalencia vida Prevalencia últimos 12 meses Prevalencia últimos 3 días 37 35 33 31 29 36,8 36,9 34,5 34 33,9 31 33 29,5 Prevalencia últimos 12 meses Prevalencia últimos 3 días 21 26 211 214 27 MARIJUANA 25 21 26 211 214 25 COCAINE 2 15 1 5 21 26 211 214 Prevalencia vida 5,3 13,1 2 23,3 Prevalencia 12 meses 1,4 5,5 8,3 9,3 Prevalencia 3 días,5 3,5 4,9 6,5 Prevalencia vida Prevalencia 12 meses Prevalencia 3 días 8 7 6 5 4 3 2 1 21 26 211 214 Prevalencia Vida 1,4 4,3 6,2 6,8 Prevalencia 12 meses,2 1,6 1,9 1,6 Prevalencia Vida Prevalencia 12 meses Prevalencia 3 dias Prevalencia 3 dias,1,8,9,6

EPIDEMIOLOGICAL INFORMATION SOURCE: VI NATIONAL HOUSEHOLD SURVEY ON DRUG USE - 214 1,2 1,8,6,4 Cocaine base paste (life prevalence),8 1,1,7 2,5 2 1,5 1 Designer drugs 2,2 2 1,5 1,5 26 211 214 ECSTASY: Use at some point in life (%) 1,5 1,4,7 %,5,4 Vida Ultimos 12 meses Ültimos 3 dias Life Last 12 months Last 3 days All amphetamine-type substances (ETA) are included: Stimulants without medical prescription Ecstasy Amphetamines Methamphetamines,1,1 a21 a26 a211 a214 Ambas sustancias presentan una baja prevalencia, fuerte segmentación territorial y socioeconómica (en sentidos opuestos)

Number of cases Treatment demand: Primary drug- (in %) HEALTH THREATS 1: TREATMENT DEMAND 28 213 214 215 216 217 Treatment Demand (absolute numbers) 4 35 Smokable Cocaine 88,9 69,6 66,1 64,8 64,9 69.1 3 25 2 15 Cocaine 4,2 22 23,1 24,9 22,5 19.5 1 5 Alcohol 1,5 4,7 6,5 6,2 6,3 6.1 Marijuana 3,4 3,4 3,8 3,8 5,5 4.7 Source: Information System Treatment.Registration: Centro de referencia Porlal Amarillo 214 215 216 217 OTRAS 1 1 3 2 ALCOHOL 17 21 22 23 MARIHUANA 1 13 19 18 COCAINA 6 84 78 74 PBC 172 22 225 262 Source: Information System Treatment.Registration: Centro de referencia Porlal Amarillo

HEALTH THREATS 2: NPS Source: 214 Early Warning System- 57 National complaints in the system 17 complaints about intoxication cases Reasons for consultation: amphetamine-type stimulants, levamisole (adulterant), cannabis, alcohol, 25B NBOME, ketamine, cocaine hydrochloride, anabolic steroids, pharmaceutical product (syrup) with opiate derivative 3 complaints with analysis of substances seizures/samples More than 17. units (tablets, seals, wrappings, tears, etc.) and 1,6 grams (powder substance) involved in the analyses Main substances detected: MDMA, MDA, fentanyl, DOB, DOC, 25 NBOME, 25B NBOME, 25C NBOME, 1,4 Butanediol, 3c b fly, Amphetamine, BZP, Synthetic cannabinoids (JWH 15, JWH 18, JWH 73, JWH 2, JWH23, JWH25, AM 122, AM 221, AM 2232), Catinones (mephedrone, methedrone, methylone, buphedrone, 4- fluoromethcathinone, 3- fluoromethcathinone, methcathinone), ketamine, LSD, LAMPA, MDPV, cocaine base paste, hydrochloride of cocaine, mescaline, nicotine, adulterants (levamisole, caffeine, phenacetin, etc.) and other minor components.

HEALTH THREATS 3: NPS- Specific studies in the field of NPS and synthetic drugs OUD-Fac. Humanidades (215): Viajes Sintéticos. Estudio sobre uso de drogas de síntesis en el Uruguay contemporáneo 214-215 Polo Tecnológico, Fa. Química OUD (216): Screening de NSP y cocaína en muestras de orina en fiestas de electrónica en Uruguay CIAT (216): Caracterización de casos agudos con consumo de NSP

SUPPLY CONTROL DATA SOURCE: (MINISTRY OF THE INTERIOR RECORD) YEAR Marijuana* Cocaine* CBP* ECSTASY** LSD** 214 1457 43,28 28,26 32 215 2521 134,84 67,625 54533 96 216 435 144 137 219149 2264 * Quantities expressed in kilos ** Quantities expressed in units No. of defendants for drug law violations YEAR No. of defendants 215 1233 216 92

DATA ON REGULATION OF THE CANNABIS MARKET POTENTIAL MARKET: 147, people Source: VI National Household Survey on Drug Use. Regulated market on 11/5/217 1521 acquirers 7441 cultivators 68 membership clubs 15% of the absolute market 37% of the "REAL" market

Contact Héctor Suárez Coordinator Uruguayan Drug Observatory hsuarez@presidencia.gub.uy (+598)15- Internal 1249 For more information www.infodrogas.gub.uy