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Since early 2020, the COVID-19 pandemic has had a dramatic impact on the way we live, with European countries having to introduce unprecedented measures to protect public health. As with all areas of life, drug consumption, related harms and drug markets have been impacted, as have the drug services established to respond to drug-related problems. Since the start of the pandemic in March 2020, the European Monitoring Centre for Drugs and Drug Addiction instigated three rapid assessment studies to identify the initial impact and implications of COVID-19 on drug markets, use, harms and drug services in the community and in prisons. Findings from these studies revealed that the pandemic and associated health prevention measures implemented by the countries impacted drug markets and use differently depending on the different periods and events throughout the pandemic, but also according to particular drugs or user characteristics. Most drug services remained operational throughout the pandemic in order to assure continuity of care. This was achieved by innovation and adaptation of their services, especially during the different lockdown periods. Thus, the results from these rapid assessments provide a glimpse into new developments in the drugs field across European countries emerging both during and in response to the pandemic, and which could have important implications for the future. [ABSTRACT FROM AUTHOR]

Abstract All previous studies of the sub-acute effects of ecstasy have failed to adequately control for group differences in psychopathology and past and concurrent substance use. The present study was [...]

Background: Little is known about the knowledge and use of technology-based interventions (TBIs) by health personnel working in the addiction field across Europe. Methods: An online questionnaire was designed using SurveyMonkey® in order to determine the level of knowledge, use and perceived efficacy of TBIs in substance use disorders (SUDs), among health professionals across six EU Member States: Germany, Italy, UK, France, Poland and the Netherlands. The survey was sent to a convenience sample of 1200 addiction experts. Results: Surveyed participants (311, response rate 26%), had a mean professional addiction experience of 17 years; 23% stated to have good knowledge of TBIs, while 12% use them in their clinical practice. Forty-six percent consider TBIs useful in the treatment of addiction, and 44% foresee a significant increase of them in the future. TBIs were considered important for people facing barriers to accessing treatment (63%) and for providing support outside the formal care settings (60%). Lack of technical support (48%), poor infrastructure and equipment (42%), and lack of digital literacy among health workers (38%) were identified as the main obstacles in the diffusion of TBIs. Conclusions: Knowledge and utilisation of TBIs among health workers in drug addiction field is low. Nevertheless, TBIs are perceived as a possible means of facilitation in providing access to treatment, and as therapeutic tools which will become more important in the future. The need to improve training policies, awareness and attitudes towards TBIs among EU health professionals, working in the field of addiction is paramount. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore the prevalence of primary illicit stimulant use among people who enter drug treatment in Europe. Drawing on information provided by European Union treatment centres in 2009 (excluding Latvia, Lithuania, Portugal and Norway), the European Monitoring Centre for Drug and Drug Addiction showed data in relation to the analysis of two of the most problematic drugs: cocaine and stimulants other than cocaine. The analysis reached three conclusions: the primary use of stimulants (cocaine and amphetamines) among clients entering treatment appears to be widespread throughout Europe; stimulant use including different forms of stimulants varied from country to country and two geographical patterns emerge across Europe: North-Eastern European countries show high levels of prevalence of problematic use of amphetamines and methamphetamines, while South-Western countries report high levels of problematic use of cocaine. [ABSTRACT FROM AUTHOR]

Since the 1960s, illicit drug use in Europe has been marked by the serious health consequences of drug injecting, in particular of heroin. The present article discusses the development of two major harm reduction interventions conducted in Europe to reduce heroin injection and its detrimental consequences, namely opioid substitution treatment and needle exchange programmes. Data collected by the EMCDDA, the specialized EU drug monitoring agency, show that these interventions have progressively become part of the common response in Europe for reducing problems related to drug injecting. The data illustrate the emergence in the mid-1980s of these measures as 'new' public health responses to injecting drugs and HIV/AIDS, a process that was preceded by intensive discussions between stakeholders at national and local level. Data also indicate that the scaling up of the measures was not immediate, but happened only about a decade later, during the 1990s—and predominantly in the Western part of the European region. While current social, cultural and legal responses to drug use in EU Member States remain diverse, a recent assessment of national priorities and approaches in preventing infectious diseases and drug-related deaths showed a considerable trend towards a convergence of policies across the whole region. This is discussed in relation to strategic guidance and target-oriented action plans that emerged at the level of the European Union since the late 1990s, concluding that European policy consensus was mediated by EU guidance, while not originating from it. [ABSTRACT FROM AUTHOR]

Ecstasy (MDMA; 3,4-methylenedioxymethamphetamine) has a well-recognized neurotoxic effect on central serotonergic (5-HT) systems in animals, and there is some evidence of persistent serotonergic dysregulation in human ecstasy users. Serotonin is believed to mediate impulsive behavior and effective decision-making. Thus, the aim of the present study was to investigate impulsive behavior and decision-making in abstinent regular ecstasy users. Three groups were compared: ‘ecstasy users’ (recreational ecstasy users who reported modest use of illicit drugs other than cannabis), ‘polydrug controls’ (ecstasy naïve illicit drug users), and ‘drug-naïve controls’. All participants completed personal details and general drug history questionnaires, the National Adult Reading Test, Matching Familiar Figures Test (MFF20), a risky decision-making task (RDMT), and the Card Arranging Reward Responsivity Objective Test (CARROT). The groups did not differ on the CARROT measure of responsiveness to financial incentive; however, the ecstasy group displayed significantly elevated MFF20 impulsivity, and showed reduced discrimination between magnitudes of prospective gains and losses when making risky decisions, compared to the ‘polydrug’ and ‘drug-naïve’ control groups. These findings may reflect a vulnerability of 5-HT systems in the orbital prefrontal cortex and interconnected corticolimbic circuitry to the cumulative neurotoxic effects of ecstasy and have clinical significance for regular ecstasy users. The combination of elevated impulsivity and impaired use of reinforcement cues in uncertain decision-making may comprise risk factors for continued drug abuse and everyday functioning.Neuropsychopharmacology (2006) 31, 1562–1573. doi:10.1038/sj.npp.1300953; published online 9 November 2005 [ABSTRACT FROM AUTHOR]

This paper explores the recent resurgence in use of ecstasy/MDMA in Europe and highlights keys areas of continuity and divergence between the ecstasy market of the 1990s and the current MDMA market. Based on a scoping study involving a targeted multi-source data collection exercise on MDMA, it highlights nine areas that have undergone some level of change, linked with both supply and demand for the drug. Factors discussed include: innovation in production techniques; changes in precursor chemical availability; the role of online markets; competition with other stimulants and new psychoactive substances; the increased availability of high-strength MDMA; and the shift from subcultural towards more mainstream use of the drug. The paper proposes that the MDMA on Europe's contemporary market is in some respects a third generation product with a different consumer profile, with implications that responses developed at the time of the drug's earlier iteration, may be in need of a review and revamp. [ABSTRACT FROM AUTHOR]