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Current data on the prevalence of prior illicit drug use among the prison population in Europe is scarce. The aim of this study is to identify the prevalence of illicit drug use prior to incarceration, as reported by studies conducted in 30 European countries. A comprehensive literature review was conducted from the 5–31 of March 2018 using the databases Cochrane Library, Embase, MEDLINE, PsychINFO and PubMed. After the deletion of duplications, 2607 articles meeting the eligibility criteria for review were identified. In total, 26 studies from 12 different countries have been included in this review. The review found that the lifetime prevalence of illicit drug use before imprisonment ranged from 30 to 93%; last year prevalence from 51 to 69%; last 6 months prevalence from 13 to 75% and last month prevalence from 58 to 62%. The prevalence of illicit drug use was especially high among women. The rates varied across the 26 studies although high prevalence values are reported in most studies and variations are partly related to methodological differences in the reviewed studies. The high levels of prior involvement with drugs, necessitates prisons to develop clear strategies to deal with illicit drug use. [ABSTRACT FROM AUTHOR]

Aims: To describe cocaine treatment demand in 10 western European countries and to examine the size, direction and temporality of recent trends in the proportion of cocaine users among all clients entering treatment. Design Aggregated data collected through the European Union standardized treatment demand monitoring system (TDI) between 2011 and 2018 were used. Setting: Belgium, England, France, Germany, Ireland, Italy, Luxembourg, Spain, Switzerland and the Netherlands. Participants: In total, more than 700 000 cocaine treatment records were analysed. Clients in treatment for cocaine as primary drug were predominantly male (85%), with an average age of 35 years. Measurements Number of treatment episodes for substance use and for cocaine as primary or secondary drug were collected year‐ and country‐wise. When available, powder cocaine and crack and patients with and without previous treatment were differentiated. Findings Among the participating countries the share of cocaine as primary drug in treatment demand ranged between 4.7% [95% confidence interval (CI) = 4.6–4.9%] in Germany and 43.1% in Spain (95% CI = 42.6–43.5%). The general trend analysis showed a decreasing proportion of cocaine‐related treatment entrants between 2011 and 2014 among all subgroups followed by a strong increase in 2015. The increase appeared stronger than for powder cocaine. Seven of 10 countries observed a recent significant increase in the proportion of treatment entrants reporting cocaine as the primary substance: Belgium [annual percentage change (APC) = 9.6%, P < 0.01], England (APC = 14.9%, P < 0.05), France (APC = 21.8%, P < 0.01), Ireland (APC = 28.2%, P < 0.01), Italy (APC = 7.8%, P < 0.01), Spain (APC = 7.0%, P < 0.05) and Switzerland (APC = 12.0%, P < 0.05). Trends were similar when looking at cocaine reported as primary or adjunctive substance. Conclusions: Despite substantial country‐specific variation regarding cocaine prevalence and treatment demand, there has been an overall significant increase since 2015 in the share of cocaine‐related treatment demand in western Europe. [ABSTRACT FROM AUTHOR]

Abstract Background Heroin addiction often severely disrupts normal social functioning. The aims of this multi-centre study of heroin users in long-term replacement treatment were: i) to provide information on aspects of social condition such as employment, educational background, living status, partner status and any history of drug addiction for partners, comparing these data with that of the general population; ii) to assess the prevalence of hepatitis, syphilis and HIV, because serological status could be a reflection of the social conditions of patients undergoing replacement treatment for drug addiction; iii) to analyse possible relationships between social conditions and serological status. Methods A cross-sectional study was carried out in sixteen National Health Service Drug Addiction Units in northern Italy. The data were collected from February 1, 2002 to August 31, 2002. Recruitment eligibility was: maintenance treatment with methadone or buprenorphine, treatment for the previous six months, and at least 18 years of age. In the centres involved in the study no specific criteria or regulations were established concerning the duration of replacement therapy. Participants underwent a face-to-face interview. Results The conditions of 1091 drug treatment patients were evaluated. The mean duration of drug use was 14.5 years. Duration was shorter in females, in subjects with a higher educational background, and in stable relationships. Most (68%) had completed middle school (11–14 years of age). Seventy-nine percent were employed and 16% were unemployed. Fifty percent lived with their parents, 34% with a partner and 14% alone. Males lived more frequently with their parents (55%), and females more frequently with a partner (60%). Sixty-seven percent of male patients with a stable relationship had a partner who had never used heroin. HCV prevalence was 72%, HBV antibodies were detected in 42% of patients, while 30% had been vaccinated; 12.5% of subjects were HIV positive and 1.5% were positive for TPHA. Conclusion A significant percentage of heroin users in treatment for opiate addiction in the cohort study have characteristics which indicate reasonable integration within broader society. We posit that the combination of effective treatment and a setting of economic prosperity may enhance the social integration of patients with a history of heroin use.

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]

Aims: To assesses the extent of the gender gap among the treated population of drug users across Europe. Methods: This analysis reports data on 363,170 clients from 4647 treatment units in 23 countries (22 European Union member states and Switzerland). Findings: Overall, males outnumber females by four, but the gender ratio varies not only by geographical region/country, but also by drug. In the majority of countries, the most common primary problem drug is opioids, and the overall gender ratio mirrors the gender ratio of opioid users. In some countries, a considerable proportion of treated drug users have cannabis and stimulants (cocaine/amphetamines/methamphetamines) as primary problem drugs. Stimulants other than cocaine and other drugs have lower, while cannabis has a higher than overall male-to-female gender ratio. Conclusions: The very high male-to-female gender ratios may reveal differential access to treatment. Our findings highlight the need to assess access to treatment for women problem drug users and to make women-focussed programmes more available to increase the proportion of women in drug treatment programmes across Europe. [ABSTRACT FROM AUTHOR]

Background: Heroin addiction often severely disrupts normal social functioning. The aims of this multi-centre study of heroin users in long-term replacement treatment were: i) to provide information on aspects of social condition such as employment, educational background, living status, partner status and any history of drug addiction for partners, comparing these data with that of the general population; ii) to assess the prevalence of hepatitis, syphilis and HIV, because serological status could be a reflection of the social conditions of patients undergoing replacement treatment for drug addiction; iii) to analyse possible relationships between social conditions and serological status. Methods: A cross-sectional study was carried out in sixteen National Health Service Drug Addiction Units in northern Italy. The data were collected from February 1, 2002 to August 31, 2002. Recruitment eligibility was: maintenance treatment with methadone or buprenorphine, treatment for the previous six months, and at least 18 years of age. In the centres involved in the study no specific criteria or regulations were established concerning the duration of replacement therapy. Participants underwent a face-to-face interview. Results: The conditions of 1091 drug treatment patients were evaluated. The mean duration of drug use was 14.5 years. Duration was shorter in females, in subjects with a higher educational background, and in stable relationships. Most (68%) had completed middle school (11-14 years of age). Seventy-nine percent were employed and 16% were unemployed. Fifty percent lived with their parents, 34% with a partner and 14% alone. Males lived more frequently with their parents (55%), and females more frequently with a partner (60%). Sixty-seven percent of male patients with a stable relationship had a partner who had never used heroin. HCV prevalence was 72%, HBV antibodies were detected in 42% of patients, while 30% had been vaccinated; 12.5% of subjects were HIV positive and 1.5% were positive for TPHA. Conclusion: A significant percentage of heroin users in treatment for opiate addiction in the cohort study have characteristics which indicate reasonable integration within broader society. We posit that the combination of effective treatment and a setting of economic prosperity may enhance the social integration of patients with a history of heroin use. [ABSTRACT FROM AUTHOR]