European illicit drugs policy and global health

The use and abuse of addictive substances, whether controlled by the state, like alcohol and tobacco, or illicit drugs such as heroin, cocaine and amphetamines, have a major impact on health. Such drugs not only affect their users, but also have an impact on crime, violence and accident levels. Public concerns about the issue have been raised in recent years due to the high-profile role that injecting drug use has played in the spread of blood-borne infectious diseases such as HIV. However, equally important is the role that substance abuse has been shown to play in the epidemiology of mental illness. This was acknowledged in a 2008 World Health Organization initiative, the Mental Health Gap Action Programme (mhGAP), which addresses mental, neurological and substance-abuse disorders and deaths together as related concerns.

Drugs prevention policies require international police and health action because of the close relationship between illicit drugs and crime. The smuggling and supply of cigarettes, alcohol, and soft and hard drugs support international criminal networks and smuggling routes that may, in turn, support the trafficking of women and children – most often for prostitution – or men for illicit labour. Such routes, leading back to sources in failed states, may also support international terrorism – the major source of heroin for Europe is from insurgent-controlled areas of Afghanistan.

The EU’s interdisciplinary approach and action plan to combat drugs – with its acknowledgement of the need to coordinate internally and act externally – mirrors recent developments in Europe’s strategy for health. Like drug use and addiction in a population, health is also a largely social phenomenon requiring coordination horizontally between various policy fields and vertically through different levels of government. Global health policy and drug policy professionals should be able to cooperate and learn from each other’s experiences in tackling such large-scale issues, which depend on effective collective action.

More on European Illicit Drugs Policy

Further Definitions

Illicit Drugs in Europe:

According to the 2008 annual report of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), drug use remains a significant challenge across Europe. The use of cocaine in Europe continues to rise with 3.5 million young Europeans estimated to have used cocaine in the last year. European countries remain major producers of designer drugs such as amphetamines and ecstasy, (the second most popular drug group in Europe after cannabis), with between 70 and 90 production sites detected each year. In addition, though recent data shows a stabilisation and slight decline in the use of cannabis among the general population, its use still remains at a historical high. 12.5 million Europeans are estimated to have used cannabis in the past 30 days and new data also suggests that there are considerable populations of regular and intensive cannabis users among whom trends may move independently from that of the general population.

Substance abuse disorders and deaths, 

(fatal poisonings directly attributable to drug use), are a significant burden on public health in Europe. Even with known under-reporting, there are still 7,000 – 8,000 drug-induced deaths reported in Europe each year. For the period of 1990 – 2004 the EMCDDA estimates 122,000 deaths from drug overdose which in 2005-06 accounted for 3.5% of all deaths of adults in the age range of 15 – 39 years old. While these figures are relatively low when compared to other regions (such as the U.S.) this is no reason for complacency. Of the known consequences of drug use, drug related mortality is only one extreme-long-term drug addiction and use also has significant social and economic impacts on drug users and their communities. Chronic illnesses and disorders associated with drug use contribute to the overburdening of health systems and have significant affects on social services, criminal justice systems, educational sectors, and road traffic safety. Nor is the burden of combating drug use on public expenditures negligible. A recent EMCDDA study found that drug-related public expenditure in the EU is around EUR 34 billion per annum.

EU’s interdisciplinary approach:

Much like global health, combating drug use requires an interdisciplinary approach. An effective drugs policy must simultaneously tackle the problem from both the supply and demand side from within Europe while also addressing drug trafficking and production beyond Europe’s borders. At the European level this involves horizontal coordination between various directorates general of the Commission such as those for freedom, security and justice, public health, external relations, and development assistance. It also involves close cooperation with the member states and coherence in their domestic and foreign policies. This work must then be coupled with strong partnerships with international organisations. These above mentioned facets are said to embody a “European approach” to combating drugs that was first reflected in the official EU drugs policy (2005 – 2012) and the EU Drug Action Plan.

Action plan:

2008 was a decisive year for European and international drug policy as both the UN and the EU began assessing the results of their drug policies. For Europe this amounted to the most extensive assessment of the implementation of EU drug policy to date. Despite the fact that rates of drug use have not declined, and in some cases have increased, the evaluation report credits the EU with successfully containing this complex social phenomenon at a time of unprecedented rise in the production of opiates globally, as well as a rise in the trafficking of cocaine specifically targeted at the EU. The report, supported by previous studies in 2007, also finds an increasing degree of convergence in the drug policies of the Member States and improved coordination of EU positions in international fora on drugs, such as in the UN’s Commission on Narcotics Drugs. There has also been a notable shift within Member States towards underpinning national policies with action plans just as is done at the EU level.

Among these positive findings the report also acknowledges the need to further improve policy coordination as problems with this persist in many areas. Furthermore, while the quality of information on the EU situation regarding drug use, prevention and treatment has consistently improved, the report acknowledges that considerable knowledge gaps remain with regard to the EU’s global activities. There is a persistent lack of reliable data on drug supply in Europe but also on the scope and outcomes of drug-related assistance to third countries. In the EU’s 2009-2012 Drug Action Plan, which was approved at the end of 2008, priority is given to the further improvement of coordination of EU policies at the Member State and the Community level. As one of its objectives the action plan calls for the systematic inclusion of EU drug policy concerns in relations with third countries and regions where appropriate and to do so on the basis of strategic planning and coordination between all actors concerned.