The Family Council on Drug Awareness
"Responsible decisions based on accurate information."
Study finds teenage drug use higher in USA than Europe
By KATE ZERNIKE, NY Times February 21, 2001
American teenagers are far more likely than their European peers to use marijuana and other illicit drugs, but European teenagers are more likely to smoke cigarettes and drink alcohol, according to a study of 31 nations. The study, released yesterday at a meeting of the World Health Organization in Stockholm, compared the results of 1999 surveys answered anonymously by 14,000 10th-grade students in the USA and 95,000 10th-grade students in 30 European countries.
Among the European students, 37 percent had smoked at least one cigarette in the previous 30 days, compared with 26 percent in the USA. Sixty-one percent of the European 10th graders had consumed alcohol in the previous 30 days, compared with 40 percent of the students in the USA.
Forty-one percent of 10th graders in the USA had tried marijuana, compared with 17 percent of those in Europe. And 23 percent of the students in the United States had used other illicit drugs, compared with 6 percent of Europeans. Researchers said that the study, the first to make such broad comparisons, would help them and policy makers determine the effects of culture and other factors on drug use.
"We tend to think within national boundaries," said Thor Bjarnason, a sociologist at the State University of New York at Albany and a co-author of the report, the European School Survey Project on Alcohol and Drugs. "If you're having a war on drugs, one measure is within a comparative perspective. If drug use is increasing at a slower rate in your country, that could be a victory."
The study was developed by the Council of Europe, an intergovernmental organization focused on social and economic issues, with the help of researchers at the University of Michigan's "Monitoring the Future" project, which has surveyed students on a variety of issues for 26 years and is considered the most reliable barometer of student drug-use trends.
The European survey was designed in such a way so the two could be accurately compared.
Dr. Bjarnason called the differences in illicit drug use "very striking." "That's one in four students in this country," he said. "Even in the European countries with the highest rates, it's only one in 10." Yet while a smaller percentage of European students used illicit drugs, that percentage rose from 1995 to 1999, particularly in former Eastern- bloc countries.
By contrast, much drug use in the USA has declined or held steady â " with the exception of Ecstasy use, which has risen sharply. Researchers offered little analysis to explain the differences. That, they said, would come in the second phase of the study. But, they noted, the widespread use of marijuana and other illicit drugs began in the United States and spread to Europe so it might be that Europeans simply follow the American trend.
Others cited the more relaxed rules governing alcohol and cigarette use in many European nations, as well as other cultural differences. Researchers said they were particularly interested in the survey results of marijuana use in the Netherlands, known for its relatively permissive drug laws.
While marijuana use was relatively widespread there â " 28 percent of 10th graders had tried it, compared with the European average of 17 percent â " four other European countries, Ireland, France, the Czech Republic, and Britain, had higher rates, as did the USA.
Worrisome Swedish data, where prohibition is strongest.
The European Monitoring Center for Drugs and Drug Addiction (EMCDDA) released their year 2000 Annual Report this month. It reminds us that international comparisons can be difficult to interpret in some areas, but they have gone to some lengths to standardize a variety of important fundamental population and outcome findings in this field.
While the report will be summarized elsewhere, I have done a search of 'Sweden' in order to obtain some data on their latest statistics, when compared with the other 10 member states (these do not include Norway or Switzerland - and some UK figures exclude Scotland and N. Ireland). Some contributors to the Update and Drugtalk lists have used Sweden as an example of success in drugs policy and treatment. While some Swedish figures are favourable, the latest comparative statistics reveal a rather worrying picture in some key areas. Because of the nature of domestic politics, statements by individuals should be viewed with caution when they are not backed by evidence such as in this exhaustive report.
The report states that the rate of hepatitis C amongst injectors in Sweden is the highest in Europe at more than 90%. This is about double the rates in Belgium or the UK and significantly higher than Greece, Germany and France at around 60%. Swedish rates of HIV amongst drug users at 2-3% is about double that in the UK (or Australia). It is still a low figure by comparison with Italy, Spain, France and Portugal which are all over 15%. The report states that actual prevalence rates of heroin use are difficult to determine but are probably under 1% of the population across Europe. Population surveys do show, however, that cocaine use in Sweden is about average, being higher than 5 other countries, but less that the other 5.
The number of drug seizures decreased markedly since 1995 in Denmark, Germany, France, Italy, Luxembourg and Austria, but has increased in Ireland, Finland, Sweden and the UK.
It is stated that Sweden, unlike other countries, does not have geographical cover for all potential recipients of methadone treatment. Also, Sweden is one of only 3 member states which do not permit any alternative prescribing (other used are codeine, morphine, LAAM, buprenorphine dihydrocodeine, heroin and 'Mephanon') (p30).
Sweden is not amongst 5 member states which provide drug treatment programs for female prisoners, but they do fast-track treatment for pregnant women generally (p34).
'Lifetime use' of cannabis was highest in Britain, Spain and Denmark at 20 to 30% (1994-1998). Lifetime experience of cannabis was reportedly about 13% in Sweden, which was the same as Greece and West Germany. Lowest rates are in (former) East Germany, Belgium and Finland where less than 10% of the population had reported using the drug.
The reported use of amphetamine was higher in Sweden than in France, East Germany, Belgium, Greece and was about the same as West Germany and Holland and Spain. Only Britain and Denmark substantially exceeded the Swedish figure for this stimulant.
The report uses a number of classifications of 'acute drug related deaths' in order to make more valid international comparisons. Whichever method is used, the mortality in Sweden was amongst the highest at 1.5, slightly below the UK at 2.2 using the strictest definition (units are stated to be deaths per 100,000 population per year).
The rates in Holland and France were 0.2 and 0.3 respectively which are close to the levels of the 19th century when opium products were available over the counter in most countries (see Berridge & Edwards, 'Opium and the People'). These staggering excess deaths in Sweden and UK are 7 to 10 times the figures from Holland (or, I understand, Switzerland which is not a member state, but last reported 5 overdose deaths per million, I understand in ±1997).
Dr Andrew Byrne,, General Practitioner, Drug and Alcohol, Email firstname.lastname@example.org
75 Redfern Street,, Redfern,, New South Wales, 2016, Australia, Tel +61-2-9319-5524; Fax 9318-0631 www.emcdda.org/publications/publications_annrepstat_00.shtml
The Council of Europe's Parliamentary Assembly's Social, Health and Family Affairs Committee on Tuesday adopted a report calling for member states to concentrate on harm reduction, saying legal sanctions against drug possession and use have no effect. The report will be part of draft recommendations to be debated in the Parliamentary Assembly later this year. The URL to access the COE's press release, text of which is below, is: http://press.coe.int/cp/2001/111a(2001).htm
The following is an unofficial English translation of excerpts from questions asked in Dutch Parliament and the answers given by the government. (Second Chamber Document 24077 NR 85, Dated 16-01-2001)
Translator: Jan van der Tas, Netherlands Drug Policy Foundation.
QUESTION LABOUR PARTY (member of government coalition, moderate left): Foreign criticism of Dutch drug policies is not in the first place leveled at the decriminalization aspects of our policies. On the contrary, many European countries seem to be in the process of adjusting their policies in the direction of the Dutch model. These members are of the opinion that the government does not rate this positive appreciation of Dutch drug policies at its true value and for that reason reacts too negatively to proposals for further changes.
ANSWER: In a number of European countries nowadays a pragmatic approach is chosen -- at the executive level -- with regard to the commitment of available resources for criminal investigation and prosecution. This leads among other things to a de facto decriminalization of use and possession for own use of cannabis in such countries. In a much smaller number of countries this pragmatic attitude finds support at the political level and can thus be considered to have become governmental policy. For the time being most European countries are opposed to official changes in policy with regard to penalization of possession of and dealing in cannabis.
QUESTION CHRISTIAN DEMOCRATS (opposition, rightish): While trying to generate international support for the Dutch concept and policy of separating markets of hard and soft drugs, does the government also promote its policy of permitting 'coffeeshops'?
ANSWER: As announced in its letter to the Second Chamber of September 15, 2000, the government shall make an effort to generate international support for the concept of separation of markets for hard and soft drugs as applied in the Netherlands. This is done from the perspective of 'harm reduction' (i.e. prevention and/or limitation of the risks of drug use for the user, his direct surroundings and society as a whole). In the Netherlands this has resulted in a policy of permitting coffeeshops, as an instrumental part of the policy of separation of markets, which aims at safeguarding the user of soft drugs as much as possible from contacts with the markets for more risky illicit drugs.
QUESTION "D-66" (member of government coalition, liberal democrat left): May the Chamber expect to receive a government analysis of the connections between criminality and coffeeshops and how best to combat them? .
ANSWER: Traffic in products or services made illegal by law, but for which a lively demand exists all the same, shall always attract organized crime. Combating this criminality can in theory be done in either of two ways: by, at the demand side, reducing demand to zero or, on the supply side, by legalizing the product or service in question. Reducing the demand for cannabis to zero is an illusory objective. Legalizing or regulating drugs is not an option for the time being, in view of the international treaties and arrangements to which the Netherlands is a party.
QUESTION "D-66" (member of government coalition, liberal democrat left): What options does the government see, now that she refuses to follow the direction indicated by a majority in the House? Are there alternatives that have not yet been discussed and that respect the separation of markets for hard and for soft drugs, while taking into account the fact that soft drugs represent only a marginal or even no harm to public health at all?
ANSWER: The government is of the opinion that in the field of narcotic drugs the Netherlands can not introduce major policy changes without the consent of at least the partners in the European Union. Mobilizing support within the union for the concept of separation of markets, a concept inspired precisely by the lesser health risks of the use of cannabis, is a first phase in a process that ultimately may lead to policy changes at world level.
QUESTION "GREEN LEFT" (opposition, left): Furthermore the members of the parliamentary group of the Green Left are interested to be informed about the results of the conference of national drugs coordinators organized at the end of September 2000 by the French EU presidency. How did the discussion on this theme develop? And what are the results of the ministerial conference held in the middle of October 2000, where the tension between the theory of the treaties and the practical reality of their implementation was on the agenda? Has the Netherlands delegation at this conference pleaded for a change in the rules, that are supposed to make it impossible to organize and tolerate a non-criminal supply channel to the coffeeshops, whose role as a non-criminal point of sales to the consumer we tolerate? Has the government at the moment got a clear insight in policies implemented in other European countries? More and more indications reach the members asking this question according to which ever more European countries practice ever more progressive policies in this field. Can the government confirm these indications, and if so what precisely is the content of the policies and practices of these countries?
ANSWER: During the meeting of national drug coordinators in Paris at the end of September 2000 three themes were dealt with: trends in member states, new measures, and coordination of drug policies within the EU and in the member states themselves. Subjects that ran through the discussions like a continuous thread were the decriminalization of the use of drugs and 'harm reduction', i.e. the search for measures that can combat the harmful consequences of drug use. Furthermore the Netherlands have informed the partners about the application of the so-called 'expediency-principle' in Dutch law and the prioritization of tasks as applied by the Public Prosecutors. The United Kingdom delegation formulated the question which is highly relevant for Dutch policies, namely: "How to manage a high level of our laws when a million people or even more break our drug laws each week?"
At the ministerial conference of the so-called 'Pompidou group', which took place October 12-13, 2000, the government, in conformity with its promises to the House, brought up and explained the cannabis policies pursued in the Netherlands. In this context coffeeshops have been presented as a form of 'harm reduction'. A discussion ensued about the prevalence of drugs (hard and soft drugs) in relationship with the existence of coffeeshops and the so-called 'stepping stone' theory. The so-called 'backdoor of the coffeeshop' problem was dealt with and in this context the discussion on this subject in the Netherlands' parliament was explained and the area of tension that is experienced by all countries that do not criminally prosecute use and possession for own use came under review. Bilaterally talks were held with the Swiss, German and Belgian delegations about the cannabis conference to be organized this year. The Netherlands' delegation came away from the conference with the impression, that -- more and more -- the idea is gaining ground that a pragmatic approach to this problem is effective, and that the treaties (in particular the UN treaties on this subject) cannot remain trend-setting for many years to come. Rather, they must be seen as subject to adaptation to the practices of the present moment.
Content (c) 2000-2004. Family Council on Drug Awareness (FCDA), El Cerrito CA