The EMCDDA annual report 2010: the state of the drugs problem in Europe.

Injecting drug use is strongly associated with severe health problems in drug users, including blood-borne infections (e.g. HIV/AIDS, hepatitis) and overdose. According to the annual report of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), published on 10 November, the latest data from treatment monitoring are encouraging, showing a stable to downward trend in drug injecting. Among heroin users entering treatment, a decline in the proportion of injectors was reported in 13 countries between 2002 and 2007. The latest data show that under half (42%) of those entering treatment for primary opioid use in Europe report 'usually injecting' their drug, while the proportion for those entering for the first time is lower (38%) [1]. But while drug injecting may be stable or declining, it remains central to Europe's drugs problem. And injecting is still the most common route of administration for opioid users in many eastern European countries: the highest proportions of injectors among opioid users entering treatment in 2008 were reported by Romania (95%), Estonia (91%) and Slovakia (86%). The public health consequences of drug use in some of the neighbouring countries of the European Union (EU) are also examined in the report. At the eastern border of the EU, the United Nations Office on Drugs and Crime (UNODC) estimates that Russia and Ukraine both have levels of problem opioid use that are two to four times higher than the EU average, around 4 cases per 1,000 population aged 15–64. The problems associated with opioid use in this region include high rates of HIV infection and drug-induced deaths. Around 1.68 million problem opioid users (mostly injec-tors) are reported in Russia and between 323,000 and 423,000 in Ukraine (UNODC, 2010). And studies estimate that in both countries around 40% of them are reported to be HIV positive. The rate of newly reported HIV cases among injecting drug users is much higher in Russia and Ukraine than in other countries and regions of the world, such as Australia, Canada, the United States and the EU. 'The prevention of infectious diseases is an important public health goal of the European Union and a component of most Member States' drug policies', says EMCDDA Chairman João Goulão. 'Europe has made impressive progress in preventing new drug-related infections, but continued effort is essential. The growing and severe drug-related problems now faced by many of our neighbouring countries are not just public health disasters …