from Dr Andrew Byrne,
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...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 in 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). Lowest rates are in (former)
East Germany, Belgium and
Finland where less than 10% of the
population had reported using the
drug. Lifetime experience of
cannabis was reportedly about 13% in
Sweden, which was the same
as Greece and West Germany.
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 10000(?0)
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).
http://www.emcdda.org/publications/publications_annrepstat_00.shtml
comments
by Andrew Byrne
..
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dr
Andrew Byrne,
General Practitioner, Drug and
Alcohol,
75 Redfern Street,
Redfern,
New South Wales, 2016,
Australia
Tel (61 - 2) 9319 5524 Fax 9318
0631
Email
ajbyrne@ozemail.com.au~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~