Drug use in the population

a) Main results of surveys and studies

In comparison with EU countries, Slovenia was staying approximately ten years behind in consumption of illicit drugs among the young. Lev Milčinski with his co-workers, and Dušan Nolimal with co-workers studied the extent of drugs in Slovenia at the beginning of the 80s and discovered that it was not large.

Research among students in Ljubljana (A. Gosar at all, Medicinski razgledi, 1984) at the beginning of the 80s showed that the widespread of illegal drugs in that period was not as great as in some western countries in the same period.

The situation became much worse at the end of the 80s, when younger and younger age groups started to take heroin and certain other prohibited drugs and began to inject their drugs.

Based on scare literature and observation reports, the following trends can be observed. From the late 1960s to the mid 70s cannabis, LSD, tranquillisers, solvents and minor pain relievers were popular, but there was no epidemic of drug use. After that there was a period of initially increased illicit drug use. In that period there was limited experimentation with opiates. Injection use was rare. In the late 70s, small groups of dropouts started to inject opiates more frequently. Most opiates and opioids were stolen from pharmacies and there was some home grown opium from the farmers. In the late 80s there was the increase of the incidence and prevalence of cannabis, followed by considerable increase in the injection use of heroin.

The police reports also said that at the end of the 80s and at the beginning of the 90s was discovered a visible increase in the illegal production and sale of drugs. That was seen also in much larger quantities of seized drugs, especially heroin; in the increase of criminal offences which the Penal Code defines as illegal production; in the increased sale of drugs and drugs consuming

permissions as well as other offences, violent acts and secondary crimes linked with drugs.

The only general survey on the prevalence of drug use among population older than 18 years is from 1994.

Although a small amount of heroin use was noted in the late 1980s. Use of heroin first emerged as a considerable problem in Slovenia during the early 1990s. It started to increase in the mid 1990s and expanded rapidly in the second half of the 1990s.

The quantities of heroin seized in the country have increased dramatically. The

b) General population

There are presently estimated 5000 -10.000 heroin users in a total population of two million citizens. But this information is not reliable since it is based on key actors’ opinion. The majority of heroin users inject. The first demand for heroin addiction treatment, as recorded by the majority of treatment centres, rose rapidly until 1991. Drug injecting is an important risk factor for HIV and hepatitis infection. The fieldwork and ethnography suggest that the level of HIV risk behaviours among injection drug users is unacceptably high. This paper also provides an assessment of the current general drug use situation and status of epidemiological research in Slovenia, with an emphasis on heroin misuse.

Trends in demand and market indicators are basis for this report. At present, HIV seroprevalence among treatment populations is low. This merely indicates that HIV has not yet been introduced into the networks of injection drug users in Slovenia. Methadone maintenance began in late 1980s and first syringe

exchange started in 1992. Through continuous implementation of harm reduction approaches aimed at injection drug users it may be possible to contain an HIV epidemic in the population of heroin users.

Since early 90s a considerable increase in injection drug taking, heroin in particular, was noticed in Slovenia. More drug-related overdoses were

registered for the first time. The rise in hepatitis C and B among drug users in treatment centres was observed.

At present HIV seroprevalence among treatment populations is practically non-existent. This merely indicates that HIV has not been introduced yet into the networks of IDUs. This should not be taken as a reassurance - when

introduced, the virus could spread like a wildfire.

The seizure of other drugs has also being increased. The trend in the growth of the amount of confiscated drugs is continuing.

In 1995, the Slovenian police confiscated the first larger quantities of

amphetamines (1302 tablets) and ecstasy (7354 tablets). These are new drugs previously hardly found on the Slovenian market. They are mainly used in connection with rave parties and the population of users differs from the one using heroin. No relevant research about ecstasy use has been published yet.

Epidemiological situation of drug use and dependency in Slovenia is subject to dynamic changes. However, the most commonly used drugs are still alcohol and tobacco. On the second place are different medicaments, mainly sedatives, hypnotics, anxiolitics, analgesics. Most frequently prescribed psychoactive drugs are benzodiazepins. Smoking of cannabis has become part of the young people’s social behavior. No reliable data on the prevalence of drug

consumption in Slovenia is available.

c) School and youth population

The ESPAD survey was carried out by the Institute of Public Health of the Republic of Slovenia in 1995 and in 1999. The data for 1999 and comparisons 1995 –1999 will be presented in this report.

In 1999 the target population consisted of all secondary students in grade 1 born in 1983. It was estimated that about 90% of the age group attended some kind of secondary education in spring 1999. The majority (83%) were found in the first grade. There were 170 secondary schools in Slovenia at the beginning of school year 1998/99. Traditionally, secondary education is offered in four types of schools: grammar schools, 4-year technical schools, 3-year vocational schools and 2,5-year vocational schools.

Table 2.2.1. School survey data, Slovenia, 1999

lifetime prevalence, % last 12 months

prevalence, % last 30 days prevalence, %

Cannabis 24,9 21,2 12,8

Heroin 2,6 Cocaine 1,8 Hallucinogens 3,0

LSD 2,4 Other halluc.

Magical mushroom 1,5

Solvents 14,5 7,0 2,7

Hypnotics and sedatives 7,9

Amphetamines 1,2 Ecstasy 4,1 Anabolic steroids or other

doping substances 2,3

Source: Eva Stergar, Institute for Public Health

0

Any alc.last 12 m. Drunk last 12 m. Ever smoked

Smoked last 30 d. Cannabis lifetime Any drug but cann.

Source: Eva Stergar, Institute for Public Health

The proportions of Slovenian students who had been drinking any alcohol and had been drunk during the previous 12 months are both very close to the averages of all ESPAD countries (83% and 56% respectively). The lifetime prevalence of smoking cigarettes is somewhat lower than the average (64 vs.

69%), as is the 30 days prevalence (29 vs. 37%). The proportion of students who have used marijuana or hashish is higher than average (25 vs. 16%), while the use of other illicit drugs is about equal (7%). The use of inhalants is higher (14%) than average (10%), while the use of tranquillizers or sedatives without a doctor's prescription as well as alcohol in combination with pills are both very close to the averages of all countries (8 and 9% respectively).

d) Specific groups (e.g. conscripts, minorities, workers, arresters, prisoners, sex workers, etc.)

• General information about prisoners with drug problems

Among people who have problems with drugs we include long-time drug users and people who occasionally use drugs. There are also people who started experimenting with drugs in prison.

We obtain information about people who are dependent on drugs or who occasionally use drugs on the basis of the documentation accompanying the person on the path to prison (e.g. court ruling, compulsory treatment measure imposed on a drug addict, report from the Social Work Centres etc.), but generally at the beginning of his sentence a drug addict himself discloses his problem because he is concerned about a withdrawal crisis or because he is on a methadone therapy.

Drug problems are presented among all categories of prisoners – remand prisoners, inmates, people sentenced in a misdemeanour procedure, young offenders. Most often they are men between the ages of 16 and 49.

Table 2.2.2. Number of prisoners with drug problems compared to a total prison population

1995 1996 1997 1998 1999 2000

Total prison population 4046 3767 3882 5113 6348 6703 No. Dependent on drugs 133 156 268 306 471 512

Percentage 3.28 4.14 6.90 5.98 7.40 7.63 Source: Central Prison Administration

Other problems connected with drugs are illegally bringing drugs into prisons, dealing in drugs on the black market, taking drugs, a danger of infection from sharing needles and experimenting with drugs.