Estimating prevalence of problem drug use at national level in countries of the European Union and Norway

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Abstract
Objectives This paper will present the most recent estimates for problematic drug use in European Member States and explore the problems of comparability. Methods Estimates of problematic drug use, derived according to agreed guidelines, were collected from all EU countries and Norway. Methods included multipliers based on treatment, police, mortality or AIDS/HIV data, the capture–recapture method and the multivariate indicator method. Prevalence estimates were transformed into rates per 1000 population aged 15–64 years. Results Target populations varied according to data selection. Estimates for six partially overlapping types of drug use could be identified: ‘problem opiate use’, ‘problem opiate or cocaine use’, ‘problem amphetamine or opiate use’, ‘problem drug use’, ‘(current) injecting’ and ‘life‐time injecting’. Rates of injectors ranged from 2.6 in Germany to 4.8 in Luxembourg; rates in Austria, Denmark, Finland, Portugal and the United Kingdom fell within this range. For problem opiate use, a group of high prevalence countries were found with average rates exceeding six cases (Italy, Luxembourg, Spain and the United Kingdom) and a group with lower prevalence with average rates close to three cases (Austria, Germany, Ireland, the Netherlands). Rates obtained for France (problem opiate or cocaine use), Finland and Sweden (problem amphetamine or opiate use) are not directly comparable and fall between these rates. Conclusions Cross‐national comparisons should be made with care and estimated target populations may vary greatly between countries. For estimating various forms of problem drug use at national level, a multi‐method approach is recommended.