Poly drug use and

trends among

treated

methamphetamine

users in Latvia

Marcis Trapencieris1

For presentation at EMCDDA TDI expert meeting

September 24, 2013. Lisbon, Portugal

1 Institute of Philosophy and Sociology, University of Latvia

Introduction

� Amphetamine and methamphetamine use a relatively

recent phenomenon in Latvia

� Before 1990s home-made ephedrine/methcatinone

preparations common in some groups and still used by

some pockets of older drug users

� In 2011 2.3% 15–64 y.o. population have tried

amphetamines and ranks among countries with highest

amphetamine use prevalence rates in EU

Drug testing (Riga and surrounding areas)

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

0500

100015002000250030003500400045005000550060006500

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Methamphetamine Total Percent

Source: Riga Centre for Psychiatry and Addiction Disorders, 2013 (author’s calculations)

Drug testing (Riga and surrounding areas)

2%10% 10% 10% 11%

17% 19% 19%21% 20%

23%19%

88%61%

28%37%

44%44%

50% 53% 45%

32% 30% 30%

10%

29%

61%53%

45% 39%31% 29% 34%

49% 47% 51%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Heroin+Meth Heroin, no meth Meth, no heroin

Source: Riga Centre for Psychiatry and Addiction Disorders, 2013 (author’s calculations)

Aims

� To describe trends, socio demographic

characteristics and poly drug use among

treated amphetamine users in specialized

drug treatment facilities in Latvia

Source: The Centre for Disease Prevention and Control, 2013

Trends in first treatment demand

for amphetamine use

0

5

10

15

20

25

30

35

40

Percent

Total Male Female 34.8% of FTD among females:

26.9% of FTD among males

24.6% of FTD among males

Mean age (FTD)

26

30

26

22

26

21

0

5

10

15

20

25

30

35

2007 2008 2009 2010 2011

Male (amph)

Male (heroin)

Male (poly)

Female (amph)

Female (heroin)

Female (poly)

Polydrug diagnosis prevalence

among amphetamine users

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Percent

No Polydrug diagnosis Polydrug

50.0% of amphetamine users with ICD-10 F19

Secondary drugs

� 55.8% of heroin users

have amphetamines

as secondary drug

� 63.5% of

amphetamine users

have at least one

secondary drug

� 39% cannabis, 20%

alcohol, 17% opioids, 6%

sedatives, 3%

hallucinogens

28 2234 34

5642 37

56 5363

0

20

40

60

80

100

2007 2008 2009 2010 2011

Secondary amph among heroin users

Secondary drugs among amph users

Time before treatment2007 2008 2009 2010 2011

Amphetamines

Mean 2.4 3.2 3.7 4.6 4.3

Median (IQR) 2 (1-3) 2 (1-5) 2 (1-5) 3 (1-7) 3 (1-6)

Amphetamine

poly-users

Mean 2.2 3.1 3.8 4.5 4.3

Median (IQR) 2 (1-3) 3 (1-5) 2 (1-7) 3 (1-7) 2 (1-6)

Heroin

Mean 5.4 5.7 5.4 7.4 7.0

Median (IQR) 5 (2-8) 5 (2-8) 5 (2-8) 7 (2-11) 7 (3-11)

Summary� (Meth)amphetamines ranks 1st among new treatment entrants (~25%)

� Rapid increase 2000–2004 and gradually increasing / stable since 2004

� 26–30% of FTD among females related to primary amphetamine use

� ~20% – for heroin and

Summary (2)

� About 46% of FTD amphetamine clients

injecting the drug

� but decreasing

� 41–54% (2007–2012) of amphetamine

treatment clients – poly drug users (ICD-10

F19)

�About 2/3 have at least one secondary drug;

�Cannabis – the most often mentioned

� No specific treatment or harm reduction programmes for (meth)amphetamine users exist in Latvia

� According to previous studies the number of treatment episodes among amphetamine users per year very low

�On-going work

� Mortality among amphetamine users

� Drug Users’ Cohort Study

� Psychiatric comorbidity among amphetamine users

Thank you!