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Contents

Drug use among the general population and young people
Socio-demographic overview
Prevention
Problem drug use
Treatment demand
Drug-related infectious diseases
Drug-related deaths
Treatment responses
Harm reduction responses
Drug markets and drug-related offences
National drug laws
National drug strategy
Coordination mechanism in the field of drugs

     
Short info
Country situation summary (CSS)
A Country situation summary (CSS) is a concise, standard-format overview (4-5 pages) of the drug situation in a specific European country. Based on a single template for all countries, Country situation summaries provide an at-a-glance overview of key recent developments in a country's drug situation. They are updated each year by the EMCDDA's national focal points. Note that detailed analytical reports (approx 100 pages) are also available for each country, see national Reports.
   
National focal point in Spain

The Spanish National Focal Point is located within the Delegación del Gobierno para el Plan Nacional sobre Drogas, a government organisation under the auspice of the Ministry of Health and Consumer Affairs. The Delegación del Gobierno para el Plan Nacional sobre Drogas is entrusted with co ordination of different aspect of the drug policy ranging from drug trafficking to responses to the drug problem.

Delegacíon del Gobierno para el Plan Nacional sobre Drogas (Government Delegation to the National Plan on Drugs - DGPND)
C/ Recoletos 22
E-28001 Madrid
Tel: +34 91  822 61 24
Fax: +34 91 822 60 95
Head of Focal point: Ms Carmen Moya Garcia
Email: relinstipnd[a]msc.es

E-mail addresses have been inserted in a way discouraging spam. Please replace [a] by @ before actually using any of the e-mail addresses. 		Further reading
External links
Country situation summary

Spain


 

Year

Spain   

EU (25 countries)

Source

Population

 2005 43.03.800 461.478.700

Eurostat

GDP per capita in PPS

(Purchasing Power Standards) (1)

 2005 98.6 100

Eurostat

Inequality of income distribution (2)

 2004 5.1 4.8 (s) 

Eurostat

Unemployment rate

2005 9.2% 8.8%

Eurostat

Prison population rate
(per 100.000 of national population)

 2005 140 Range in the EU including Norway (26 countries) based on data from 2003-2005:50-339 

Council of Europe Annual Penal Statistics
(s) Eurostat estimate.
(1) Gross domestic product (GDP) is a measure for the economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU25) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
(2) The ratio of total income received by the 20 % of the population with the highest income (top quintile) to that received by the 20 % of the population with the lowest income (lowest quintile). Income must be understood as equivalised disposable income.

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Drug use among the general population and young people


A general population survey is conducted in Spain on a biennial basis. Since 2001 the survey has been in line with EMCDDA recommendations and targeted at persons aged 15–64. The results from the survey conducted in 2003 showed that cannabis is the illegal substance most commonly used in Spain. 29% of the respondents aged 15–64 reported lifetime use of cannabis followed by cocaine (5.9%), ecstasy (4.6%), amphetamines (3.2%) and hallucinogens (3.0%). Lifetime prevalence rates for opiates were below 1%.

The last national survey on drug use among students aged 14–18 was conducted in 2004. Overall, 43.4% of respondents admitted to having used at least one illegal drug during their lifetime. The most commonly used illegal drug was cannabis, with lifetime prevalence of 42.7%. Lifetime prevalence rates for other illegal drugs were 9% for cocaine, 5% for ecstasy, 4.8% for amphetamines, 4.7% for hallucinogens and 4.1% for solvents. Only 0.7% reported lifetime experience with heroin.

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Socio-demographic overview


  Year Spain    EU Source

Unemployment rate of population aged less than 25 years

 2004 22.1% 

18.6%

Eurostat

Percentage of the population aged 20-24 having completed at least upper secondary education

 2004 61.8%

76.7% (p)

Eurostat

Children aged 0-17 living in jobless households (1)

 2004 6.3% 

9.8% (p)

Eurostat
(p) Provisional value.
(1) The indicator Children aged 0-17 years living in jobless households is calculated as a share of persons aged 0-17 who are living in households where no one is working.

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Prevention


The main objectives and features of prevention policy in Spain are strong cooperation with the education system, full coverage of the school population with school-based prevention programmes, additional training of teachers and the establishment of a quality control and standardisation system for all prevention approaches. Implementation of curricular school-based prevention programmes is a top priority and has achieved almost full coverage. The contents and components of the programmes in place is fully in line with international recommendations and the available knowledge base. Quality control of school-based prevention is very highly developed and a monitoring system (databases) has been in place for more than 10 years and is the established reference model for prevention interventions.

Selective prevention is targeted at several vulnerable groups and benefits from very high political resonance and practical relevance. Selective prevention in recreational settings is carried out by NGOs (bottom up) and some municipalities with a focus on alternative leisure activities. The evaluation of prevention is very highly developed and many examples of relevant intervention examples can be found in the EMCDDA’s Exchange on Drug Demand Reduction Action (EDDRA) database. Special characteristics of the prevention culture in Spain within the European context are strong commitment to evidence-based prevention in all areas, good cooperation within a decentralised system, a public health approach that combines high coverage in universal prevention through standardised programme-based approaches with a strong attention to selective prevention (for vulnerable groups). Evaluation is well developed and routine for many programmes.

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Problem drug use (*)


Between 1999 and 2002 several estimates of problem drug use were made, applying the demographic and multiplier methods. For example, in 2002, the number of problematic opiate users was estimated at 4.04 per 1000 inhabitants aged 15–64 based on the treatment multiplier method. In 2001, the estimate was 4.91 per 1000 inhabitants aged 15–64 based on the same method. However, the results must be interpreted with caution due to possible biases that could not be ruled out.

(*) The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category.

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Treatment demand


Treatment demand data in Spain is collected from each region and collated at the Government Delegation for the National Plan on Drugs. The data includes 89% of all outpatient centres in the country and 42% of treatment units in prison. Double counting of cases is accounted for within each region but cannot be ruled out between regions.
 
Figures from 2004 show that there has been a continued decrease in admissions to treatment for heroin and a rapid increase in admissions for treatment for cocaine and cannabis. The proportion of treatment cases for other psychoactive substances was low. Among first treatment seekers, 57.8% were treated for cocaine, 21.8% were treated for cannabis, 15.7% for heroin, 1.0% for amphetamines and 0.8% for ecstasy. The proportion treated for other psychoactive drugs (excluding alcohol and tobacco) was 2.9%. For the total of treatment admissions (first treatment in lifetime or not) the proportions were: 42.2% (cocaine), 40.0% (cannabis), 12.7% (heroin), 0.6% (amphetamines), 0.5% (ecstasy) and 4.5% (other psychoactive substances).
 
In terms of trends the total (first treatment in lifetime or not) number of admissions to treatment due to cocaine has increased 7 times between 1996 and 2004. The number of admissions to treatment due to cannabis has increased 4 times and the number of clients treated for heroin has decreased to less than half total admissions. The increase in cocaine treatment can mainly be attributed to persons treated for first time in their lifetime, while most used cocaine mainly via the intranasal route (sniffing/snorting).

Heroin users represent the highest share of IDUs. In 2004, 26% of clients who entered in treatment for heroin use reported injecting drug use in the 12 months before treatment admission. 54.7% reported injecting drug use in their lifetime. 24.9% had used heroin mainly by injecting during the 30 days before treatment admission. .

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Drug-related infectious diseases


The National AIDS Registry collects data on diagnosed AIDS cases in Spain. The registry also provides data on the cause of infection, including information on injecting drug use among diagnosed AIDS cases. These data show that the proportion of AIDS cases infected due to intravenous drug use has declined from 69.6% in 1990 to 46.3% in 2004. It is assumed that this decrease can be attributed to the improvements that have been made in the fight against drugs such as the implementation of maintenance treatment.
 
One study was repeated several times among voluntary tested IDUs who attended centres for treatment of sexually transmitted diseases (11 in total) located in 9 different cities in Spain. The study results showed that the number of drug injectors being tested dropped from 1547 in 1991 to 191 in 2004. The prevalence of HIV in this sample decreased also from 44.6% to 20% over the same period.

Among voluntarily-tested recent IDUs (those who have injected in the last 12 months prior to admission to treatment) captured by the treatment demand indicator, the HIV infection rate was 29.3% in 2004 (23.5% among male and 30.9% among females). The HIV prevalence among young tested IDUs (under 25) decreased from 20.3% in 1996 to 13.1% in 2000 and 7.1% in 2004..

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Drug-related deaths


Since 1993 Spain has had a special registry that collects data on deaths due to acute reactions to drugs in different geographical areas. Data is collected on deaths with judicial intervention where the direct and main cause is an acute adverse reaction after a non-medical and deliberate use of psychoactive substances excluding alcohol and tobacco in the population aged 15–49 years old.
 
The data not only refers to ’overdoses’ in the strict sense as they may also include deaths due to complications due to withdrawal. Data was collected by each autonomous community (5) after consulting the forensic and toxicological sources that provide information in their areas. In 2002 there were 496 deaths caused by acute reaction after using psychoactive substances in 119 administrative areas (49% of the Spanish population). Over the years the proportion of cases with available toxicological results has increased constantly, from 66% in 1993 to 99% in 2002.
 
The number of deaths for acute reactions to opiates or cocaine increased continuously between 1983 and 1991 followed by a decrease. In 2000 and 2001 the figures seem to have stabilised. The number of deaths due to overdoses in five Spanish cities (Madrid, Barcelona, Valencia, Zaragoza and Bilbao) decreased from 553 in 1991 to 254 in 1999 and 245 in 2001.
As in previous years, the mortality rate differed by region. Higher rates are for the most part found in areas with higher rates of injecting drug users such as in Palma de Mallorca or Barcelona. In terms of type of drugs identified as present for those cases where toxicological analyses were available, the majority were positive for opioids (84%) but also for cocaine (54%), benzodiazepines (53%) and cannabis (20.2%). Over the decade it has been observed that the ratio between the number of positive deaths relating to opiates and negative for cocaine and the number positive death to cocaine and negative for opiates has dropped from 37.7 in 1983–1989 to 5.1 from 1998–2001.

(5) Spain consists of 17 autonomous communities and 2 Autonomous Cities (Ceuta and Melilla).

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Treatment responses


Drug treatment responses in Spain can be broken down into the three main categories as suggested by the EMCDDA, namely drug-free treatment, medically-assisted treatment and withdrawal treatment. Drug-free inpatient treatment is provided at 84 therapeutic communities and in hospitals as well as on an outpatient basis by a dense public network of assistance centres.
 
The majority of services in Spain are outpatient facilities, which are publicly owned. By contrast, two thirds of drug free inpatient treatment are privately owned but are also dependent on public funding. Responsibility for organisation and delivery of drug-free treatment services in Spain lies with the autonomous communities and cities in Spain.

Medically-assisted treatment is available at specialised outpatient centres, at other health and mental health centres and at hospitals. Pharmacies are involved in dispensing medication to patients. The majority of programmes use methadone, which was introduced in 1990, although two centres around Madrid also use buprenorphine, which has been available as maintenance drug since 1996.
 
Withdrawal treatment takes place at 40 hospital detoxification units, on a non-hospital inpatient basis within therapeutic communities and on an outpatient basis at the outpatient assistance centres.
 
Most after care and reintegration programmes consist mainly of training and employment programmes run by Autonomous Communities (Regional Plan on Drugs and employment regional agencies), municipalities and NGOs. Spain has a relatively well-developed social reintegration system with many places available, in particular for vocational training and employment.

Monitoring systems for clients in substitution treatment exist at the level of the Autonomous Communities and data are reported to the Government Delegation for the National Plan on Drugs. 

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Harm reduction responses

With regard to harm reduction activities information was available in 2004 from 17 autonomous communities and 2 Autonomous Cities in Spain. Most programmes include a socio-sanitary service that offers preventive educational interventions, sterile material, emergency care and assistance to injecting drug users who are not in contact with any assistance intervention. In general such services are provided by social emergency centres, mobile units and pharmacies. The majority of users in 2002 were reached through social emergency centres and other centres such as the above mentioned mobile units and pharmacies. Outpatient facilities also carry out harm reduction activities, as well as several NGOs. It is also important to highlight that needle and syringe exchange is available in prisons. Drug consumption facilities are also available for chronic drug users who have failed previous treatments, in particular in Madrid, Catalonia and the Basque country.

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Drug markets and drug-related offences

Due to its geographical position Spain is one of the countries in the European Union most targeted by international drug traffickers. According to the information from law enforcement agencies, seized cocaine generally originates in Colombia, hashish in the north of Africa, heroin in Turkey, while synthetic drugs are smuggled to Spain from other European countries (particularly from the Netherlands and Belgium). Nevertheless, about half of the seized drugs in Spain are of unknown origin. In terms of the number of seizures, data from the criminal intelligence central unit at the Ministry of Interior shows an increasing trend for cannabis seizures between 2000 and 2004, and a decrease of 45% in heroin seizures and quantities seized between 1998 and 2004. The seizure data for cocaine are less consistent, showing an overall increase in the number of seizures. However, cocaine seizures have seen considerable fluctuation since 1997, which may indicate an adjustment process between the modus operandi of traffickers and the institutional reaction by law enforcement agencies. The increase in the number of cannabis seizures (since 2000) was accompanied by an increase in the number of offences related to cannabis trafficking over the same period. In 2000, cannabis trafficking accounted for 44% of all trafficking offences. In 2004, this proportion had risen to 50%. Data on cocaine-related trafficking offences have also shown an increase (since 1998), representing 33% of trafficking offences in 2004 (vis-à-vis 26% in 1998). A decrease has been observed in heroin-related trafficking offences since 2000, and they accounted for 7.5% of trafficking offences in 2004, fown from 13% in 2000. 

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National drug laws

For trafficking, the Spanish law lays down penalties in line with the seriousness of the health damages associated to the drugs and any aggravating and mitigating circumstances that may exist. Penalties can reach up to 20 years and 3 months in prison, with such long terms reserved for cases with aggravating circumstances such as sale to minors under 18, or the sale of large quantities (over 500 doses). When no such circumstances exist, those who have committed the crime can be sentenced to prison for one to three years if the drugs do not cause serious health damage, and from three to nine years when they do. In all cases, a fine is also imposed. The law on protection of citizens' security (1992) considers drug consumption in public as well as illicit possession as a serious order offence punishable by administrative sanctions. Fines are the usual punishment, but the law foresees that the execution of the fine can be suspended if the person freely attends an official drug treatment program.

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National drug strategy

The Spanish National Drug Strategy (2000–2008) (Plan Nacional sobre Drogas) was adopted in 1999. The strategy aims to be the framework for establishment of essential cooperation and coordination between different public administration and NGOs working in the field of drugs The strategy is built upon three classic pillars: demand reduction, supply reduction and international cooperation. Within these, different domains receive special attention. Prevention for example has a primary goal and is targeted at prevention at workplace and leisure settings. Other specific domains include attention given to legal drugs (alcohol and tobacco), harm reduction, treatment and rehabilitation, combating international drug trafficking and cooperation. In 2004, the National Drug Strategy was evaluated. The results of this evaluation led to the approval of a 2005–2008 Action Plan by the government in March 2005. This plan is divided across 6 axes namely: coordination, prevention and social awareness, comprehensive care, improvement of knowledge, supply reduction and international cooperation.

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Coordination mechanism in the field of drugs


The Government Delegation for the National Plan on Drugs (GDNPD) under the responsibility of the Ministry of Health and Consumer Affairs is the national drug coordination body. It coordinates and aims to improve the partnership of the different governmental administrations involved in the national drug policy. It also evaluates the measures and programmes of the different departments and funds activities on prevention, treatment and coordination in the Autonomous Governments and Municipalities.
 
An Inter-ministerial Group, presided by the Minister of Health and Consumer Affairs and composed of representatives of various ministries, is responsible for the proposal and adoptions by the government of all drug-related measures and activities under state competence.

In order to ensure collaboration between the Central Administration and the Autonomous Governments, a Sectorial Conference and the Inter-Autonomy Commission have also been established. The Sectorial Conference includes members of the inter-ministerial group and counsellors responsible for drug dependence in the autonomous governments. The Inter-Autonomy commission is composed directly of those responsible for the autonomies’ government plans on drugs in the 17 autonomous communities and 2 Autonomous Cities (Ceuta and Melilla). This commission submits technical proposals to the Sectorial Conference

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