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!