Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Research Report Eur Addict Res 2013;19:74–81 DOI: 10.1159/000341719 Cocaine-Related Health Emergencies in Europe: A Review of Sources of Information, Trends and Implications for Service Development Guillermo Mena a, b Isabelle Giraudon a Elena Álvarez c John M. Corkery d João Matias a Kari Grasaasen e Noelia Llorens c Paul Griffiths a Julian Vicente a a European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal; b Preventive Medicine and Epidemiology Unit, Hospital Clínic, and Barcelona Centre for International Health Research (CRESIB, Hospital Clínic Universitat de Barcelona), Barcelona, and c Spanish Observatory on Drugs, Government Delegation for the National Plan on Drugs, Ministry of Health, Social Services and Equality, Madrid, Spain; d School of Pharmacy, University of Hertfordshire, Hatfield, UK; e National Board of Health, Copenhagen, Denmark since the end of the 1990s in these countries; these increases peaked in Spain and England around 2007/08. Conclusions: The analysis reported here suggests the need to develop more standardized approaches to monitoring drug-related emergencies. It points to the potential value of developing effective referral links between the emergency and special- ized drug services working with cocaine users. Copyright © 2012 S. Karger AG, Basel Introduction Cocaine use and seizures of cocaine have increased during the last decade in Europe, with cocaine now being the most-used illegal drug after cannabis. More than 14.5 million Europeans, or 4.3% of adults aged 15–64 have re- portedly used cocaine at least once in their lifetime [1]. However, patterns of cocaine use in Europe vary consid- erably with a high prevalence in a restricted group in mainly Western European countries. During 2010, the highest prevalence of cocaine use among young males (15–34 years) was reported by Spain, Ireland, Italy and the UK, as well as in Denmark (16–34 years) [2]. Key Words Illegal drug use Cocaine-related health consequences Health emergency services Abstract Background: Cocaine-related health consequences are dif- ficult to observe. Data on drug users in health-emergency settings may be a useful source of information on conse- quences that are not visible via other information sources. Methods: Thirty European countries submit an annual na- tional report on the drug situation to the EMCDDA. All re- ports for the period 2007–2010 were analyzed, with particu- lar attention given to auditing cocaine-related mentions. Analysis was also performed in order to identify sources and case definitions, assess coverage, audit cases and, where possible, to identify long-term trends. Results: Considerable heterogeneity existed between countries in their approach to recording drug-related emergencies, with only Spain and the Netherlands having established formal indicators. The highest annual numbers of cocaine-related episodes were reported by the UK (3,502), Spain (2,845) and the Nether- lands (1,211). A considerable (2- to 3-fold) increase in the numbers of cocaine-related episodes has been reported Received: March 31, 2012 Accepted: July 9, 2012 Published online: October 5, 2012 European Addiction c Re e s ar h Isabelle Giraudon European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Cais do Sodré PT–1249-289 Lisbon (Portugal) E-Mail isabelle.giraudon  @  emcdda.europa.eu © 2012 S. Karger AG, Basel 1022–6877/13/0192–0074$38.00/0 Accessible online at: www.karger.com/ear