Evolution of direct drug-related death cases and mortality rates per 100,000 inhabitants; Credit: RELIS, 2019

The RELIS National Drug Report 2020 has confirmed a continued decline in the number of new injection drug use-related HIV infections, as well as a decrease in drug overdose deaths in Luxembourg.

The RELIS 2020 report, published by Luxembourg's Ministry of Health, aims to provide an overview of the drug phenomenon in the Grand Duchy, particularly regarding the use of illicit drugs and its consequences at the national level.

In terms of drug use among the general population, the most recent data show that cannabis remains the most widely used controlled substance nationally, followed by stimulants. Compared to the situation in 2014, there was a slightly higher prevalence of liftetime cannabis and stimulant use, as well as their use in the last twelve months and the last 30 days. Nevertheless, recent cannabis and stimulant use among young adults (15-34 years) remained below the respective average rate in the European Union (EU). Among 15-18 year olds, a moderate increase in cannabis use over the past month was observed between 2006 and 2018; this increase was statistically significant only among girls. The use of heroin remained marginal within the general population, all ages combined.

With reference to the high-risk use of illicit drugs, a downward trend is observed in Luxembourg. Based on data updated since the previous annual report, it is estimated that the number of people who use such drugs in Luxembourg is around 2,100, which is equivalent to a prevalence rate of 5.02 users per 1,000 inhabitants aged between 15 and 64 years old. In 2000, this same rate was equivalent to nine users per 1,000 inhabitants and was then among the highest in the EU.

Opioids (heroin in particular) remained the most common drugs among high-risk drug users. Whilst the use of opioids as a first choice is decreasing, the use of cocaine and cocaine-containing mixtures / cocktails is on the rise. Polydrug use, although showing a slight longitudinal decline, remained predominant among this population.

Among users attending supervised drug consumption facilities nationwide, the use of inhalants continued to gain ground over injection drug use. Through joint efforts to reduce risks, 53% of users of supervised drug consumption facilties have been using inhalants, which constitute a lower risk mode of consumption. This has contributed in particular to a reduction in the risk of drug overdoses and transmission of certain infectious diseases.

Between 2014 and 2016, there was a significant increase at the national level in new HIV infections among people who injected drugs nationally (21 cases in 2016), in part due to the increased availability and cocaine injection. Data from the past three years have shown a marked decline in the number of new injection drug use-related HIV infections. In 2019, there were three new cases of HIV infection among injecting drug users, the lowest incidence since 2011. 

Whilst HCV (hepatitis C) infections among injecting drug users recently seemed to show a slight decrease, the prevalence rates (69.6% - 71.1%) among these same users remained very high.

Since the launch of the national action plans on drugs and drug addiction, an overall downward trend in drug overdose deaths has been observed at the national level: six victims were counted in 2020, compared to 26 in 2000.

In addition, the number of drug users in treatment has been following a general upward trend, as has the number of people reaching out to national aid and risk reduction structures, which were contacted 164,000 times in 2019 (up from 150,937 in 2016). There was also an overall increase in the number of sterile syringes distributed as part of the national syringe exchange programme between 2013 and 2019 (2013: 190,257; 2019: 425,906 sterile syringes distributed) with, however, a first decrease recorded since 2013 in 2019, with reference to data from the previous year.

The average age of drug users in treatment has increased over the past 20 years (34.6 years in 2019 compared to 28 years in 1997). The majority of those seeking treatment were men (76.9%). The number of opioid users entering treatment has decreased discontinuously over the past eleven years (46.2% in 2019 compared to 82% in 2008) while the number of people in treatment for cannabis and cocaine use has experienced a discontinuous upward trend over the same period. Since 2013, there has been a stabilisation in the number of applicants for opioid substitution treatment.

Overall, cannabis represented 70% of the total number of drug seizures made by police or customs in Luxembourg in 2019. The number and quantity of cannabis seized was on the rise (a peak of 371 kg was reached in 2019). The number of cocaine seizures were also on the rise, although the total amount had decreased compared to 2018. Since 2014, the purity of cocaine in the market has tended to increase, while 2019 represented its first stagnation. The average THC concentration in cannabis increased from around 11% in 2010 to 18.4% in 2019.

The RELIS 2020 summary report can be downloaded from the Health portal: www.sante.lu.