Summary

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In view of the identified indicators of the demand in 1999-2000, the situation in the country must be assessed as very serious. All relevant indicators characterising the situation have become worse. In comparison with 1998 some indicators have become 2-3 time worse, e.g. drug-related death and driving in condition of drug intoxication. Such drugs as methamphetamine, DOB appeared in Latvia.

The results of drug of abuse testing in living persons in 2000 are presented (3456 analyses, with positive results - 2614 (76%)).

Introduction

The geographical location of Latvia makes possible transit of drugs across the country. Last year two clandestine laboratories, producing amphetamines, methadone and heroin were found. Such drugs as DOB, methamphetamine, ephedron as hydrochloric acid salt, sodiumoxybutyrate appeared at the "black market". Heroin abuse became the most serious problem in Latvia. Cocaine, LSD, MDMA, MDA, cannabinoids are still popular drugs. Price of drugs at the "black market" is lower than before. In 2000 price of heroin (0,05-0,1 g) was 10-15 USD), cocaine (1 g) - 120-150 USD, MDMA (1 tablet) - 12-15 USD, annabis (1 g) - 10-15 USD, amphetamine (1 g) - 50-60 USD. According the official data there are more than 30,000 persons dealing with narcotics in Latvia, and this value still increase rapidly. 466 new HIV and 24 AIDS patients were registered in 2000. There are 958 HIV patients (in 695 cases-after i.v. injection of heroin). A number of new cases of registered addicted patients has increased more than twice.

All relevant indicators characterising the situation have become worse. In comparison with 1998 some indicators have become 2-3 time worse, e.g. the number of drug-related death,driving in the condition of drug intoxication.The structure of addiction patients contingent reveals a rapid increase in the group of opiate addiction and a slight growth in the group of sedative and soporofic as well as amphetamine addiction. The target of our study was to identify different drugs and drug combinations in biological specimens of drug addicts in 2000.

Materials and methods

The detection of narcotic and psychotropic substances in body fluids of living persons was carried out at the chemical toxicological laboratory of non-profit organization State enterprise Center of Drug Abuse Prevention and Treatment in 2000. About 4,000 biological specimens has been analyzed by means enzymatic immmuno assay (Vitalab Viva, Syva's EMIT), gas chromatography-masspectrometry, thin-layer chromatography.

Results and discussion

Individual drugs we found in drug abuser's biologicals are shown in the Tab. 1. The most popular individual drugs in Latvia are opioids (heroin etc.), cannabinoids, benzodiazepines barbiturates, amphetamins. Such psychotropic drugs as diphenhydramine, benzhexol, tramadol, zopiclone are used mostly when other hard drugs are not available. Drug combinations in drug addict's are shown in Tab. 2.

In most cases combinations two and more different drugs are common.In such cases to predict effect of drug combinations is very difficult.The most dangerous combinations of drugs are opioids with benzodiazepines, barbiturates, tramadol, diphenhydramine when action is more potent than individual drug alone. In cases when opioids are used with cocaine, amphetamines, ephedrone, ephedrine final effect is more predictable as a result of antagonism of drugs. Combinations of cannabinoids with other drugs (stimulants mostly) are popular as recreational mixtures.Tramadol is less potent drug than fentanyl and it is widely used and abused in Latvia.Combinations of tramadol with other drugs are very popular.

Table 1. Individual drugs in drug abuser's biologicals

Nr.	Individual drugs or groups	Cases	%
1	Opioids	592	17
2	Cannabinoids	373	11
3	Benzodiazepines	47
4	Barbiturates	32
5	Amphetamines	31
6	Ephedrine	10
7	Ephedrine+ephedron	27
8	Diphenhydramine	14
9	Benzhexol (cyclodol)	14
10	Methadone	13
11	Tramadol	12
12	Cocaine	7
13	Naltrexon	6
14	Phenothiazines	6
15	Zopiclone (imovan)	4
16	LSD	3
17	MDMA	3
18	Acetone	3
19	Analgin	2
20	Methamphetamine	1
21	Clonidine	1
22	Carbamazepine	1
23	Atenolol	1
24	Heroin (in syringe)	1
25	Unknown	1
	Total:	1204	35

Age and sex distribution of drug addicts was as follows: up to 15 - 1%, 15-20 - 21,3%, 21-30 - 48,6%, 31-40 - 25,1%, 41-50 - 4,0%, males -77,3%, females - 22,7%.

Drug and psychotropic substance users and addiction patients, first time registered in 2000, breakdown by route of administration: injection-60,6%, smoking - 8,7%, internally (by eating, drinking) - 13,2%, sniffing - 1,7%, inhaling - 4,8%, other types or a combination of several types - 11%. The results of our study shows an increase in the use of opioids in comparison with 1999. The number of sedative and soporofic-depen-dent patients has been gradually growing with every year.

Table 2. Drug combinations in drug abuser's biologicals (2000)

Nr.   Drug combinations                                      Number of cases       

Opioids+benzodiazepines                                            154
Opioids+barbiturates                                                99
Opioids+barbiturates+benzodiazepines                                92
Opioids+tramadol                                                    61
Benzodiazepines+barbiturates                                        38
Opioids+diphenhydramine                                             20
Opioids+barbiturates+tramadols                                      15
Opoids+amphetamines                                                 26
Opioids+cocaine                                                     11
Opioids+tramadols+ephedrine+ephedron                                 7
Opioids+benzodiazepines+tramadols+cannabinoids                      13
Opioids+tramadols+naltrexone+amphetamines+benzodiazepines            1
Amphetamine+cannabinoids                                             5
MDMA+cannabinoids                                                    5
Benzodiazepines+tramadols                                            6
Cocaine+cannabinoids                                                 4
Ephedrine+ephedron+diphenhydramine                                  12
Ephedrine+ephedron+benzodiazepines+cannabinoids                     12
Others                                                             824
     Total:                                                            1410  41%
    

The number of new registerd cases of inhalant dependence has rapidly declined. The analysis of data by district and city/town shows the highest drug addiction prevalling in:

• the city and district of Ventspils - 86,0 per 100 000 inhabitants;

• the city and district of Jelgava - 36,0 per 100 000 inhabitants;

• Riga - 30,4 per 100 000 inhabitants;

• Jurmala - 22.1 per 100 000 inhabitants;

• the district of KuldНga 20,1 per 100 000 inhabitants;

In 2000 the number of drug-related crimes registered in Latvia has increased to 725 (in 1999 - 521);

Over the recent years there has been evidence of a rapid growth of the number of drivers detained when driving in the condition of drug and psychotropic substance intoxication (in 1998 - 44, in 2000 - 152)

Summary, current situation of drug abuse in Latvia is very serious and demands effective actions of Drug Enforcement Bureau of the Main Criminal Police Board and all society.