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Table PDU-102. Prevalence of problem drug use at national level - full listing of studies

Part(ii) Injecting drug use

Country	Year	Method	Type of Drug Use	Central Estimate	Lower Bound of Prevalence Estimate	Upper Bound of Prevalence Estimate	Central rate/1000 (15-64)	Lower rate/1000 (15-64)	Upper rate/1000 (15-64)	Population (15-64)	Interval Type	Target Population�	Original age range in study�	Bibliographic Reference�	Target Population Definition	Comments / Sources
Belgium	1995	HM	Overall	19600			2.92			6707199	n.a.	IDU	15 to 64	99 ; 1		Mortality and HIV/AIDS multipliers are assumed to give estimates of injecting drug use, which is only part of the problem drug use. The police and treatment multiplier methods are assumed to result in estimates to problem drug use (EMCDDA definition of problem drug is "injecting drug use or long-duration/regular use of opiates, cocaine and/or amphetamines").
Belgium	1997	HM	Overall		23200	28400		3.46	4.24	6705928	n.a.	IDU	15 to 64	1 ; 2 ; 99		Self-reported prevalence of HIV among IDUsserological based prevalence The lower estimate is based on extrapolation from self-reported prevalence of HIV among IDUs and the higher on serological based prevalence.
Belgium	2010	HM	Overall	5125	3377	7829	0.71	0.47	1.09	7147512	95% CI	IDU	16 to 64	4	Ever injecting drug users.	Belgian HIV/AIDS register hosted by the Scientific Institute of Public Health, Brussels (WIV-ISP), routine diagnostic testing at drug facilities (EMCDDA ST92).
Czech Republic	2004	TM	Overall	27000	24200	30300	3.73	3.34	4.19	7239720	n.a.	IDU	15 to 64	4		Reports from low-threshold facilities - number of pervitin (methamphetamine) and opiate users in contanct with these facilities in 2004.HCV national study - in-treatment rate (portion of above mentioned persons in contact with low-threshold facilities, nomination technique used)
Czech Republic	2005	TM	Overall	29800	26800	33500	4.1	3.68	4.6	7274860	95% CI	IDU	15 to 64	5		Reports from low-threshold facilities - number of IDUs in contact with these facilities in 2005.HCV national study - in-treatment rate (portion of above mentioned persons in contact with low-threshold facilities, nomination technique used)
Czech Republic	2006	OT	Opioid & Stimulant	29000	25496	33823	3.97	3.49	4.63	7307591	95% CI	IDU	15 to 64	2	Benchmarks of both sumed up estimates are active IDUs being in contact with low threshold facilities in 2006.	Benchmark = data from low threshold facilities, multiplier = nomination technique within questionnaire study among clients of low threshold facilities. For Prague new multiplier was obtained in 2007. Therefore estimates have been done separately for Prague and the rest of the Czech Republic (respective 8 STs provided). National estimate is a sum of both of them.Estimated number of IDUs in the Czech Republic unless Prague (done by multiplier method with the data on clients in contact with low threshold facilities/programmes).Estimated number of IDUs in Prague (done by multiplier method with the data on clients in contact with low threshold facilities/programmes).
Czech Republic	2007	TM	Opioid & Stimulant	29500	28400	30500	4	3.87	4.15	7350513	95% CI	IDU	15 to 64	2	EMCDDA PDU definition with one basic exception. There is not cocaine included in Czech PDU definition, because cocaine use prevalence is very low and almost not measurable. Current IDUs.	Total number of clients in contact with all Czech low threshold facilities/programmes. Users currently injecting opiates (heroin + Subutex (buprenorphine)) and/or pervitin (methamphetamine). Total number of clients of all low threshold facilities/programes who participated on the questionnaire study within nomination technique. Clients of low threshold facilities/programes. current IDUs.
Czech Republic	2008	TM	Opioid & Stimulant	31200	30000	32400	4.21	4.05	4.37	7414532	95% CI	IDU	15 to 64	2	EMCDDA PDU definition with one basic exception. There is not cocaine included in Czech PDU definition, because cocaine use prevalence is very low and almost not measurable. Current IDUs.	Benchmark = data from low threshold facilities, multiplier = nomination technique within questionnaire study among clients of low threshold facilities. We have obtained multiplier for all 14 regions - multiplier filled bellow is a mean of all of them. National estimate is then a sum of estimates for all regions. Total number of clients in contact with all Czech low threshold facilities/programmes. Users currently injecting opiates (heroin + Subutex (buprenorphine)) and/or pervitin (methamphetamine). Total number of clients of all low threshold facilities/programes who participated on the questionnaire study within nomination technique. Clients of low threshold facilities/programes.
Czech Republic	2009	TM	Opioid & Stimulant	35300	34200	36400	4.75	4.61	4.90	7425083	95% CI	IDU	15 to 64	7	We have adopted the EMCDDA PDU definition with one basic exception. There is not cocaine included in Czech PDU definition, because cocaine use prevalence is very low and almost not measurable.	Benchmark = data from low threshold facilities, multiplier = nomination technique within questionnaire study among clients of low threshold facilities. We have obtained multiplier for all 14 regions - multiplier filled bellow is a mean of all of them. National estimate is then a sum of estimates for all regions.Total number of clients in contact with all Czech low threshold facilities/programmes.Users currently injecting opiates (heroin + Subutex (buprenorphine)) and/or pervitin (methamphetamine).Total number of clients of all low threshold facilities/programes who participated on the questionnaire study within nomination technique.Clients of low threshold facilities/programes.
Czech Republic	2010	TM	Opioid & Stimulant	37200	35950	38450	5.03	4.86	5.2	7394316	95% CI	IDU	16 to 64	7	We have adopted the EMCDDA PDU definition with one basic exception. There is not cocaine included in Czech PDU definition, because cocaine use prevalence is very low and almost not measurable.	Benchmark = data from low threshold facilities, multiplier = nomination technique within questionnaire study among clients of low threshold facilities. We have obtained multiplier for all 14 regions - multiplier filled bellow is a mean of all of them. National estimate is then a sum of estimates for all regions.Total number of clients in contact with all Czech low threshold facilities/programmes.Users currently injecting opiates (heroin + Subutex (buprenorphine)) and/or pervitin (methamphetamine).Total number of clients of all low threshold facilities/programes who participated on the questionnaire study within nomination technique.Clients of low threshold facilities/programes.
Denmark	1996	MM	Overall	15416	12372	18460		3.5	5.22	3535829	n.a.	IDU	15 to 64	99 ; 4		Mortality and HIV/AIDS multipliers are assumed to give estimates of injecting drug use, which is only part of the problem drug use. The police and treatment multiplier methods are assumed to result in estimates to problem drug use (EMCDDA definition of problem drug is "injecting drug use or long-duration/regular use of opiates, cocaine and/or amphetamines").
Denmark	2006	CR	Overall	12754	10066	16821	3.56	2.81	4.7	3580756	95% CI	IDU	All	7		The estimate is based on a capture-recapture estimate with four sources of intravenous drug users: Newly admitted in the treatment registry in each of the years 2003-2005 and those registered in DEADHEP in 2006 (a total of 5,126 subjects). The estimate was stratified by age, gender and geographic region and calculated by means of a log-linear model. See national report 2009. Based on national treatment register (SIB): Injecting drug use reported within four weeks prior entering the register. Drug related death identified in 2006, based on the register of the Police: Fresh injection marks demonstrated by autopsy
Germany	1996	MM	Overall		80000	112000		1.43	2.01	55846564	n.a.	IDU	15 to 64	99 ; 12
Germany	2000	HM	Overall		90000	158000		1.61	2.83	55915209	n.a.	IDU	15 to 64	2 ; 5 ; 6 ; 99		Treatment monitoring system: outpatient unitsHIV cases estimated on the basis of AIDS cases by the Robert-Koch-Institut Berlin.
Germany	2000	MM	Overall		126875	169167		2.27	3.03	55915209	n.a.	IDU	15 to 64	2 ; 4 ; 6 ; 99		Heroin users registered by the police.Drug related deaths registered by the police.
Germany	2005	MM	Opioid		78000	110500		1.4	2	55209000	n.a.	IDU	15 to 64	18	Problematic users of opiates	Heroin users registered by the policedrug related deaths registered by police
Estonia	2004	CR	Overall	13886	8132	34443	15.2	8.9	37.6	916316	95% CI	IDU	15 to 44	1		Covariate capture-recapture estimates of IDUs aged 15-44 in Estonia in 2004.Estonian Police Database.Health Insuarnce FundState HIV Reference Laboratory.A study was conducted in 2005. Data sources of IDUs were identified, collated and matched using gender, day/month/year of birth, and initials to identify the subject. Only exact matches were used. Analysis was conducet on those aged 15-44 years. 6704 recods were identified as IDUs from 4 data source (Police N05311), Health Insurance Fund drug treatment and overdose (N=1299), State HICV reference laboratory (N=94) and 3024 unique IDs after matching. Poisson regression model were fitted to the observed data, with interactions between data sources fitted to replicate "dependencies" between data sources. Population prevalence was calculated using official population as denominators. Original age range of study was 15-44, rates have been adjusted to 15-64.
Ireland	1996	MM	Overall		4694	7884		2	3.37	2342670	n.a.	IDU	15 to 64	99 ; 2
Greece	2003	CR	Overall	9626	8044	11607	1.29	1.08	1.56	7461938	95% CI	IDU	all ages	3		Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services
Greece	2004	CR	Overall	9251	7728	11162	2.46	2.05	2.97	3762887	95% CI	IDU	15 to 64	3	Male current injectors	Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services
Greece	2004	CR	Overall	1031	711	1565	0.28	0.19	0.42	3707770	95% CI	IDU	15 to 64	3	Female current injectors	Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services
Greece	2004	CR	Overall	10427	8811	12425	1.4	1.18	1.66	7470657	95% CI	IDU	15 to 64	3		Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services
Greece	2005	CR	Overall	9416	8187	10883	1.26	1.09	1.46	7477561	95% CI	IDU	15 to 64	4	Last month injecting drug users	Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services.The analysis was carried out by fitting a model to the 4-way table: Source A x Source B x Source C x Year (2004-2005).
Greece	2005	CR	Overall	8426	7257	9835	2.23	1.92	2.61	3770620	95% CI	IDU	15 to 64	4	Male last month injecting drug users	Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services.The analysis was carried out by fitting a model to the 4-way table: Source A x Source B x Source C x Year (2004-2005).
Greece	2005	CR	Overall	797	625	1042	0.22	0.17	0.28	3706941	95% CI	IDU	15 to 64	4	Female last month injecting drug users	Treatment demands at KETHEA's services.Treatment demands at "18 ANO" services.Treatment demands at other services.The analysis was carried out by fitting a model to the 4-way table: Source A x Source B x Source C x Year (2004-2005).
Greece	2006	CR	Overall	9729	8542	11134	1.3	1.14	1.49	7471090	95% CI	IDU	15 to 64	3		Model fitted the 4-way table: Source A x Source B x Source C x Year (2005-2006).Treatment demands KETHEA services.Treatment demands "18 ANO" services.Treatment demands other services."Injecting" is last month injecting (TDI protocol) irrespective of main substance
Greece	2007	CR	Overall	9916	8380	11818	1.32	1.12	1.57	7511948	95% CI	IDU	15 to 64	3		3 source Capture-Recapture. "KETHEA" treatment services. "18 ANO" treatment services.
Greece	2008	CR	Overall	8148	6882	9727	1.08	0.91	1.29	7522622	95% CI	IDU	15 to 64	3		3 source Capture-Recapture. "KETHEA" treatment services. "18 ANO" treatment services. Other treatment services. Treatment demands
Greece	2009	CR	Overall	10658	8999	12713	1.41	1.19	1.69	7544503	95% CI	IDU	15 to 64	3		3 source Capture-Recapture:"KETHEA" treatment services,treatment demands."18 ANO" :treatment services, treatment demands.Other treatment services:treatment demands.
Greece	2010	CR	Overall	9439	8110	11060	1.25	1.08	1.47	7539573	95% CI	IDU	16 to 64	4		3 source Capture-Recapture:"KETHEA" treatment services,treatment demands."18 ANO" :treatment services, treatment demands.Other treatment services:treatment demands.
Spain	1998	MM	Opioid	83972			3.12			26923202	n.a.	IDU	15 to 64	99 ; 2	Problematic opiate users.
France	1995	HM	Overall		141000	177000		3.74	4.69	37736396	n.a.	IDU	15 to 64	99 ; 2		Mortality and HIV/AIDS multipliers are assumed to give estimates of injecting drug use, which is only part of the problem drug use. The police and treatment multiplier methods are assumed to result in estimates to problem drug use (EMCDDA definition of problem drug is "injecting drug use or long-duration/regular use of opiates, cocaine and/or amphetamines").
France	1999	HM	Overall	122000			3.2			38131287	n.a.	IDU	15 to 64	2		Method not based on HIV but on use of syringes and substitution substanceuse of syringes and substitution substance
Italy	1996	HM	Overall	326000			8.34			39099069	n.a.	IDU	15 to 64	99 ; 3
Cyprus	2004	TP	Overall	539	414	740	1.083	0.832	1.488	497300	95% CI	IDU	15 to 64	1		Truncated Poisson (Chao's formula).Treatment Demand: drug users requesting treatment for their drug use during the specific year.It is the first time problem drug use is being calculated in Cyprus.The results could be biased by the newly established detox centre where methadone is used (first time in Cyprus).This couls result in a large number of users repeatedly requesting treatment in this particular centre (and indeed, we could observe the largest numbers of double/ triple etc. counts there).
Cyprus	2004	TP	Overall	512	283	1018	1.029	0.569	2.047	497300	95% CI	IDU	15 to 64	1	(non, current)	Truncated Poisson (Chao's formula).Treatment Demand: drug users requesting treatment for their drug use during the specific year.It is the first time problem drug use is being calculated in Cyprus.The results could be biased by the newly established detox centre where methadone is used (first time in Cyprus).This couls result in a large number of users repeatedly requesting treatment in this particular centre (and indeed, we could observe the largest numbers of double/ triple etc. counts there).
Cyprus	2005	TP	Overall	543	426	727	1.05	0.82	1.4	516100	95% CI	IDU	15 to 64	2	Heroin injectors (those who have ever injected)	Truncated Poisson (Chao's formula).Treatment Demand data.The estimate should be treated with great caution, as the coverage of the Treatment Data for the year 2005 is lower than the respective one in 2004 (no data could be provided from Central Prison). Additionally, the number of drug users asking treatment repeatedly in one centre was higher than in 2004. The number of total population and population 15-64 years of age is based on the recent estimates referring to the end of 2004 (Satistical Service, 2005)
Cyprus	2005	TP	Overall	327	258	444	0.63	0.49	0.86	516100	95% CI	IDU	15 to 64	2	Heroin injectors (current injectors)	Truncated Poisson (Chao's formula)Treatment Demand data.The estimate should be treated with great caution, as the coverage of the Treatment Data for the year 2005 is lower than the respective one in 2004 (no data could be provided from Central Prison). Additionally, the number of drug users asking treatment repeatedly in one centre was higher than in 2004. The number of total population and population 15-64 years of age is based on the recent estimates referring to the end of 2004 (Satistical Service, 2005)
Cyprus	2006	TP	Other	604	498	764	1.13	0.93	1.43	532800	95% CI	IDU	15 to 64	3 ; 4	Person with a long term career/intravenous/regular use of heroin or cocaine (as a primary drug), who have ever injected.	Truncated Poisson method (Chao's formula) based on treatment demand data.Treatment demand data.The estimate should be treated with caution, as the number of drug users asking treatment repeatedly within the year was higher than in 2005.
Cyprus	2006	TP	Other	305	257	382	0.57	0.48	0.71	532800	95% CI	IDU	15 to 64	3 ; 4	Persons with a long term career/ intravenous/regular use of heroin or cocaine (as a primary drug), who are currently (last 30 days) injecting.	Truncated Poisson method (Chao's formula) based on treatment demand data. Treatment demand data. The estimate should be treated with caution, as the number of drug users asking treatment repeatedly within the year was higher than in 2005.
Cyprus	2006	TP	Opioid	518	429	653	0.97	0.8	1.22	532800	95% CI	IDU	15 to 64	3 ; 4	Person with a long term carrer/intravenous/regular use of heroin (as a primary drug), who have ever injected.	Truncated Poisson method (Chao's formula) based on treatment demand data.Treatment demand data. The estimate should be treated with caution, as the number of drug users asking treatment repeatedly within the year was higher than in 2005.
Cyprus	2007	TP	Opioid & Stimulant	1055	826	1392	1.94	1.52	2.56	543250	95% CI	IDU	15 to 64	5	Persons with a with a long term career//regular use of opiates or cocaine (as a primary drug), who have ever injected. Ever IDUs among current.	Person in treatment during 2007, with a long term career/regular use of opiates or cocaine (as a primary drug), who have ever injected.
Cyprus	2007	TP	Opioid & Stimulant	572	442	778	1.05	0.81	1.43	543250	95% CI	IDU	15 to 64	5	Persons with a long term career/ intravenous/regular use of opiates or cocaine (as a primary drug.). Current IDUs	Person in treatment during 2007, with a long term career/ intravenous/regular use of opiates or cocaine (as a primary drug), currently injecting.
Cyprus	2007	TP	Opioid	565	435	772	1.04	0.8	1.42	543250	95% CI	IDU	15 to 64	5	Current IDUs.	Person in treatment during 2007, with a long term career/ intravenous/regular use of opiates (as a primary drug), currently injecting.
Cyprus	2007	TP	Opioid	995	771	1331	1.83	1.41	2.45	543250	95% CI	IDU	15 to 64	5	Ever IDUs among current.	Person in treatment during 2007, with a long term career/ intravenous/regular use of opiates (as a primary drug), who have ever injected.
Cyprus	2008	TP	Opioid	575	466	742	1.0	0.8	1.3	553200	95% CI	IDU	15 to 64	7	Persons with a long term career/ regular use if opioids (as a primary drug), who have ever injected.	Treatment demand data. Persons in treatment during 2008, with a long term career/ intravenous / regular use of opiates (as a primary drug), who have ever injected.
Cyprus	2008	TP	Opioid & Stimulant	598	487	768	1.1	0.9	1.4	553200	95% CI	IDU	15 to 64	7	Persons with a long term career/ regular use of opioids or cocaine (as a primary drug), who have ever injected.	Treatment demand data. Persons in treatment during 2008, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), who have ever injected.
Cyprus	2008	TP	Opioid	444	337	625	0.8	0.6	1.1	553200	95% CI	IDU	15 to 64	7	Persons with a long term career/ regular use if opioids (as a primary drug), currently injecting.	Treatment demand data. Persons in treatment during 2008, with a long term career/ intravenous / regular use of opiates (as a primary drug), currently injecting.
Cyprus	2008	TP	Opioid & Stimulant	446	341	642	0.8	0.6	1.1	553200	95% CI	IDU	15 to 64	7	Persons with a long term career/ regular use if opioids or cocaine (as a primary drug), currently injecting.	Treatment demand data. Persons in treatment during 2008, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), currently injecting.
Cyprus	2009	TP	Opioid	678	562	850	1.2	1.0	1.5	558995	95% CI	IDU	15 to 64	8	Persons with a long term career/ regular use if opioids (as a primary drug), who have ever injected.	Treatment demand data.Persons in treatment during 2009, with a long term career/ intravenous / regular use of opiates (as a primary drug), who have ever injected.
Cyprus	2009	TP	Opioid & Stimulant	706	587	878	1.3	1.1	1.6	558995	95% CI	IDU	15 to 64	8	Persons with a long term career/ regular use of opioids or cocaine (as a primary drug), who have ever injected.	Treatment demand data.Persons in treatment during 2009, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), who have ever injected.
Cyprus	2009	TP	Opioid	478	375	645	0.9	0.7	1.2	558995	95% CI	IDU	15 to 64	8	Persons with a long term career/ regular use if opioids (as a primary drug), currently injecting.	Treatment demand data.Persons in treatment during 2009, with a long term career/ intravenous / regular use of opiates (as a primary drug), currently injecting.
Cyprus	2009	TP	Opioid & Stimulant	481	379	646	0.9	0.7	1.2	558995	95% CI	IDU	15 to 64	8	Persons with a long term career/ regular use if opioids or cocaine (as a primary drug), currently injecting.	Treatment demand data.Persons in treatment during 2009, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), currently injecting.
Cyprus	2010	TP	Opioid	456	408	529	0.8	0.7	0.9	562800	95% CI	IDU	16 to 64	8	Persons with a long term career/ regular use of opioids (as a primary drug), who have ever injected.	Treatment demand data.Persons in treatment during 2010, with a long term career/ intravenous / regular use of opiates (as a primary drug), who have ever injected.
Cyprus	2010	TP	Opioid & Stimulant	467	418	539	0.8	0.7	1.0	562800	95% CI	IDU	17 to 64	8	Persons with a long term career/ regular use of opioids or cocaine (as a primary drug), who have ever injected.	Treatment demand data.Persons in treatment during 2010, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), who have ever injected.
Cyprus	2010	TP	Opioid	269	234	329	0.5	0.4	0.6	562800	95% CI	IDU	18 to 64	8	Persons with a long term career/ regular use if opioids (as a primary drug), currently injecting.	Treatment demand data.Persons in treatment during 2010, with a long term career/ intravenous / regular use of opiates (as a primary drug), currently injecting.
Cyprus	2010	TP	Opioid & Stimulant	275	239	337	0.5	0.4	0.6	562800	95% CI	IDU	19 to 64	8	Persons with a long term career/ regular use of opioids or cocaine (as a primary drug), currently injecting.	Treatment demand data.Persons in treatment during 2010, with a long term career/ intravenous / regular use of opiates or cocaine (as a primary drug), currently injecting.
Luxembourg	1999	HM	Overall	1780			6.2			287096	n.a.	IDU	15 to 64	99 ; 2
Luxembourg	1999	MM	Overall	2121	2087	2155	7.4	7.3	7.5	287096	n.a.	IDU	15 to 64	99 ; 2
Luxembourg	2000	HM	Overall	1715			5.9			291010	n.a.	IDU	15 to 64	99 ; 2
Luxembourg	2007	OT	Overall	1485	1253	1919	4.6	3.9	6.0	322000	95% CI	IDU	15 to 64	4	Current IDUs.	Multi-methods: Treament multiplier, Police multiplier, mortality multiplier, Capture-recapture (2,3 and 4 sources) and Truncated Poisson. Drug-related deaths, criminal justice system, drug treatment, infectious diseases registries and methadone programmes.
Hungary	2005	CR	Overall	3941	2069	5813	0.56	0.29	0.83	6932000	n.a.	IDU	15 to 64	2		TreatmentPolice
Hungary	2007-08	CM	Overall	6146			0.89			6912704	n.a.	IDU	15 to 64		The study applied a capture-recapture method to estimate IDU group size, using DRID screening data. By using a unique identifier, the repetition pattern of the IDU clients of the needle/syringe programmes and specialised outpatient treatment centers was recorded between 2006 and 2009. Data of two adjacent years were used to make CR estimates, after selecting the same service providers to make coverage identical over the years. As appearance at the NSPs by the IDUs is not independent over the years, a sensitivity analysis was completed differentiating the 'intentional' and 'random' appearance at the NSPs. Then, service providers were asked to estimate the proportion of the 'random' appearance, as expert estimates. After all service providers gave the estimates an overall 'random' proportion value was calculated and applied to the sensitivity analysis. A confidence interval could be calculated for the CR part for the hidden population. Then the central estimate was used to apply the 'random proportion rate' val	Target population was the group of IDUs, who injected at least once in the given two-year period.
Hungary	2008-09	CM	Overall	5699			0.82			6912704	n.a.	IDU	15 to 64	4	The study applied a capture-recapture method to estimate IDU group size, using DRID screening data. By using a unique identifier, the repetition pattern of the IDU clients of the needle/syringe programmes and specialised outpatient treatment centers was recorded between 2006 and 2009. Data of two adjacent years were used to make CR estimates, after selecting the same service providers to make coverage identical over the years. As appearance at the NSPs by the IDUs is not independent over the years, a sensitivity analysis was completed differentiating the 'intentional' and 'random' appearance at the NSPs. Then, service providers were asked to estimate the proportion of the 'random' appearance, as expert estimates. After all service providers gave the estimates an overall 'random' proportion value was calculated and applied to the sensitivity analysis. A confidence interval could be calculated for the CR part for the hidden population. Then the central estimate was used to apply the 'random proportion rate' val	Target population was the group of IDUs, who injected at least once in the given two-year period.
Netherlands	2001	TM	Overall	3115	2211	4321	0.29	0.2	0.4	10835036	n.a.	IDU	15 to 64	24	Problem drug users currently injecting	The percentage of current injectors as found in the treatment population is multiplied to the whole population of problem drug users.The estimated number of problem drug users (see previous sheet).The National Alcohol and Drugs Information System (LADIS) with treatment data on problem users of opiates and/or cocaine, especially with data on the routes of administration of the primary and secondary drug of abuse.
Netherlands	2008	TM	Opioid	2390	2336	2444	0.22	0.21	0.22	11090914	n.a.	IDU				Source: Guus Cruts based on proportion of injectors among POU.
Austria	2000	MM	Overall		12000	23000		2.19	4.19	5483440	n.a.	IDU	15 to 64	12
Portugal	1999	HM	Overall		22656	33593		3.34	4.96	6778900	n.a.	IDU	15 to 64	99 ; 2
Portugal	1999	MM	Overall		18450	36900		2.72	5.44	6778900	n.a.	IDU	15 to 64	99 ; 2
Portugal	2000	HM	Overall		29620	43966		4.28	6.35	6920368	n.a.	IDU	15 to 64	99 ; 1		Combined interval from multiple capture-recapture and truncated Poisson estimates.
Portugal	2000	MM	Overall		15900	31800		2.3	4.6	6920368	n.a.	IDU	15 to 64	99 ; 1	IDUs or regular / long time users of opiates, cocaine and / or amphetamines.	Special register (Nactional Institute of Forensic Medicine - Ministry of Justice)
Portugal	2000	TM	Overall		41720	48673		6.03	7.03	6920368	n.a.	IDU	15 to 64	99 ; 1	IDUs or regular / long time users of opiates, cocaine and / or amphetamines.	Specialised Treatment Centres (SPTT - Ministry of Health)
Portugal	2005	TM	Overall		13 183	16 285		1.8	2.2	7115262	n.a.	IDU	15 to 64	5	Users (actual or recent) of drugs by intravenous administration route	Treatment multiplier - Respondent-driven sampling (RDS) was implemented to recruit problem drug users (n=237) in a large metropolitan area (Porto) and in a medium size city (Viseu;n=50).To implement RDS, ethnographic research was conducted to develop familiarity with local sites and populations. An incentive system (financial reward) was also used. In order to estimate the multiplier value, nomination techniques were used. First, respondents could nominate 5 friends of their network of acquaintances that were using drugs regularly in the past year. Second, respondents had to indicate the proportion of these drug-using acquaintances that have been for treatment in the past year. Respondents were also questioned using a direct question technique.
Portugal	2005	MM	Overall		10950	21900		1.5	3.0	7115262	n.a.	IDU	15 to 64	5	users (actual or recent) of drugs by intravenous route	Outreach Work Teams Multiplier. Harm reduction data.
Slovenia	2001	CM	Other	7320			5.24			1397039	n.a.	IDU	15 to 64	1	Heroin Users	Data on Characteristics of persons starting treatment for drugs and prevalence estimate on problem drug use for 2001 were used. Percentage of heroin IDU was multiplied by prevalence estimate of PDU.
Slovakia	2005	OT	Overall	18000	13300	31600	4.66	3.4	8.2	3862234	95% CI	IDU	15 to 64	3 ; 4		multiplier method - TMreports from low-threshold facilities - number of IDUs in contact with these facilities in Slovakia in 2005.In-treatment rate = portion of IDUs in contact with low-threshold agencies, nomination technique was used (223 respondents). Survey was carried out in Bratislava (88 respondents), Nitra, SereÄ, Trnava (altogether 37 respondents), Banská Bystrica (11 respondents), Å�iar nad Hronom (14 respondents), PreÅ�ov (56 respondents) and KoÅ�ice (17 respondents).
Slovakia	2006	OT	Opioid & Stimulant	18841	13732	34343	4.86	3.5	8.87	3870796	95% CI	IDU	15 to 64	5	Injecting drug users	Multiplier method (TM) - using data of low treshold agenciesreports from low-threshold facilities - number of IDUs in contact with these facilities in Slovakia in 2006.In-treatment rate = portion of IDUs in contact with low-threshold agencies, nomination technique was used (223 respondents). Survey was carried out in 2005.
Finland	1997	MM	Overall		4000	8500		1.17	2.48	3420598	n.a.	IDU	15 to 64	99 ; 2	Problem opiate and amphetamine users.
Finland	2002	CM	Overall	15650	12200	19700	4.5	4.3	5.7	3480722	95% CI	IDU	15 to 55			Treatment multiplier and three and four sample capture-recapture method. Drug Treatment Information System (STAKES): Anonymous, statistical data dollection, which is based on TDI protocol.Hospital Patient Discharge Register (STAKES): opiate (F11, T36, T40.0-T40.4, T40.6 (N01AH or N02A)) and amphetamine (F15, T36, T43.6, A08) related diagnoses as a primary or secondary diagnoses.'Driving under the influence of drugs' Register (National Public Health Institute and Ministry of Interior); amphetamine and opiate findings from blood.Criminal Report File (Ministry of Interior and National Bureau of Investigation): persons suspected of narcotics offences, specified as drug use or possession of drugs and limited to amphetamines, amphetamine types of stimulants and opiates.Register of infectious diseases (National Public Health Institute); cases of diagnosed hepatitis C-infections. Ratio of injectors is based on data source a, that covers 56 per cent of drug treatment patients. Separate estimates for amphetamine an
United Kingdom	1996	HM	Overall	161200			4.36			37007584	n.a.	IDU	15 to 64	1
United Kingdom	1996	MM	Overall	161133			4.35			37007584	n.a.	IDU	15 to 64	1
United Kingdom	2001	OT	Overall	123498			3.2	3.07	3.34	38593141	n.a.	IDU	15 to 64	5
United Kingdom	2004	OT	Overall	164036	158881	178614	4.18	4.04	4.55	39283066	95% CI	IDU	15 to 64			The UK estimate is the England estimate for 2004/05, the Scotland estimate for 2003, an estimate for Wales that assumes the same prevalence for England and an estimate for Northern Ireland that assumes the proportion of problem drug users who inject drugs are the same as the rest of the United Kingdom
United Kingdom	2005	OT	Overall	156398	151032	165696	3.95	3.81	4.18	39608066	n.a.	IDU	15 to 64		Current injecting (by opiate and / or crack cocaine users)	MI+CR structured treatment CR - probation CR - prison MIM sources - treatment, prison, drug-related deaths, social benefit claims Drug Action Team area (county, 149 in England) http://www.homeoffice.gov.uk/rds/pdfs07/rdsolr2107.pdf
United Kingdom	2006-07	OT	Overall	142650	139365	149154	3.52	3.44	3.69	40475300	95% CI	IDU	15 to 64	19	Opiate and / or crack cocaine users who inject any drug	Treatment, population density, prison, drug-related deaths, drug offences, police, probation. Capture-recapture, multivariate indicator method.
United Kingdom	2004-07	CM	Opioid & Stimulant/Other	147900	143298	156017	3.69	3.57	3.89	40104690	95% CI	IDU	15 to 64	17;19;21	Includes benzodiazepine use in Scotland.	Estimates of problem drug use in the United Kingdom are derived using two indirect measurement techniques: the capture-recapture (CRC) method; and the multiple indicator (MIM) method.CR - structured treatmentCR - probationCR - prisonCR - policeMIM sources - population density, prison, drug offences
United Kingdom	2004-10	CM	Opioid & Stimulant/Other	133112	126852	143278	3.27	3.11	3.52	40890655	95% CI	IDU	16 to 64	24; 26; 28; 29	Includes benzodiazepine use in Scotland.	Estimates of problem drug use in the United Kingdom are derived using two indirect measurement techniques: the capture-recapture (CRC) method; and the multiple indicator (MIM) method.CR - structured treatmentCR - probationCR - prisonCR - policeMIM sources - population density, prison, drug offences
Croatia	2006	MM	Opioid	3318	2768	4128	1.11	0.93	1.39	2969981	95% CI	IDU	all ages	1		Register of treated drug addictsCroatian mortality database Since DRD data and data from treatment register are somehow related, the multiplier method may lead to an underestimation. For the multiplier the average of 2002 to 2006 was taken. Note: The central estimate turned out to be quite low since the sample size was very small and it didn't refer to all i.v. users but only covered i.v. users that were intravenously taking opiates during the last month at least once per week or more often (excluded all users that have i.v. taken opiates ever in their lifetime except last month and those currently taking pharmacotherapy).
Croatia	2007	MM	Opioid	3447	3024	4000	1.16	1.02	1.35	2969981	95% CI	IDU	16 to 64	2
Croatia	2008	MM	Opioid	3257	2696	4148	1.09	0.91	1.4	2969981	95% CI	IDU	all ages	2		Register of treated drug addicts. Current IDUs (intravenous drug use in last 30 days). Croatian mortality database. Drug related deaths according selection B DRD definition
Croatia	2009	MM	Overall	3145	2521	4167	1.06	0.85	1.40	2969981	95% CI	IDU/PDU	all ages	2	Study population was the same as EMCDDA described	To calculate the Mortality multiplier, we used data from the Registry on the treatment of drug abusers and data on deaths and causes of death from mortality database.
Croatia	2010	MM	Opioid	2490	2010	3323	0.84	0.68	1.12	2969981	95% CI	IDU	16 to 64	2
Norway	1997	MM	Overall		7200	10300		2.54	3.63	2835512	n.a.	IDU	15 to 64	99 ; 2		Mean of the years 1995, 1996, 1997 number of drug related deaths used to avoid the effect of random variations and outliers.
Norway	1998	MM	Overall		9000	13000		3.15	4.56	2852913	n.a.	IDU	15 to 64	99 ; 2		Combined interval from multiple capture-recapture and truncated Poisson estimates.
Norway	1999	MM	Overall		9952	13270		3.4	4.6	2900748	n.a.	IDU	15 to 64	4	injected at least once during 1999	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 3 and 4 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2000	MM	Opioid		10500	14000		3.62	4.83	2900748	n.a.	IDU	15 to 64	99 ; 2	Opiate users.	For the number of drug related deaths the mean of the years 1998, 1999, 2000 was used to avoid the effect of random variations and outliers.
Norway	2000	MM	Overall		11374	15296		3.9	5.2	2922179	n.a.	IDU	15 to 64	4	injected at least once during 2000	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.9 and 3.9 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2001	MM	Overall		11942	16207		4.1	5.5	2941945	n.a.	IDU	15 to 64	4	injected at least once during 2001	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.8 and 3.8 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2002	MI	Overall	14962	10920	19450	5.04	3.68	6.55	2968348	n.a.	IDU	15 to 64	3		Local health and social serviceLocal police serviceMunicipality survey. Municipality size: smaller than 5000 inhabitants/5000-20000/20000-160000/160000+. Non-response 15%. Non-response figures estimated by regression on social indicators for responders. Possibly double counting in large cities
Norway	2002	MI	Overall	15456	11885	19027	5.2	4	6.4	2968348	n.a.	IDU	15 to 64	4		Confidence intervals, based on anchor point sample predicted standard deviations, are preliminary.Overdose deaths, Statistics Norway.Overdose deaths, Police reports/Kripos.Methadone maintenance treatment.Positive morfin tests in road trafficMunicipality survey for four anhcor points17 counties Oslo figures is estimated by mortality multiplier. Measurements probably 2-4000 too high, based on anchor point values being too high, including some IDUs in treatment/in prison/out of drug use.
Norway	2002	MM	Opioid		11000	15000		3.71	5.1	2968000	n.a.	IDU	15 to 64	1	Opiate users.
Norway	2002	MM	Overall		10238	14030		3.4	4.7	2968348	n.a.	IDU	15 to 64	4	injected at least once during 2002	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.7 and 3.7 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2003	MI	Overall	16215	14801	17629	5.5	5	5.9	2992562	n.a.	IDU	15 to 64	4	injected at least once during 2003	Confidence intervals, based on anchor point sample predicted standard deviations, are preliminary.Overdose deaths, Statistics Norway.Overdose deaths, Police reports/Kripos.Methadone maintenance treatment.Positive morfin tests in road trafficMunicipality survey for four anhcor points17 counties Oslo figures is estimated by mortality multiplier. Measurements probably 2-4000 too high, based on anchor point values being too high, including some IDUs in treatment/in prison/out of drug use.
Norway	2003	MM	Overall		8604	11914		2.9	4	2992562	n.a.	IDU	15 to 64	4	injected at least once during 2003	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.5 and 3.5 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2003	OT	Overall	16066	11580	20998	5.37	3.87	7.02	2992562	n.a.	IDU	15 to 64	3		Local health and social serviceLocal police serviceMunicipality survey. Municipality size: smaller than 5000 inhabitants/5000-20000/20000-160000/160000+. Non-response 15%. Non-response figures estimated by regression on social indicators for responders. Possibly double counting in large cities
Norway	2004	MI	Overall	15690	14062	17319	5.3	4.7	5.8	3019325	n.a.	IDU	15 to 64	4	injected at least once during 2004	Confidence intervals, based on anchor point sample predicted standard deviations, are preliminary.Overdose deaths, Statistics Norway.Overdose deaths, Police reports/Kripos.Methadone maintenance treatment.Positive morfin tests in road trafficMunicipality survey for four anhcor points17 counties Oslo figures is estimated by mortality multiplier. Measurements probably 2-4000 too high, based on anchor point values being too high, including some IDUs in treatment/in prison/out of drug use.
Norway	2004	MM	Overall		8190	11467		2.7	3.8	3019325	n.a.	IDU	15 to 64	4	injected at least once during 2004	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.5 and 3.5 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2004	OT	Overall	16335	13460	20099	5.5	4.5	6.8	3019325	n.a.	IDU	15 to 64	4	injected at least once during 2004	Municipality surveyReports from the local police and social service in 433 municipalities Measurements probably 2-4000 too high, including some IDUs in treatment/in prison/out of drug use. Confidence intervals based on that the logaritm of the proportion of IDUs in municipalities, gathered in groups by municipality size, is approx. normal.
Norway	2005	MI	Overall	14406	13232	15580	4.7	4.3	5	3089606	95% CI	IDU	15 to 64	2		Overdose deaths, Statistics NorwayOverdose deaths, Police reports/The National Bureau of Crime InvestigationMethadone maintenance /substitution treatmentPositive morphine tests in road traffic Methods explained in: Bretteville-Jensen, A.L. and Amundsen E.J. Prevalence of Injecting drug use in Norway. (In Norwegian:Omfang av spr?ytemisbruk i Norge). Report 5/2006 SIRUS Oslo and in The Drug situation in Norway. 2006, the annual report to EMCDDA
Norway	2005	MM	Overall		8374	11724		2.7	3.8	3050939	n.a.	IDU	15 to 64	4	injected at least once during 2005	Overdose deaths, Statistics Norway.Overdose deaths, Police reports/KriposSeveral studies of death rates among IDUs Based on a death rate of 2.5 and 3.5 percent among IDUs and the proportion of overdose deaths among all deaths to be 70 percent
Norway	2005	MM	Overall	9502	7918	11086	3.1	2.6	3.6	3089606	SA	IDU	15 to 64	2		Use three year moving average for the mean value of the two studies. Death rate 3 percent, proportion of overdose deaths 70 percent. Mean from several studies up to 2005Overdose deaths, Statistics NorwayOverdose deaths, Police reports/The National Bureau of Crime Investigation Methods explained in: Bretteville-Jensen, A.L. and Amundsen E.J. Prevalence of Injecting drug use in Norway. (In Norwegian:Omfang av spr?ytemisbruk i Norge). Report 5/2006 SIRUS Oslo and in The Drug situation in Norway. 2006, the annual report to EMCDDA
Norway	2005	OT	Overall	16888	13135	21701	5.5	4.3	7.1	3089606	95% CI	IDU	15 to 64	2		Municipality survey. Yearly survey of drug use and services in all municipalitiesReports from local police and the social service in the municipalities on injecting drug use in the municipalitiesValue for the municipality of Oslo is imputed from the MMM. Methods explained in: Bretteville-Jensen, A.L. and Amundsen E.J. Prevalence of Injecting drug use in Norway. (In Norwegian:Omfang av spr?ytemisbruk i Norge). Report 5/2006 SIRUS Oslo and in The Drug situation in Norway. 2006, the annual report to EMCDDA
Norway	2006	MM	Overall	10229	8524	11933	3.3	2.8	3.9	3089606	SA	IDU	15 to 64	2	Current IDUs.	Use three year moving average for the mean value of two data sources. Death rate 3 percent, proportion of overdose deaths 70 percent. Mean from studies up to 2007. Overdose deaths, Statistics Norway (EMCDDA overdose deaths definitions minus intentional poisoning). Overdose deaths, police reports/The National Bureau of Crime Investigations (Reports from local offices regarding acute fatal poisonings and deaths of drug abusers where cause is assessed to be their drug abuse). Methods explained in: Bretteville-Jensen, A.L. and Amundsen E.J.Prevalence of ionjecting drug use in Norway. (In Norwegian: Omfang av spr?ytemisbruk i Norge). Report 5/2006 Oslo and The drug Situation in Norway 2006. Annual report to EMCDDA.
Norway	2006	OT	Overall	16467	12830	19183	5.3	4.2	6.2	3089606	95% CI	IDU	15 to 64	2	Current IDUs.	Municipality survey. Yearly survey of drug use and services in all municipalities. Reports from local police and the social services in the municipalities on injecting drug use in the municipalities. Summary figure on injecting drug users. Out of 431 municipalities, there were 86 percent who filed at least one report. Value for the municipality of Oslo is imputed from the MMM. Methods explained in: Bretteville-Jensen, A.L. and Amundsen E.J.Prevalence of ionjecting drug use in Norway. (In Norwegian: Omfang av spr?ytemisbruk i Norge). Report 5/2006 Oslo and The drug Situation in Norway 2006. Annual report to EMCDDA.
Norway	2007	MM	Overall	10032	8599	12038	3.2	2.7	3.8	3136486	SA	IDU	15 to 64	2	Heavy drug users injecting at least once during the calendar year	Use three year moving average for the mean value of two data sources. Death rate 3 percent, proportion of overdose deaths 70 percent. Mean from studies up to 2008. Police (KRIPOS) reports on drug overdose deaths. Drug overdose deaths, up to 60 year sof age. Register for cause of deaths, Statistics Norway. EMCDDA filter B, including non-intentional overdose deaths up to 60 years of age
Norway	2008	MM	Overall	10238	8810	12480	3.2	2.8	3.9	3182224	SA	IDU	15 to 64	2	Heavy drug users injecting at least once during the calendar year	Use three year moving average for the mean value of two data sources. Death rate 2,9 percent, proportion of overdose deaths 70 per cent. Mean from studies up to 2009Police (KRIPOS) reports on drug overdose deaths.Drug overdose deaths, up to 60 years of age.Register for cause of deaths, Statistics Norway.EMCDDA filter B, including non-intentional overdose deaths up to 60 years of age
Norway	2008	MM	Overall	10320	8803	12470	3.2	2.8	3.9	3182224	SA	IDU	16 to 64	3	Heavy drug users injecting at least once during the calendar year	Police (KRIPOS) reports on drug overdose deaths, Register for cause of deaths, Statistics Norway

Notes:

n.a.= not available

CR = Capture Recapture

CM = Combined method

TM = Treatment Multiplier

TP = Truncated Poisson

OT = Other

HM = HIV Multiplier

MM = Mortality Multiplier

MI = Multivariate Indicator Method

SA = Sensitivity analysis

(�) PDU = Problem Drug Use; POU = Problem Opioid Use; PSU = Problem Stimulant Use

(�) See Table PDU-00 for details on Bibliographic references

(�) In case the only age range in study was not 15-64, the rates have been recalculated to 15-64.

Sources:

See Table PDU-00 for details on Bibliographic references

2011 REITOX National Reports - Fonte PDU template

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