The use of addictive products is the leading cause of premature death from preventable diseases in Europe
Policymakers should rethink addiction strategies and adopt modern and rational evidence-based addiction policies. Evidence suggests that policies aiming at minimising harms and risks, such as regulating the market according to the risks posed by different products and substituting high-risk products with less harmful alternatives, is an effective way forward.
Lisbon, 22 October 2024: Policymakers should rethink addiction strategies and adopt modern and rational evidence-based addiction policies. Evidence suggests that policies aiming at minimising harms and risks, such as regulating the market according to the risks posed by different products and substituting high-risk products with less harmful alternatives, is an effective way forward. Effective policies should focus on harm reduction, with abstinence as an option, rather than relying solely on the ideologically driven but often failing abstinence approach.
Estimates indicate that over a fifth of the population suffers from some form of addiction, whether it is illicit drugs, alcohol, pharmaceuticals, cigarettes, sugar, gambling, digital addiction, or something else. When combining various forms of substance use disorders and behavioral addictions, and accounting for overlapping cases, the total proportion could be even higher. From a medical and psychological perspective, all addictions share the same root: a natural phenomenon that targets sensors in the brain, but at the same time, each can pose different risks.
CVD (cardiovascular diseases), Europe’s number one killer, is often driven by addictive behaviour. Illicit drugs, alcohol, smoking, and even gambling contribute to cardiovascular problems such as hypertension and heart disease. CVD costs the EU €282 billion annually and represents 12 % of the total disease burden.
The World Health Organization (WHO) reports[1] that up to 50 % of people with substance use disorders have a co-occurring mental health disorder. In the Czech Republic, studies have found that 47 %[2] of substance users also suffer from mental health issues, often present before high-risk substance use. Similarly, data from the Centers for Disease Control and Prevention (CDC) indicates that over 30 %[3] of smokers suffer from some form of mental health issue.
To shine a light on this challenge and propose effective solutions, experts gathering for the European Drug Agency (EUDA) Lisbon Addictions 2024 conference, will hold a high-level roundtable on 22 October hosted by the Institute for Rational Addiction Policies. Leading experts including Jindřich Vobořil, Chairman of the Institute for Rational Addiction Policies, Viktor Mravčík, Head of Science at the Institute for Rational Addiction Policies and Alternate Member of the Management Board of EUDA, and Judy Chang, Executive Director of INPUD (International Network of People who Use Drugs), will be joined by former Members of the European Parliament, experts and economists to share their research and discuss effective policy approaches.
“As scientists, policymakers, and addiction experts, we consider addiction as one phenomenon,” explains Jindřich Vobořil, Chairman of the Institute for Rational Addiction Policies. “Science-driven policies clearly suggest that the harm reduction approach should be the main principle.” He adds: “Abstinence-driven policies are not realistic: balanced policies based on prevention, support services, and a regulated market substituted with less risky substances are the way forward. Moreover, they must be applied consistently across addictions—from currently illicit substances, smoking, and alcohol to gambling and digital addictions.”
The EU currently applies a harm reduction approach to addressing illicit drug addiction but does not extend this approach across all addictions. The EUDA is more open to harm reduction policies, and conference speakers will advocate for increased investment in prevention and innovative harm reduction strategies and policies that minimise the consequences of addictive behaviours by regulating products according to their level of risk and offering safer alternatives. Data show that such approaches are not only effective but also more cost-efficient. Creating a substitute market with low-risk alternatives is essential, supported by appropriate regulation and taxation.
“It is vital that policymakers recognise the compelling science behind harm reduction,” urges Jindřich Vobořil. “Research clearly shows that prohibitionist policies and substance bans do not work. Instead, they often exacerbate health harms by pushing individuals toward more dangerous substances or practices.”
Evidence indicates that harm reduction approaches are both effective and cost-efficient. A study published in The Lancet Global Health[4] in 2022 found that opioid substitution therapy reduces the risk of overdose death by over 50 % and provides long-term cost savings. Similarly, implementing needle exchange programmes and supervised consumption sites has led to a decrease in the transmission of infectious diseases such as HIV and hepatitis C. According to the EMCDDA's 2023 report[5], countries that have adopted these measures have seen a 30% reduction in new HIV infections among people who inject drugs.
The Institute for Rational Addiction Policies continues to collaborate with EU institutions in promoting rational addiction policies. Further discussions will be organised during the Polish Presidency of the Council of the EU in 2025.
About IRAP:
Multidisciplinary association of independent and prominent experts. Addresses addiction from all angles: public and individual health, legislation and other legal implications, including security challenges, economics (market modelling, tax, economic impacts on public budgets), education and prevention, social and sociological and political science. IRAP aims to influence public opinion and thereby model political attitudes, to influence strategic documents of a political and professional nature, including the professionally correct setting of legislation, on the other hand to influence strong industry to adopt basic ethical standards.
[1] World Health Organization (WHO). (2022). Mental Health and Substance Use.
[2] National Monitoring Centre for Drugs and Addiction (Czech Republic). (2022). Annual Report on Drug Use and Health in the Czech Republic.
[3] Centers for Disease Control and Prevention (CDC). (2022). Vital Signs: Smoking and Mental Health.
[4] Sordo, L., et al. (2022). Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. The Lancet Global Health.
[5] European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2023). Harm Reduction: Evidence, Impacts, and Challenges.
