Spain drug consumption

These examples highlight that the interpretation of this relative magnitude, chosen by many authors as an indicator of the exception that Spain constitutes as regards pharmaceutical drug consumption, is questionable at best. This empirical measure is far from representing the combination of pharmaceutical... 

Our empirical evaluation of competition between pharmaceuticals was based on information on prescription drug consumption by non-hospital patients in the National Health Service (NHS) in England in 19% and the Sistema Nacional de Salud or SNS (National Health System) in Spain in 1997. The authors wish to thank Statistics Division IE of the UK Department of Health and the Directorate-General of Pharmacy and Health Products of the Spanish Ministry of Health and Consumer Affairs for supplying us with these data. As can be seen from Table 4.1, public consumption of pharmaceuticals... 

Considering that the consumption pattern observed in the area of the Ebro River basin studied, which covers about half of the population living in the basin, could be representative of the whole Spanish country, the estimated average consumption data were used to calculate the annual consumption of each drug in the whole basin and in the Spanish territory. According to the extrapolated figures, which are shown in Table 2, around 21 tons of cocaine, 8 tons of cannabis, 3 tons of amphetamine and ephedrine, 300 kg of ecstasy and heroin, and 7.5 kg of methamphetamine are annually consumed in Spain. These amounts would move in the black market for around 1,100 million Euros. 

One issue which remains unclear in the literature is if the occurrence of drugs of abuse in the atmosphere is related to trafficking, manufacture or abuse [46]. The temporal or spatial patterns of drug manufacture in cities are uncertain. However, the concentrations detected in Spain peaked on weekends and in the nightlife areas, thus suggesting consumption and/or small-scale trafficking (dealing) as the main emission source. 

Statistics published in 1981 from the European Dialysis and Transplant Association on the causes of chronic renal insufficiency suggested that in Europe about 3.1% of cases up to that time had been drug-induced the figures cited varied from 0.4% in Spain to 17.5% in Switzerland. Some of the best-documented reports were those from Switzerland, where per capita consumption of phenacetin reached a peak of some 10 g annually between 1955 and 1968 (44). Between 1962 and 1978 the proportion of phenacetin users coming to autopsy increased from 1.8 to 3.1%. 

There were relatively few restrictions on drug availability or drug use prior to the beginning of the 20th century (an exception is Islamic law s edicts on alcohol consumption). Occasional efforts were made to decrease or eliminate certain substances, but these efforts tended to be short-lived or ineffective. For example, initial introductions to Europe of tobacco, coffee, and tea all met some resistance. Rodrigo de Jerez, a colleague of Columbus and thought to be the first European to smoke tobacco, was jailed in Spain because the authorities felt the devil had overtaken him (Whitaker, 1987). Also, at different times efforts were made to ban the use of coffee and tea. 

STPs are found to be the major contributor of pharmaceuticals in the Ebro River water. Compounds more frequently detected in the Ebro River basin were analgesics (diclofenac, naproxen, ibuprofen), lipid regulators (gemfibrozil, bezafibrate), antibiotics (azythromycin, trimethoprim, erythromycin, sulfamethoxazole), the antiepileptic carbamazepine, the antihistaminic ranitidine, and the 6-blockers atenolol and sotalol, which are the ones of major consumption in Spain as well as the ones excreted at higher percentages as parent drugs. Concentrations detected in both waste and surface waters are from 100 to 1000 times lower than the levels reported to cause acute toxicity. However, with respect to chronic effects, for some of the most ubiquitous compounds the margin of safety is narrow. As a wide spectrum of pharmaceuticals has been detected in natural waters, effects of mixtures should also be taken into account. 

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