Published:

European Drug Report 2023

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has published the 'European drug report 2023: trends and developments' on 16 June 2023. The purpose of this report is to provide an overview and summary of the European drug situation up to the end of 2022.

The Health Research Board (HRB) provides the Irish data and research for the EMCDDA report. This media brief provides an overview of the drug situation in Europe and a comparison with the Irish drug situation where possible.

The European drug report highlights: 

  • Availability of the commonly used illicit drugs remains high. 
  • There is a broader range of drugs available, and these are often at high potency or purity, presenting increased threats to public health. 
  • Drug treatment and other services are returning to normal after the COVID-19 restrictions. 
  • Cannabis products are becoming increasingly diverse and the production of synthetic drugs within Europe is on the rise. 

EMCDDA Director Alexis Goosdeel says: “Almost everything with psychoactive properties can appear on the drug market, often mislabelled or in mixtures. This is why illicit drugs can affect everyone, whether directly through use, or indirectly, through their impact on families, communities, institutions and businesses. They also increasingly expose our citizens to drug-related violence and its consequences.

New cannabis policy developments in a complex market

Cannabis policy in European countries covers not only illicit cannabis control, but also the regulation of cannabis and cannabinoids for therapeutic and other uses. Five European Union (EU) Member States (Czechia, Germany, Luxembourg, Malta and the Netherlands) are regulating the supply of cannabis. These changes will require investment in monitoring and evaluation to fully understand their impact on public health and safety.

Latest data

  • Around 83.4 million or 29% of adults (aged 15-64) in the EU are estimated to have used illegal drugs at least once in their lifetime.
  • Cannabis remains by far the most commonly consumed illicit drug in Europe. National surveys of cannabis use would suggest that overall, around 8% of European adults are estimated to have used cannabis in the last year. 
  • Cannabis remains the most widely consumed substance, with over 22 million European adults reporting its use in the last year. Last year drug use is largely concentrated among young adults and is estimated at 15.5% among EU inhabitants aged 15–34 years. 
  • It is estimated that in the last year 3.5 million adults consumed cocaine, 2.6 million MDMA and 2 million amphetamines. Surveys indicate that nearly 2.2 million 15–34-year-olds (2.2% of this age group) used cocaine in the last year.
  • Around one million Europeans used heroin or another illicit opioid in 2020. 
  • Opioids, often in combination with other substances, were found in around three quarters of fatal overdoses reported in the EU for 2020.
Cocaine

Cocaine is the second most commonly used illicit drug in Europe, after cannabis. Cocaine is usually available in two forms in Europe: the most common is cocaine powder (the salt form) and less commonly available is crack cocaine, a freebase form of the drug that can be smoked. 

Cocaine purity at retail level remains high by historical standards and its price is stable. Additionally, there is now a well-established secondary cocaine production industry in Europe, with 34 cocaine laboratories dismantled in 2021, an increase on the previous year. 

There have been historically high seizures of cocaine in recent years, an indicator of its widespread availability and raising concerns that this is associated with increasing levels of consumption and associated harms. The available data also suggest that the drug was involved in about a fifth of overdose deaths in 2021. 

European situation

  • In 2021, EU Member States reported 67,000 seizures of cocaine, amounting to a historically high 303 tonnes (up from 211 tonnes in 2020). 
  • The purity of cocaine has been on an upward trend over the past decade, and in 2021 reached a level 43% higher than the index year of 2011.
  • After cannabis, cocaine was the second most frequently cited drug in offences related to use or possession.
  • In the EU, surveys indicate that nearly 2.4 million 15-34-year-olds (2.4% of this age group) used cocaine in the last year. Of the 11 European countries that have conducted surveys since 2020 and provided confidence intervals, five reported higher estimates than their previous comparable survey.
  • Cocaine was the second most common problem drug for first-time drug treatment entrants, cited by an estimated 25,000 clients or 21% of all first-time entrants.
  • The latest European data reveal a time lag of 10 years between first cocaine use, on average at the age of 23, and first treatment for cocaine-related problems, on average at the age of 33.
  • Cocaine was the most common substance reported by Euro-DEN Plus sentinel hospitals in 2021, mentioned in 27% of acute drug toxicity presentations. Where recorded, most presentations were associated with co-ingestion of alcohol.

Irish comparison

  • In Ireland the most recent National Drug and Alcohol Survey (NDAS) in 2019-20 shows that 4.7 per cent of 15–34-year-olds used cocaine in the last year.
  • In 2021, for the first time, there were more cases of treatment for cocaine as a main problem drug (3,248 or 30% of all cases) than heroin (3,168).  
  • In 2021, 1,359 new entrants into treatment reported cocaine as the main problem. This represents 38% of all new entrants into treatment. 
  • Cocaine was implicated in 53 deaths in Ireland in 2017, an increase of 26% on the 2016 figure.
  • Forensic Science Ireland recorded 1994 seizures of cocaine in Ireland in 2020, the second most prominent drug in quantities seized after cannabis.
  • Forensic Science Ireland reported that the cocaine content of seized samples has remained broadly consistent over the four-year period 2016-19, with an increase at street level from 34.7% to 46.5%, noted. European analysis reports increases in trafficking routes, supply, seizures, and seizure volumes during this time period, ultimately leading to an increase in cocaine content for users.
Cannabis

Developments in the cannabis area are creating new challenges for policy makers and services responding to its use. On the illicit drug market, the availability of high-potency extracts and edibles is a particular concern and has been linked to acute toxicity presentations in hospital emergency departments. In addition, there are concerns that some products sold on the illicit market as natural cannabis may be adulterated with potent synthetic cannabinoids. Cannabis products are becoming increasingly diverse, including extracts and edibles (high THC content) and CBD products (low THC content). In 2021, the average THC content of cannabis resin was 20%, almost twice that of cannabis herb (9.5%).

European situation

  • Cannabis is the most used illicit drug in Europe, across all age groups. 
  • Last year cannabis use among the EU population aged 15–34 is estimated at 15.1%. It is estimated that around 2% of adults (15–64) are daily or almost daily cannabis users.
  • In 2022, of the 38 cities with comparable data, 15 reported an annual increase in the cannabis metabolite THC-COOH in wastewater samples, while 18 reported a decrease.
  • Cannabis was the main problem drug most frequently cited by new treatment clients, accounting for 45% of all first-time treatment entrants in Europe.
  • Approximately 566,000 cannabis use or possession offences were reported in the EU in 2021 (551,000 in 2020), alongside 100,000 supply offences (93,000 in 2020).
  • In 2021, the average THC content of cannabis resin in the European Union was 20%, more than twice that of herbal cannabis, at 9.5%. 
  • Cannabis was the second most frequently reported substance by the Euro-DEN Plus hospital network in 2021. It was involved in 25% of acute drug toxicity presentations (23% in 2020), usually in the presence of other substances.

Irish comparison

  • The 2019/20 National Drug and Alcohol Survey (NDAS) reported that 24.4% of the population (15–64 years) had used cannabis at some point in their lives; 7.1% reported use in the year prior to the survey and 3.4% in the preceding month.
  • The NDAS reported that 13.8% of young adults (15-34 years) used cannabis in the year prior to the survey.
  • The 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) reported that 16% of Irish secondary school students (aged 15–16) had used cannabis in the last 12 months (recent use). 
  • Cannabis was the main problem drug for 2,262 of cases (21% of all cases) entering drug treatment in Ireland in 2021. 
Opioids (mainly heroin)

Data on entry to drug treatment, as well as data from other indicators, support the conclusion that Europe’s cohort of heroin users is ageing, with little current evidence to suggest that the rate of recruitment into this behaviour is growing. Between 2010 and 2021, the mean age of all clients entering specialist drug treatment for heroin use and for those doing so for the first time increased, as did the proportion of older clients.

European situation

  • Overall, the available indicators suggest that heroin use remained stable in 2021 compared with previous years. 
  • Opioid use was reported as the main reason for entering specialised drug treatment by 50,000 clients in 2021, representing 26% of all those entering drug treatment in Europe. An estimated 206,000 clients received opioid agonist treatment in 2021 (205,000 in 2020).
  • Heroin remained the third most commonly identified drug in acute drug toxicity presentations in Euro-DEN Plus hospitals in 2021, accounting for 15% of all reported cases.
  • Opioids, including heroin and its metabolites, often in combination with other substances, were estimated to be present in three quarters (74%) of fatal overdoses reported in the EU. 

Irish comparison 

  • The proportion of all entrants to treatment reporting an opioid as their main problem drug has decreased year-on-year since 2004, from a peak of 65% in 2004 to 34% in 2021.
  • In 2021, of those entering treatment for opioid use, 90% had heroin as the main problem drug.
  • In 2017 there were 77 deaths where heroin was implicated, compared to 74 in 2016. Fentanyl was implicated in seven poisoning deaths in 2017, the same as in 2015 and 2016.
New psychoactive substances and stimulants

European situation 

At the end of 2022, the EMCDDA was monitoring around 930 new psychoactive substances, 41 of which were first reported in Europe in 2022. The 24 new cannabinoids detected accounted for over half of the new substances first reported to the EU Early Warning System in 2022. Synthetic cathinones and new synthetic opioids are sold as replacements for stimulants such as amphetamine or opioids such as heroin, respectively. In 2022, large quantities of cathinones such as 3-MMC and 3CMC continued to be seized. 

  • Approximately 400 new psychoactive substances were detected in seizures in 2021. In 2022, the EU Early Warning System received reports of 24 new cannabinoids, bringing the total number being monitored to 245. 
  • In 2021, just 5 substances accounted for over 80% of the quantity of new psychoactive substances seized in EU countries: 3 cathinones (3-CMC, 3-MMC and 4-CMC, amounting to 4.0 tonnes), ketamine (0.9 tonnes) and GBL (2.0 tonnes). 
  • Since 2009, a total of 74 new opioids have been identified on the European drug market, with one new substance notified in 2022 (6 in 2021, 10 in 2020).
  • National estimates of last year use of new psychoactive substances (excluding ketamine and GHB) among young adults (aged 15–34) range from 0.1% in Latvia to 5.1% in Romania. 
  • In 2021, 3-MMC was reported in 68 acute drug toxicity presentations in 5 Euro-DEN Plus hospitals.

Irish comparison

  • The 2019/20 National Drug and Alcohol Survey reported last-year prevalence of MDMA of 6.5% for young adults (aged 15-34 years). 1.9% of young adults had taken a new psychoactive substance in the past year.
  • MDMA (alone or with other drugs) was implicated in 14 poisoning deaths in 2017, up from 8 in 2016.
  • Benzodiazepines were the main problem drug for 11% of cases entering treatment in 2021, an increase from 9% of cases in 2015.

ENDS

If you have any queries in relation to the Irish figures, you can contact:

Brian Galvin, Programme Manager for Drug and Alcohol Research, Health Research Board
m +353 86 1573471    e bgalvin@hrb.ie

Notes on Irish data

  • The Irish drug treatment data referred to above is taken from reports on those entering treatment in 2021. Data on those entering treatment in 2022 will be published on 20 June 2023.
  • The most recent year for which drug-related deaths estimates are available is 2017. Data on drug-related deaths for the years 2018-20 will be published later in 2023.