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 Monitoring Centre for Drugs and Drug Addiction (EMCDDA) today publishes the European drug report 2024: trends and developments. The purpose of this report is to provide an overview and summary of the European drug situation up to the end of 2023.

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

  • Drug availability remains high in Europe, with a wider range of psychoactive substances, often of high potency or purity, or in new forms, mixtures and combinations, and many products mis-sold and so presenting serious health risks.
  • Adulteration of cannabis with synthetic cannabinoids and MDMA with cathinones and synthetic opioids is becoming more common, as well as synthetic stimulant mixtures such as ‘pink cocaine’
  • The use of two or more psychoactive substances at the same time or close together is increasing.  Polydrug use carries its own health risk and makes effective responses more problematic.
  • Heroin remains the most commonly used illicit opioid in Europe but use of internationally controlled synthetic opioids (e.g. fentanyl) and new (uncontrolled) synthetic opioids (e.g. fentanyl derivatives) is increasing.

EMCDDA Director Alexis Goosdeel says: ‘In this year’s European Drug Report, we highlight the growing challenges posed by a highly complex and rapidly evolving drug market, where established illicit drugs are polysubstance use is driving a range of health risks, especially when drug mixtures are unknowingly consumed. We also reflect today on potential future problems in the drugs field and the need to be better prepared to face them. I am pleased to announce, therefore, that, as the new European Union Drugs Agency, we will have a stronger mandate to anticipate future emerging threats and trends, alert in real time on new risks for health and security, help the EU and Member States to respond, and learn from experience to adapt and improve our drug strategies and interventions’.

Latest data  

  • Around 83.4 million or 29% of adults (aged 15-64) in the European Union 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 2.2million 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 European Union 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.

Political events in Colombia, Brazil and Ecuador have contributed to the increase in cocaine trafficked to Europe. For the sixth consecutive year, record quantities of cocaine were seized by EU Member States in 2022, amounting to a reported 323 tonnes.  As seizures of cocaine increase in Antwerp and other large ports, traffickers have made greater use of smaller ports and countries bordering the EU.  Northern European countries, including Sweden, Finland and Norway, reported record cocaine seizures in sea ports in 2023.

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 39 cocaine laboratories dismantled in 2022, an increase on the previous year. The available data suggests that the drug was involved in about a fifth of overdose deaths in 2021.

European situation  

  • 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.
  • In 2023, cocaine residues in municipal wastewater increased in 50 out of 72 cities with data compared with 2022, while 12 cities reported no change and 10 cities reported a decrease.
  • In the European Union, surveys indicate that nearly 2.5 million 15- to 34-year-olds (2.5 % of this age group) used cocaine in the last year. Of the 13 European countries that have conducted surveys since 2021, five reported higher estimates than their previous comparable survey.
  • Cocaine was the second most common problem drug among people entering specialised drug treatment for the first time in their lives, cited by an estimated 29 000 clients or 21% of all first-time entrants.
  • Among the 19 European countries providing data for both years, cocaine, mostly in the presence of opioids, was involved in 996 (2 %) overdose deaths in 2022 (807 or 20% in 2021).
  • Just six EU countries accounted for 90 % of the estimated 8,000 crack-related treatment entries in, of which 3,000 were first-time entrants.

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.
  • Cocaine was the most common drug reported for those entering treatment in Ireland in 2022, accounting for 34% of all cases, a 26% increase from 2021. Cocaine was also the most common main drug among new cases in 2022, similar to the previous two years.
  • In 2022, 898 treatment cases were recorded with crack cocaine as the main problem.
  • Cocaine poisoning deaths increased from 24 deaths in 2011 to 130 in 2020, representing 3 in 10 of all poisoning deaths.
  • 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.

Cannabis  

The cannabis market is becoming increasingly diverse in both the potency of products available and the form in which it is available for ingestion, for instance extracts and edibles.  The average THC content of cannabis resin is nearly 25%, and herbal cannabis, more than 10%.  These are historically high levels of purity and this, as well as the frequency cannabis is used, is a cause of concern for treatment providers.

Cannabis use is associated with a number of physical problems, but causal relationship is uncertain due to the wide variety of products on offer. There is also concern around adulteration with synthetic cannabinoids, with nine new forms identified in 2023.  The most commonly detected seme-synthetic opioid is hexahydrocannabinol (HHC), which is now a controlled drug in 18 EU Member States.

Five EU Member States (Czechia, Germany, Luxembourg, Malta and the Netherlands) as well as Switzerland have changed, or are planning to change, the law that makes the possession of cannabis illegal.   This will mean greater access to cannabis and may possibly result in increasing use and a greater prevalence of harms associated with this use.

European situation 

  • Cannabis is the most used illicit drug in Europe, across all age groups.
  • Findings from national surveys of cannabis use are that around 8% of European adults (22.8 million aged 15 to 64) are estimated to have used cannabis in the last year.
  • Around 1.3% of adults in the European Union (3.7 million people) are estimated to be daily or almost daily users of cannabis, and this is the group most likely to experience problems associated with this drug.
  • Among 15- to 24-year-olds, an estimated 18.6% (8.8 million) used cannabis in the last year.
  • Cannabis was the main problem drug most frequently cited by new treatment clients, accounting for 43% of all first-time treatment entrants in Europe.
  • In 2021, the average THC (the psychoactive compound in cannabis) 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 proportion of cases treated for cannabis as a main problem decreased from 26.4% in 2016 to 18.7% in 2022.
  • Among young cases aged 19 years or younger, cannabis was the main drug generating treatment demand. Among new cases the proportion reporting cannabis as a main problem decreased from 41.2% in 2016 to 32.8% in 2022.

Opioids (mainly heroin)  

While Europe’s opioid market is becoming increasingly complex and there is increasing availability of synthetic opioids (SO), such as fentanyl and nitazines, heroin is still the most widely-used opioid and a cause serious health problems and multiple deaths. Despite the ban on opium poppy cultivation in Afghanistan, the source of most of the Europe’s heroin, there is little sign of heroin shortages in Europe.  That may change in the coming years and the threat from new synthetic opioids, 81 of which have been identified in European since 2009, will increase. Most of the new SO reported to the EU Early Warning System were nitazines, which are sometimes mis-sold as heroin and resulted in several deaths in Estonia in 2023.  There have also been localised outbreaks in France and Ireland. Europe needs to prepare for possible market shifts, by ensuring adequate access to opioid agonist treatment and harm reduction services, as well as making available sufficient supplies of the overdose-reversal drug naloxone.

European situation  

  • It is estimated that 0.3% of the EU adult population, or around 860 000 people, used opioids in 2022.
  • Opioid use was reported as the main reason for entering specialised drug treatment by 63,000 cases in 2022, representing 25% of all those entering drug treatment in Europe. An estimated 508,000 cases received. opioid agonist treatment in 2022. Data suggest that the long-term downward trend in the number of people entering treatment for heroin use has continued.
  • 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 were found in an estimated 74% of fatal overdoses reported in the European Union. It should be noted that multiple drugs are commonly found in toxicology reports from suspected drug-induced deaths.

Irish comparison   

  • The 2022 study, Problematic opioid use in Ireland, 2015–2019, found that there were an estimated 19,875 problematic opioid users in Ireland in 2019, which equates to a prevalence rate of 6.68 per 1,000 population.
  • Opioids (mainly heroin) were the second most common main problem drug reported to treatment services in 2022. Heroin accounted for 86.6% of all opioid cases in 2022. The proportion of cases treated for opioids decreased from 47.0% in 2016 to 33.1% in 2022.
  • Opiates were the main drug group implicated in poisoning deaths in Ireland in 2020:
    •  Methadone was the most common single prescribable drug; it was implicated in 139 poisonings.
    • Heroin poisoning deaths increased from 64 deaths in 2011, to 113 deaths in 2020.

New psychoactive substances   

New psychoactive substances is a broad term describing drugs that are not controlled by international drug control conventions. The number of NPS entering the market is slowing, with just 26 identified in 2023, a little over half of the annual average between 2016 and 2022. China and India remaining important source countries for these substances or the precursors that are required to produce them.

The 9 new cannabinoids detected, 4 of which are semi-synthetic cannabinoids, accounted for approximately one third of the new substances first reported to the EU Early Warning System in 2023. Seven new synthetic opioids were formally notified in 2023, with 6 of them belonging to the highly potent group of benzimidazole (nitazene) opioids.

Notes on Irish data  

*The Irish drug treatment data referred to above is taken from reports on those entering treatment in 2022. Data on cases entering treatment in 2023 will be published in late June 2024.

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