Drug availability and use remain at high levels across the European Union, although considerable differences exist across countries. Almost a third of adults in the EU aged 15 to 64, or around 89 million people, have used illicit drugs at some points in their lives, with the experience of drug use being still more frequently reported by males than females. The use of illicit drugs, particularly among people who use them regularly and in bigger quantities, is associated with higher risks of cardiovascular diseases, mental health problems, accidents, as well as infectious diseases such as HIV when the drug is injected. The mortality rate due to overdoses in the EU in 2022 is estimated at 22.5 deaths per million in adults. Illicit drug use is a major cause of preventable mortality among young people in Europe, both directly through overdose and indirectly through drug-related diseases, accidents, violence and suicide (EMCDDA, 2024[1]).
Cannabis remains the most commonly used illicit drug among young adults in Europe, with approximately 15% (15.1 million) of individuals aged 15 to 34 in EU countries reporting cannabis use in the last year. The highest rates of cannabis consumption are found in Czechia, Italy and Croatia, where 20% or more of people in this age group have used cannabis in the past year. It is estimated that around 1.3% of European adults – primarily males under 35 years old – are daily or almost daily cannabis users. Recent trends in cannabis use at the national level have been mixed, with three countries reporting higher estimates, eight remaining stable, and two showing a decrease compared to their previous comparable surveys. In 2023, out of 51 EU cities with comparable data, 20 reported an increase in cannabis residues found in wastewater compared to 2021.
Cocaine is the most commonly used illicit stimulant in Europe: around 2.5% of young adults reported having used cocaine in the last year on average across EU countries (Figure 4.11). The percentage of young adults using cocaine is highest in the Netherlands, Ireland, Norway and Denmark with 4.0% or more having used cocaine at least once in the last year. Cocaine residues in municipal wastewater increased in 49 out of 72 cities in the EU with data for both 2022 and 2023.
The use of amphetamines and MDMA/ecstasy is slightly lower than the use of cocaine, with about 2.2% of young adults in EU countries reporting to have used MDMA/ecstasy and 1.5% used amphetamines in the last year. The use of MDMA/ecstasy tends to be higher in the Netherlands, Ireland and Czechia, while the use of amphetamines tends to be higher in Finland, Croatia, the Netherlands and Germany.
The consumption of opioids (i.e. heroin and other drugs) is responsible for the majority of drug overdose deaths (reported in 74% of fatal overdoses), often in combination with other substances. The main opioid used in Europe is still heroin, but there are concerns in several countries about the use of other synthetic opioids (such as buprenorphine, methadone, fentanyl and tramadol). In 2023, new synthetic opioids were detected by the EU Early Warning System on new psychoactive substances in at least 16 EU Member States, Norway and Türkiye. The use of new psychoactive substance among young adults aged 15 to 34 ranges from 0.1% in Norway to 5.1% in Romania.
More complexity in drug consumption patterns is observed, with non-controlled new psychoactive substances, polydrug consumption and substances such as ketamine and gamma-hydroxybutyrate (GHB) now associated with drug problems in some countries or among some groups. This complexity is reflected in an increasing recognition that drug use is linked with, or complicates responses to, a wide range of today’s most pressing health and social issues. Among these are mental health issues and self-harm, homelessness, youth criminality and the exploitation of vulnerable individuals and communities (EMCDDA, 2024[1]).
