Drug use remain at high levels across the EU, although considerable differences exist between countries. Almost a third of adults have used illicit drugs at some point in their lives. The use of illicit drugs, particularly among people who use them regularly and in larger 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. 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, 2022[1]).
Cannabis is the most used illicit drug among young adults in Europe, with around 15% of people aged 15 to 34 reporting having used cannabis in the last year in 2020 (Figure 4.11). Cannabis use is highest in the Czech Republic, France, Italy and Croatia. It is estimated that around 1% of European adults are daily or almost daily cannabis users; around three‑quarters are males. The COVID‑19 pandemic impacted cannabis use patterns, with more frequent herbal cannabis users consuming more, and infrequent users consuming less on average. In 2021, out of 31 cities in Europe with comparable data gathered by EMCDDA, 13 reported an increase in cannabis residues in wastewater samples.
Cocaine is the most commonly used illicit stimulant in Europe, with around 2.2% of adults aged 15 to 34 reporting having used cocaine in the last year (Figure 4.12). This proportion is highest in Austria, Croatia, France, Ireland, Spain and the Netherlands. While decreases in cocaine residues were observed in 2020 in most cities with data on municipal wastewater, data for 2021 show an increase in 32 out of 58 cities in Europe compared to 2020.
The use of amphetamines and MDMA/ecstasy is slightly lower than the use of cocaine, with about 1.4% of young adults reporting having used amphetamines and 1.9% MDMA/ecstasy in the last year. National estimates of use of new psychoactive substances among young adults aged 15‑34 range from 0.1% in Latvia to 5.1% in Romania, although some of the variations can be explained by methodological differences (EMCDDA, 2022[1]).
The consumption of opioids (i.e. heroin and other drugs) is responsible for the majority of deaths by drug overdose. The main opioid used in Europe is still heroin, but there are concerns in several countries about the use of synthetic opioids. Among adults aged 15‑64 years, 1 million are estimated to be high-risk opioid users (0.34% of the EU population).
Drug use is linked with, and complicates responses to, a wide range of today’s most pressing health and social issues. Among these are mental health issues, self-harm, homelessness, youth criminality and the exploitation of vulnerable individuals (EMCDDA, 2022[1]).
