In June 2015 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published the European drug report 2015: trends and developments, summarising the latest trends across the 28 EU member states, and Norway and Turkey.1 The European drug report highlights changing dynamics in the heroin market, with an overall stagnation in the demand for heroin in Europe. The report warns, however, that an increase in production in most of the countries supplying Europe with heroin could result in more of the drug becoming available in European drug markets. Other changes in market dynamics, including processing of heroin inside Europe, the emergence of alternative trafficking routes and diversification of products from opioid-producing countries in Asia, need to be monitored carefully. As the age profile of heroin users increases, providing appropriate treatment and care to long-term users is a growing challenge for drug treatment and social services.

Cannabis continues to dominate reports on all drug law offences. Around 80% of all drug seizures are of cannabis, two thirds of which are herbal cannabis, demonstrating the importance of domestically produced herbal cannabis in the European drug market. Cannabis use is around five times more prevalent than use of other substances and the drug is now, for the first time, the most frequently cited reason for entering drug treatment in Europe.

Responding to the report, Dimitris Avramopoulos, European Commissioner for Migration, Home Affairs and Citizenship, said: ‘The report shows that we are confronted with a rapidly changing, globalised drug market and, therefore, we need to be united, swift and determined in our response to the drugs threat.’ He continued: ‘I am particularly concerned that the Internet is increasingly becoming a new source of supply, for both controlled and uncontrolled psychoactive substances. 101 new uncontrolled psychoactive substances were reported in 2014, challenging our existing control mechanisms. I look forward to the forthcoming EU legislation in this area, which is currently under negotiation. This will further strengthen our responses and equip us with better instruments to deal with these substances more rapidly and more effectively.’

The situation described in the report is presented below under a series of headings. The European drug reports use the most recent data available to provide aggregate figures. While data on some indicators, such as treatment demand, are supplied annually, the year of the most recent prevalence data can vary.

Cannabis
• The EMCDDA estimates that around 14.6 million young Europeans (11.7% of this age group, aged 15–34) used cannabis in the last year, and 8.8 million of these were aged 15–24 (15.2% of this age group).
• The use of cannabis in Europe has stablised or is declining, especially among younger age groups. The situation varies between countries. Of the 14 countries who have conducted new surveys since 2012, four reported lower estimates, two were stable and eight reported higher estimates than in previous comparable surveys.
• Among the 3% of European adults (18–64 years) who used cannabis in the last month, about one quarter used cannabis on a daily, or almost daily, basis.
• The use of cannabis by school students aged 15¬–16 years varied considerably, from 5% in Norway to 42% in the Czech Republic.
• Cannabis is now the most frequently reported main problem drug among those entering treatment for the first time in 2013. Between 2006 and 2013 the number of such clients increased from 45,000 to 61,000. For all clients entering treatment, cannabis was the second most frequently reported main problem drug, after heroin.
• In 2013 there were 431,000 seizures of herbal cannabis, 240,000 seizures of cannabis resin, 30,000 seizures of cannabis plants and 10,000 seizures of synthetic cannabinoids
• While the number of seizures of herbal cannabis has exceeded those for cannabis resin every year since 2009, the quantity of resin seized in 2013 is still much higher (460 tonnes compared to 130 tonnes).

Opioids (mainly heroin)
• The average prevalence of problem opioid use among European adults (aged 15–64) in 2012 is estimated at around 0.4%. This is the equivalent of 1.3 million problem opioid users in Europe.
• In Europe 41% (175,000) of all clients who entered treatment in 2013 were users of opioids (mainly heroin).
• The number entering specialist drug treatment for the first time for heroin use fell from a peak of 59,000 in 2007 to 31,000 in 2013, accounting for 20% of all clients entering treatment for the first time.
• In 11 European countries more than 10% of first-time opioid clients entering specialised treatment in 2013 were misusing opioids other than heroin. In some countries, these drugs now represent the most common form of opioid use.
• Misused methadone was the most commonly reported of the drugs being misused by opioid clients entering specialised treatment in 2013 whose main problem drug was an opioid other than heroin, accounting for 60% of treatment demand by these clients.
• Between 2006 and 2013 the median age of clients entering treatment for opioid use increased by five years. Many older opioid users are susceptible to a range of chronic health problems with implications for treatment and social support services.
• Among opioid clients entering treatment in 2013, 33% reported injecting the drug.
• Injecting continues to play a major role in the transmission of blood-borne infectious diseases such as the hepatitis C virus (HCV) and, in some countries, HIV/AIDS. There were 1,458 newly reported HIV diagnoses attributed to injecting drug use in 2013, compared to 1,974 in 2012, the first time since 2010 a decrease has been recorded.
• Of the 10 countries with national data available for 2012–13, five reported a prevalence rate of more than 50% for HCV antibodies among drug users. Six countries reported an increase, with only Norway recording a fall in HCV diagnoses.
• Heroin or other opioids were present in the majority of reported fatal overdoses. Overall, around 6,100 overdose deaths were reported in 2013, slightly up from the previous year and similar to the number reported in 2011. Between 2006 and 2013, the pattern has been one of decreasing numbers of overdose deaths among younger drug users and increasing numbers among older users.
• Heroin seizures have been declining in Europe since 2010 and the number of seizures (32,000) and quantity seized (5.6 tonnes) in 2013 were among the lowest recorded in a decade.

Cocaine
• Cocaine is the most commonly used illicit stimulant drug in Europe, although most users are found in a small number of countries. It is estimated that about 2.3 million young European adults aged 15 to 34 (1.9% of this age group) used cocaine in the last year.
• Only Spain and the United Kingdom reported last-year prevalence of cocaine use among young adults of more than 3%. Most countries with the highest prevalence rates for cocaine use among young adults over the past few years, have reported a peak in use in 2008 and a steady decline since then.
• Cocaine was the main problem drug for 55,000 clients entering specialised drug treatment in 2013, 15% of all those entering specialised treatment in that year. The number of clients entering treatment for the first time who cited cocaine as their primary drug has been decreasing in recent years, from a peak of 38,000 in 2008 to 25,000 (16%) in 2012. Spain, Italy and the United Kingdom accounted for more than 70% of all those in treatment for cocaine use.
• The United Kingdom accounted for more than half of the 6,000 clients entering treatment in 2013 and citing crack cocaine as their primary drug.
• Across the 27 countries reporting data, at least 800 deaths related to cocaine use were recorded in 2013.
• In 2013, around 78,000 seizures of cocaine were reported in the European Union, amounting to 63 tonnes. There was a significant increase in both seizures and volume between 2008 and 2010, and the situation has been relatively stable since then.
Other stimulants and new psychoactive substances
• While lifetime use of new psychoactive substances (NPS) remains at a low level among young people, the number of new NPS reported continues to grow. These data are based on notifications by member states to the EU Early Warning System (EWS). During 2014 the EWS identified 101 NPS for the first time, an increase of 25% on 2012.
• Of the NPS detected for the first time, 31 were synthetic cathinones and 30 were synthetic cannabinoids. Other substance groups monitored are substituted phenethylamines tryptamines and piperazines. Thirteen newly reported compounds do not conform to the readily recognised chemical groups (including plants and medicines).
• The EWS has identified more than 70 new cathinone derivatives. In 2013, over 10,000 seizures of synthetic cathinones were reported to the EWS, the best known being mephedrone, controlled in Europe since 2010 but becoming increasingly important in the stimulants market in some countries. Cathinones are used in similar ways to, and often interchangeably with, other stimulants such as amphetamine and MDMA.
• Around 1.3 million Europeans used amphetamines during the last year.
• Ecstasy contains the synthetic substance MDMA. It is estimated that 1.8 million young European adults (aged 15–34), 1.4% of this age group, used ecstasy in the last year. Decreasing prevalence of ecstasy use has been reported in all countries that have sufficient data to allow exploration of trends.

Accompanying the European drug report are Perspectives on drugs (PODs), online interactive articles providing insight into specific issues in the drugs field. The four themes in focus this year are misuse of benzodiazepines among high-risk drug users, psychosocial interventions, drug consumption rooms, and heroin trafficking routes.