Since the start of 2020, European countries have been experiencing an unprecedented public health threat with the emergence of the coronavirus disease (COVID-19). In order to investigate the effects and implications of this pandemic for people who use drugs in Europe, the EMCDDA instigated a mixed-method trendspotter study to investigate the current situation. This briefing provides a snapshot of the state of play with respect to the impact of COVID-19 on drug consumption patterns and drug-related harms during the early stages of the pandemic.

Preliminary findings suggest an overall decline in drug use, or some forms of drug use, in Europe during the first 3 months of the pandemic.

▪ A combination of factors could explain this, notably national confinement measures, which have reduced opportunities to use drugs within social environments, and the disruption of street drug markets, resulting in a decline in the availability of some substances.

▪ The use of cocaine and MDMA appears to have been most affected, largely linked to the closure of the night-time economy and the implementation of stay-at-home measures. Decreases in the use of these drugs have been confirmed by wastewater studies in a number

▪ A more mixed picture is reported with respect to cannabis. The data available here suggest that some occasional users may have stopped using or reduced their use during the lockdown period, while those who had more frequent or intensive patterns of use may have increased their consumption. The relief of both boredom and anxiety were cited as reasons for increased use by respondents to the European web survey. Increases in the online search interest were observed for some terms such as ‘buy cannabis’, ‘seeds’ and ‘growing cannabis’, and ‘cannabis home delivery’ in various European countries during the period.

▪ Localised shortages of heroin have also been reported and may have contributed to reductions in the use of this drug in some countries. Among dependent opioid users, this is reported in some cases to have resulted in an increase in the use of replacement substances. It has also been associated with an increase in attempts to access opioid substitution treatment services in some countries.

▪ More generally, an increase in alcohol consumption has been reported, alongside an increase in the use of prescription medicines, especially benzodiazepines, among some groups. This may in part be explained by users wishing to combat the anxiety experienced in response to the COVID-19 pandemic and the resulting lockdown measures.

▪ An important caveat here is that the situation at national level appears to be heterogeneous and variable by drug type. For example, wastewater data from Finland and a city monitor in Norway suggest that amphetamine use increased during the early months of 2020.

▪ Bearing in mind that there has been an overall reduction in health service provision during the period, in particular for non-COVID-19-related issues, clinicians in a number of countries have highlighted increases in emergency presentations for mental health problems, but drops in those associated with illicit drug consumption.

▪ In conclusion, the data currently available suggest that there have been some changes in drug consumption patterns during the initial phases of the COVID-19 pandemic in Europe, mostly resulting from the implementation of confinement and social distancing measures. There is an urgent need to continue to monitor developments in this area closely — especially with respect to the establishment of particularly damaging or risky patterns of use.