The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published the European drug report 2022: trends and developments on 14 June 2022. The purpose of this report is to provide an overview and summary of the European drug situation up to the end of 2021. 

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

• A rapid bounce back of drug supply and use following disruption during COVID-19.
• Drug availability and use remain at high levels across the EU, and potent and hazardous substances are still appearing.
• Drug treatment and other services are returning to normal after the COVID-19 restrictions.
• Cannabis products are becoming increasingly diverse and the production of synthetic drugs within Europe is on the rise.

Minister of State with responsibility for the National Drugs Strategy, Frank Feighan TD said, ‘I welcome the publication of the European Drug Report 2021. Drug use effects all in society; it impacts not only the person who uses drugs, but also their loved ones and their wider community. A coordinated approach is required, which is why the EU Drugs Strategy and Action Plan will be critical in the years to come.’

EMCDDA Director Alexis Goosdeel says: ‘This report arrives at a time when major global events are touching upon all areas of our lives. Through its analysis of current trends and emerging threats, the report explores how these developments may influence drug problems in Europe in the future. I firmly believe that we can only address the complex policy issues in the drugs field if we base our responses on a balanced and evidence-based understanding of the problem.’

Hazardous new psychoactive substances

New psychoactive substances (NPS) continue to appear in Europe at the rate of one per week, posing a public health challenge. In 2021, 52 New psychoactive substances (NPS) were reported for the first time through the EU Early Warning System (EWS), bringing the total number of NPS monitored by the EMCDDA to 880. In 2021, 15 new synthetic opioids, 6 synthetic cathinones and 6 new synthetic cannabinoids were reported for the first time.  

Drug problems in Europe can be influenced by developments occurring internationally. Despite the 2022 Taliban ban on the production, sale and trafficking of illicit drugs in Afghanistan, poppy cultivation appears to continue. Following controls on synthetic cathinones in China, most bulk quantities of these substances trafficked to Europe in 2020 originated in India, reflecting market adaptation to legal controls and supply disruptions. 

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 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.

Minister Feighan commented, ‘The European Drug Report highlights a variety of challenges, including those in relation to new psychoactive substances. Strengthening harm reduction responses to high-risk drug use is an important action within our national drugs strategy. The Department of Health and the HSE have developed a pilot drug monitoring programme to be delivered by the HSE at selected music festivals, as a public health response to the harms of drug use in nightlife environments. These proposals are currently being reviewed by An Garda Síochána and I look forward to working with a variety of stakeholders to progress this important work.’ 

Minister Feighan continued, ‘As part of the national drugs strategy, a new strategic implementation group has been set up to focus and drive Prevention, Education and Awareness to build skills and confidence in young people and encourage healthy choices and behaviour. I will soon be announcing a Prevention and Education funding programme to encourage the development of evidence-based prevention measures.’

A comparison of the Irish drug situation with Europe

  Cocaine

The availability and use of cocaine in Europe remains high, and reports indicate that crack cocaine use may be increasing among vulnerable drug users. A record 213 tonnes of cocaine was seized in the EU in 2020 and 23 laboratories were dismantled.

  European situation

• In the European Union, surveys indicate that nearly 2.2 million 15-34-year-olds (2.2 % of this age group) used cocaine in the last year.
• In 2020, 14,000 people entering treatment for the first time, sought treatment for cocaine use. At 15%, this was the second most common problem drug for first-time entries.
• In 2020, there were 7,500 entries to treatment for crack cocaine use, with just five EU countries accounting for 90% of the total treatment cases.
• Cocaine, mostly in the presence of opioids, was implicated in 13.4% of drug poisoning deaths in Europe in 2022.
• The purity of cocaine has been on an upward trend over the past decade, and in 2019 reached a level 57 % higher than the index year of 2009, while the retail price of cocaine has remained stable.

Irish comparison

• In Ireland the most recent NDAS in 2019-20 shows that 4.7 per cent of 15–34-year-olds used cocaine in the last year.
• In 2021, for the first time, there were more cases of treatment for cocaine as a main problem drug (3,248 or 30% of total treatment cases) than heroin (3,168).
• In 2021, the 1,359 new entrants into treatment reporting cocaine as the main problem.  This represents 38% of all new entrants into treatment.
• Cocaine was implicated in 53 deaths in Ireland in 2017, an increase of 26% on the 2016 figure.
• Forensic Science Ireland recorded 1,994 seizures of cocaine in Ireland in 2020, the second most prominent drug in quantities seized after cannabis.
• 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. European analysis reports increased trafficking routes, supply, seizures, and seizure volumes during this time period, ultimately leading to an increase in cocaine content for users. 

Cannabis

Developments in the cannabis area are creating new challenges for policy makers and services responding to its use. Cannabis products are becoming increasingly diverse, including extracts and edibles (high THC content) and CBD products (low THC content). In 2020, the average THC content of cannabis resin was 21%, almost twice that of cannabis herb (11%), reversing the trend seen in recent years, when herbal cannabis was typically of higher potency. 

European situation

• Cannabis is most used illicit drug in Europe, across all age groups.
• The EMCDDA estimates last year cannabis use among EU inhabitants aged 15-34 is at 15.5 %.
• Among EU inhabitants aged 15-24, an estimated 19.1% (9.0 million) used the drug in the last year and 10.4% (4.9 million) in the last month.
• In 2020, around 80,000 people entered specialised drug treatment in Europe for problems related to cannabis use (35% of all treatment demands); of those, about 43,000 were entering treatment for the first time.

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 2019 ESPAD survey reported that 16% of Irish secondary school students (aged 15–16) had used cannabis in the last 12 months (recent use).
• Cannabis was the main problem drug for 2,262 of cases (21% of all cases) entering drug treatment in Ireland in 2021.

Opioids (mainly heroin)

While heroin injecting is in decline, there are concerns around the injecting of a broader range of substances, including amphetamines, cocaine, synthetic cathinones, prescribed opioids and other medicines. Drug-induced deaths continue to be driven by opioids and other drugs. An estimated 5,800 overdose deaths, involving illicit drugs, occurred in the EU in 2020. Most of these fatalities were associated with polydrug toxicity, which typically involves combinations of illicit opioids, other illicit drugs, medicines, and alcohol. 

European situation

• There were an estimated one million high-risk opioid users in Europe in 2020.
• In 2020, use of opioids was reported as the main reason for entering specialised drug treatment by 66,000 clients, or 28% of all those entering drug treatment in Europe. Of these, almost 11,200 were first-time entrants.
• Toxicology reports from suspected drug-induced deaths reported that opioids were found in an estimated 74% of fatal overdoses reported in the European Union, often in combination with other drugs.

Irish comparison

• The proportion of all entrants to treatment reporting an opioid as their main problem drug has decreased year on year since 2004, from a peak of 65% in 2004 to 34% in 2021.
• In 2021, of those entering treatment for opioid use, 90% had heroin as the main problem drug.
• In 2017 there were 77 deaths where heroin was implicated, compared to 74 in 2016.  Fentanyl was implicated in seven poisoning deaths in 2017, the same as in 2015 and 2016. 

New psychoactive substances and stimulants European situation

• At the end of 2021, the EMCDDA was monitoring around 880 new psychoactive substances, 52 of which were first reported in Europe in 2020.
• A total of 224 new synthetic cannabinoids have been detected in Europe since 2008.
• In 2021, 15 new synthetic opioids, six synthetic cathinones and six new synthetic cannabinoids were reported for the first time.
• The 73 new synthetic opioids detected between 2009 and 2021 include six first reported in 2021.
• Surveys in European countries show that 1.9 million young adults (aged 15-34 years) used MDMA in the last year (1.9 % of this age group). Prevalence estimates for those aged 15-24 years are higher, with 2.2 % (1.0 million) estimated to have used MDMA in the last year.

Irish comparison

• The 2019/20 National Drug and Alcohol Survey reported last-year prevalence of MDMA of 6.5% for young adults (aged 15-34 years). 1.9% of young adults had taken a new psychoactive substances in the past year.
• MDMA (alone or with other drugs) was implicated in 14 poisoning deaths in 2017, up from eight in 2016.
• Benzodiazepines were the main problem drug for 11% of cases entering treatment in 2021, an increase from 9% of cases in 2015.