There are ongoing concerns among policymakers, law enforcement, and civil society organisations (CSOs) about the emergence of New Psychoactive Substances (NPS) in general (European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2023; United Nations Office on Drugs and Crime (UNODC), 2023a), about the appearance of NPS in more traditional illicit substances available in global and European markets, and about the emergence of new drug trends in general. International agencies continue to warn about the potential health risks (such as overdose) associated with illicit substances, including synthetic opioids. CSOs, particularly those working closely with people who use drugs, play a pivotal role in notifying signals of change with respect to the use of new substances, changing patterns of drug use, or in changes in local drug markets. This calls for new approaches to rapidly update data on drug trends that include qualitative data provided by people who use drugs and by experts who are in contact with people who use drugs. Data from CSOs are considered complementary to other sources, providing useful intelligence on emerging drug trends. This report aims to explore the latest insights with respect to the emergence of new illicit substances in cities where Focal Points (FPs) of Correlation – European Harm Reduction Network (C-EHRN)1are located, as well as other developments in drug use patterns, including polydrug use, routes of administration, and changes in local drug markets.The focus extends beyond NPS to allow for afull understanding of current local drug market developments.