Understanding substance use trends is vital to quickly respond to and reduce associated risks. This study contributes to such knowledge by qualitatively exploring drug use trends across 20 European cities between July 2024 and July 2025. It uses focus group discussions conducted with key informants who are directly or indirectly engaged in the dynamics of local drug markets, including people who use drugs. This approach permits the identification of emerging developments that may not yet appear in quantitative datasets, while providing rapid insights into changes in local drug landscapes.

Global and regional monitoring systems provide us with a good overview of the most prevalent used substances and those in decline. However, the European Drug Report notes that current monitoring systems often struggle to capture patterns and trends related to less well-known substances, making it difficult to assess their prevalence and harms with confidence2. Although the findings in this report cannot offer a representation of the European situation, they can help fill this gap by offering grounded perspectives on how the popularity and use of such substances are perceived locally.

The present report aims to complement existing monitoring systems by providing in-depth qualitative insights into trends and dynamics that shape drug markets at the city level. Cities are at the forefront of developing and implementing innovative health, social and drug policy responses and are where both problems emerge and solutions are found. A city-level monitoring offers a more nuanced perspective by producing situated data for local policy planning and implementation...