Background and introduction: While evidence from drug treatment centres suggests that injecting drug use is declining among heroin clients in the European Union, the risk of overdose death and infectious diseases associated with this mode of administration remains high for the estimated 500,000 people who inject drugs. Reliable information on the substances that are being injected is necessary to guide prevention strategies and plan the provision of harm reduction interventions. 

Objective: ESCAPE – the European Syringe Collection and Analysis Project Enterprise – aims to identify the range of substances being used by people who inject drugs in a sentinel network of cities in the European Union and neighbouring countries, and to monitor changes in patterns of use over time. The city-level data it provides can complement other information and indicators on drug consumption and potential emerging health threats in the region.

Method: Each year since 2017, city-level study teams aim to collect at least 150 used syringes from low-threshold harm reduction services. After extraction of the syringe contents, samples are analysed in participating laboratories, using either targeted or non-targeted screening methods. The primary indicator shown here (in the data explorer) is the percentage of syringes testing positive, by drug category, by city and by year. The denominator is the number of syringes testing positive for at least one drug category, as defined in the generic protocol (link). Other indicators of interest include the percentage of syringes containing two or more drug categories, and the most frequent combinations detected. Detailed information on the network’s methodology can be found in the ESCAPE generic protocol.

On the EUDA webpage use the filters at the top of the map/graphs to view data by city, year and drug category. Click on a bubble or select a location from the city drop-down list to view results from the 2024 campaign.