The European Drug Report launched by EMCDDA points out the emerging challenges posed by new substances and changes in patterns of use
“Europe faces a growing problem with drugs. New psychoactive substances, stimulants, heroin and other opioids continue to be in high demand and supply, with major impacts on public health (…)”
Dimitris Avramopoulos, European Commissioner for Migration, Home Affairs and Citizenship
The Return of MDMA
The report confirms the return of MDMA (often sold as ‘ecstasy’) as a stimulant drug of choice for young people in Europe: while, until recently, MDMA use had been in decline, latest survey data point to increased use in Europe. There are also signs that MDMA is no longer a niche or sub-cultural drug used in dance clubs, but is now being used by a wider range of young people in more mainstream nightlife settings, such as bars and parties.
Powders, crystals and tablets containing high doses of MDMA are now more commonly available, with tablets sometimes promoted through sophisticated and targeted marketing techniques. This is thought to be a deliberate strategy by producers to boost the reputation of MDMA, after a period in which poor-quality products and adulteration resulted in a decline in use.
New Drugs: New Harms
The number, type and availability of new psychoactive substances (NPS) on the European market continue to grow, with over 560 NPS now monitored by the agency. In 2015, 98 new substances were reported for the first time (vs 101 in 2014), the list being dominated by synthetic cannabinoids and synthetic cathinones – sold as ‘legal’ replacements for marijuana and for amphetamine/cocaine, respectively.
Responding effectively and rapidly to the sale of NPS, some of which are found to be highly toxic, is a major challenge. ‘Young consumers may unwittingly be acting as human guinea pigs for substances for which the potential health risks are largely unknown’, states the report. Both synthetic cannabinoids and cathinones have been associated with hundreds of acute intoxications and over 100 deaths since 2011. Lastly, the report points out the growing number of new synthetic opioids detected, such as fentanyl, or fentanyl-like products, a highly potent opioid which poses a serious risk of overdose – in 2015, 32 deaths were related to the synthetic opioid acetylfentanyl.
Rise in Overdose Deaths
At least 6,800 overdose deaths, mainly related to heroin and other opioids, are estimated to have occurred in the EU in 2014 (slightly up to the previous year’s figure), while worrying rises have been reported in countries with long-established opioid problems, such as Ireland, Sweden and the UK. The reason behind these rises remain unclear, but a number of factors may be involved, including: increased heroin availability, higher purity, ageing users and changing consumption patterns, including the use of synthetic opioids and medicines.
While heroin remains the most commonly used opioid, synthetic opioids are increasingly misused and there has been a rise in the number of countries reporting synthetic opioids as the primary drug used by those entering treatment.
Cannabis: Rises in Use, Potency and Demand for Treatment
An estimated 16.6 million young Europeans (15 – 34) have used cannabis in the last 12 months. While levels of use differ between countries, overall in Europe they do not appear to be falling and there are signs of some rises. The health and social costs of cannabis use are most pronounced among frequent or long-term users (around 1% of European adults). Potency levels of herbal cannabis and resin are high by historical standards, which may increase the risks of use.
The number of those entering treatment for the first time for cannabis problems increased from 45 thousand in 2006 to 69 thousand in 2014. This rise in demand for treatment has been linked to a number of factors, including changing levels of use and intensive use, availability of more harmful products, different referral practices and greater availability of treatment services.
In the last decade, Europe has seen a 50% rise in the number of clients entering treatment for the first time, with amphetamines as their primary drug. In addition, despite drug injecting having declined in Europe overall, stimulant injecting is now a concern with nearly half of new clients in treatment reporting injection as their main route of administration.
Cocaine remains the most commonly used illicit stimulant drug in Europe, with around 2.4 million young adults (15–34 years) reporting to have used it in the last year.