People who use drugs in Europe are facing new health risks as drug markets evolve rapidly and become more complex. This warning comes from the European Union Drugs Agency (EUDA) in its European Drug Report 2026: Trends and Developments, released today (1).
Based on data from 29 countries (EU-27, Norway and Türkiye), the annual review highlights risks to public health posed by the wide availability and use of an increasingly diverse range of substances, often of high potency or purity. New cannabis products continue to appear, while the variety of opioids and stimulants sold is on the rise. Polysubstance use is also common, with people combining drugs in ways that increase risk and complicate responses. Europe’s ability to address these complex challenges will depend on stronger service-provision systems and sustained investment in prevention, treatment, harm reduction and social reintegration.
New psychoactive substances (NPS) are still being detected at a rate of around one a week. In 2025, 50 NPS were reported for the first time in Europe, bringing the total number monitored by the EUDA to 1 050. Among these are potent new synthetic opioids, which pose an increased risk of life‑threatening poisoning. Vaping or e-cigarette use, involving nicotine-containing products, is now a common feature of substance use among adolescents in Europe (ESPAD, 2024). Vapes containing other substances, such as synthetic and semi-synthetic forms of cannabis, have been seized in EU Member States, raising concerns that they may become a vehicle for other harmful substances, potentially including new synthetic opioids.
Beyond health harms and social vulnerability, the report underlines the continued impact of drug markets on Europe’s security. Drug-related intimidation and violence remain a concern, including the exploitation and recruitment of vulnerable young people by criminal groups to traffic drugs and perpetrate violence.
At the same time, trafficking networks are adapting quickly to enforcement efforts. Following intensified policing operations at major European ports, criminals have diversified their routes and methods to evade detection. They are increasingly using smaller ports, at-sea transfers involving ‘go-fast’ boats and other vessels, as well as semi-submersibles, drones and sophisticated concealment techniques. These developments are making trafficking harder to detect and place greater demands on law enforcement and customs authorities.
The new EU Drugs Strategy and Action Plan against drug trafficking, together with proposed new rules for monitoring and controlling drug precursors, form part of a comprehensive EU response to the evolving drug phenomenon.
Magnus Brunner, European Commissioner for Internal Affairs and Migration says: The European Drug Report reveals the human cost of drug use, with the latest annual figures showing at least 7 600 overdose deaths. We must pull out all the stops to prevent dangerous new products from flooding the market and use the full force of the law to strip illegal traffickers of their business model. With the EU Early Warning System, we are identifying new trends early. Through our Action Plan against drug trafficking, we have given European authorities a clear playbook — and by stepping up international cooperation, we are building a global front to tackle this criminal trade.'
Dr Lorraine Nolan, EUDA Executive Director adds: ‘Drug markets are evolving at speed, with the variety of substances on Europe’s streets becoming ever more unpredictable. This raises the risk: people may be taking high-potency drugs, often without knowing it. Solid facts matter now more than ever. The European Drug Report provides the evidence to ensure that our policymakers, practitioners and communities are well prepared. At the same time, the EUDA is strengthening its monitoring and preparedness systems to better protect Europe’s citizens and support effective responses. A balanced approach is essential, tackling both supply and demand. As well as being grounded in science, it must also be focused on human rights and public health.’
Cannabis: shifting routes, stronger products, new health risks
Illicit cannabis supply routes and trafficking methods are evolving, with increasing amounts of herbal cannabis trafficked from outside Europe, particularly from Canada and the United States, and to a lesser extent, from Thailand. Overproduction, lower prices and strong competition in the North American cannabis market have led to a surplus of cheaper, higher-potency products there. Shipments from Canada to Europe are typically concealed in maritime containers, while those from the United States are most often detected in postal traffic.
Seizures at major ports illustrate the trend. In 2025, authorities intercepted around 21 tonnes of herbal cannabis in each of the ports of Rotterdam and Antwerp, mostly of Canadian origin. Alongside these flows, health concerns are emerging. In 2025, the EUDA issued its first risk communication via the European Drug Alert System on North American cannabis, highlighting risks from potentially hazardous pesticides. This underlines the need for targeted responses and continued international cooperation.
Cannabis is the most widely consumed illicit drug in Europe, with 24.9 million European adults (15–64 years) estimated to have used the drug in the last year. The wider availability of more potent and varied cannabis products is increasing the health risks, making responses more complex. Cannabis accounts for a third (33%) of people entering drug treatment in Europe, representing an estimated 104 000 clients in 2024. Of these, 62 000 entered treatment for the first time. Cannabis, including high-potency products, extracts and edibles, has been linked to emergency hospital presentations. Adulteration of cannabis products with potent synthetic cannabinoids and the wide availability of semi-synthetic cannabinoids increase the risk of harms. Both are sold in vapes and edibles, raising concerns about uptake among new, and possibly younger, consumers.
Cannabis policies continue to evolve in Europe, with some EU Member States having changed, or now reviewing, their approach to cannabis use and supply for recreational purposes. These reforms are at different stages of development and evaluation and vary across countries. Czechia, Germany, Luxembourg and Malta permit limited home cultivation. Germany and Malta also allow non-profit sales to members of regulated growing associations, while the Netherlands is conducting an experiment with cannabis produced in regulated premises sold through coffeeshops. Through its European cannabis policy toolkit, the EUDA will assist policymakers by encouraging comparable monitoring and evaluation of all forms of cannabis control policies.
Opioids: new synthetic opioids threaten public health, while heroin market remains resilient
Opioids, usually in combination with other substances, remain the leading cause of drug-induced deaths in Europe. The EUDA estimates that there were at least 7 600 overdose fatalities in the EU in 2024, mostly involving multiple substances. Opioids other than heroin, including highly potent synthetic opioids, opioid agonist treatment medicines and pain-relief medications, are detected in a substantial share of overdose deaths in some countries.
New synthetic opioids, often highly potent, are raising particular concern, with 95 of them detected in Europe since 2009. In 2025 alone, seven new synthetic opioids were reported to the EU Early Warning System (EWS), including nitazenes and orphines. Fake medicines containing nitazenes, mimicking legitimate prescription medicines such as oxycodone or diazepam, are also increasingly reported to the EWS. More than 50 000 nitazene‑containing tablets were seized in 2024 by 10 countries, up from 23 000 in 2023 (380 in 2022). There are concerns that such tablets may spread among groups without opioid tolerance, including young people. The EUDA coordinates a Network of forensic and toxicological laboratories to increase analytical capacity and provide frontline insights. The agency is currently preparing a threat assessment on emerging new synthetic opioids in Europe, following an assessment on highly potent synthetic opioids in the Baltic countries in 2025.
China’s blanket ban on nitazenes in July 2025 may redirect the market towards alternative opioids. There are increased reports of orphines in Europe. Since 2024, nine new orphines have been identified, with two (cychlorphine and spirochlorphine) now under EU investigation. Between June 2024 and January 2026, 18 deaths linked to orphines were reported.
Deaths related to fentanyl, a highly potent synthetic opioid, underscore the need for vigilance. In Bulgaria, it was linked to over 100 drug-related deaths reported between 2024 and 2025. Improving access to opioid agonist treatment at scale, needle and syringe programmes and take-home naloxone (THN), remains key to addressing current opioid problems and ensuring preparedness and resilience against opioid market shifts. A growing number of countries offer THN programmes (19 European countries in 2025).
Meanwhile, Europe’s heroin market is proving resilient. Advanced processing and adulteration practices, as well as tactical supply management of Afghanistan’s large stockpiles (estimated at around 12 000 tonnes of opium in 2025) by trafficking networks, appear to have provided a buffer to the sharp decline in poppy cultivation and opium production that followed the Taliban ban in 2022. Production is also shifting elsewhere. Pakistan has emerged as a source of opium and heroin, with over 9 000 hectares of opium poppy cultivation in 2025, rivalling Afghanistan’s output. In Asia, Myanmar’s opium poppy cultivation reached a 10-year peak of more than 45 000 hectares in 2025.
Cocaine: rising harms, crack use and shifting trafficking tactics
Today’s report shows that cocaine use remains high across Europe, with around 4.3 million European adults (15–64 years) having used it in the last year. Cocaine’s geographical reach is also growing, as are its harms. Latest municipal wastewater analyses show that, of the 85 cities with data for both 2024 and 2025, 48 (57%) reported an increase in cocaine residues. The number of people entering treatment for cocaine problems continues to rise. Cocaine was the second most common illicit drug among first-time entrants to specialised drug treatment in 2024, cited by an estimated 37 000 clients (up by 39% since 2018). Overall, 74 000 people entering treatment cited cocaine as their primary drug.
In 2024, available data from 20 countries suggested that the drug was involved in over a quarter (27%) of drug-induced deaths. Cocaine also remained the most commonly reported substance in presentations to sentinel hospital emergency services, mentioned in 26% of cases. High-risk patterns of cocaine use, including injecting and use alongside opioids, are reported by syringe residue analysis programmes and drug consumption rooms.
Crack cocaine is adding to concerns. It is a visible and potentially growing problem in several European cities, particularly among marginalised groups. This may be driven by high cocaine availability and the ease of local conversion from powder cocaine. In 2024, an estimated 11 400 people entered treatment for crack-related problems (up from 9 900 in 2023) — 4 300 were first-time entrants. Crack cocaine use is placing increasing strain on harm reduction and treatment providers as they respond to the needs of a group experiencing serious health and social problems. Treatment for cocaine problems remains centred on psychosocial interventions, while research continues into potential pharmacological treatments (e.g. the #ScaleUp project). The EUDA Threat Assessment System is currently investigating a potential increase in crack cocaine use and harms.
After years of record seizures, the volume of cocaine intercepted in Europe fell to 330 tonnes in 2024, down from 419 tonnes in 2023. The number of seizures, however, rose to 97 000 (95 000 in 2023), suggesting that traffickers may be moving towards smaller, more fragmented consignments to avoid detection. While bulk shipments through seaports sustain high availability, there are signs that trafficking routes and methods are diversifying. There are more reports of smaller ports being exploited, alongside more sophisticated concealment methods and at-sea transfers.
Illicit processing of cocaine products also takes place inside Europe, mainly in the Netherlands. In 2024, six EU Member States dismantled at least 42 sites related to cocaine production (34 in 2023). These included facilities for the secondary extraction of cocaine chemically concealed in other materials, such as plastics. Overall, customs and law enforcement authorities are facing increasingly complex challenges, calling for stronger inter-agency and cross-border collaborations and partnerships.
Ketamine: growing health risks, as drug increasingly diverted onto illicit market
Ketamine, which is an essential medicine used for anaesthesia and pain relief, is now increasingly misused as a psychoactive substance in Europe. While overall consumption remains relatively low, it is becoming more common in some youth and nightlife settings, where it is typically snorted in powder form. Health risks range from acute poisoning to chronic harms, such as serious bladder damage linked to intensive use.
Multiple indicators suggest that ketamine is becoming more embedded in Europe’s drug landscape. In 2024, 14% of respondents to the European Web Survey on Drugs, who had used drugs in the past year, reported ketamine use, typically alongside alcohol or other drugs (e.g. MDMA). The latest European analysis of municipal wastewater showed that ketamine residues increased in 40 of the 66 cities with data available for 2024 and 2025.
Health services are beginning to feel the impact. Although the number of people entering specialised treatment for ketamine-related problems is still low, it has quadrupled in recent years, rising from 413 cases in 2019 to 1 796 in 2024. Most cases are reported by six EU Member States, likely reflecting a longer history of availability and higher illicit ketamine use in some parts of Europe. Treatment availability remains uneven in Europe, underlining the need for appropriate services and targeted prevention and risk communication for those who may be unaware of the health risks.
Most ketamine seized on the illicit drug market in Europe originates from legitimate pharmaceutical production, particularly in India. It is legally imported into the EU, mainly via Germany, before being diverted into illicit channels (see EUDA study). This convergence of legal supply chains and illicit distribution is adding to the challenge for public health, regulators and law enforcement.
Chair of the EUDA Management Board, Dr Franz Pietsch concludes: ‘The European Drug Report provides an annual window on Europe’s drug phenomenon and a valuable foundation for informing policy and responses. For over 30 years, it has supported policymakers and practitioners with robust and evidence-based analysis to guide their decision-making. As the drug landscape evolves, the report not only offers insights for the actions we take today but also helps shape the responses of tomorrow. This edition highlights how the EUDA is providing added value to EU Member States and strengthening our preparedness in this field, by focusing on scientific research and enhanced risk assessment.’
