Source data for European Drug Emergencies Network (Euro-DEN Plus) data explorer 2025 update

This data is collected by hospitals participating in the European Drug Emergencies Network (Euro-DEN — Euro-DEN Plus)  project and is used in the data exlorer on the page: European Drug Emergencies Network (Euro-DEN Plus): data and analysis.

The Euro-DEN — Euro-DEN Plus projects involves the collection of data on emergency department presentations with acute drug toxicity in participating countries in Europe. The project aims to provide detailed information on the nature and extent of harm associated with the use of drugs.

Notes for this data:

• A selection of the data presented here are from beneficiaries of the IPA8 technical cooperation project and the EU4Monitoring Drugs II technical cooperation project; which are both financed by the European Union
• Palestine*: This designation shall not be construed as recognition of a State of Palestine and is without prejudice to the individual positions of the Member States on this issue.

For additional methodological information, please see Frequently asked questions (FAQ) on acute drug toxicity presentations to hospital emergency services.

For data and analysis of this data set, please see European Drug Emergencies Network (Euro-DEN Plus): data and analysis.

Limitations and footnotes

There are important methodological limitations to consider when interpreting this data set.

• A hospital within a city is not necessarily representative of the city, the region or the country. Local factors such as proximity to high concentrations of night-time economy venues or social deprivation may have an impact on the types of presentations seen in the sentinel centre.
• The emergency services participating in the project are mostly based in hospitals for adults. Therefore, they rarely or do not see paediatric cases of acute drug toxicity. Other surveillance would be necessary to monitor the real burden and trends in acute drug toxicity among children and adolescents.
• The data are mostly self-reported and based on the clinician’s report, rather than analytically confirmed.
• For most cases, more than one drug is reported; thus, the effect of a particular drug in this context is difficult to assess.
• Presentations with lone alcohol toxicity (without drugs) are known to be more common than drug toxicity presentations. However, presentations with lone alcohol toxicity are not collected by Euro-DEN Plus. Therefore, the mention of alcohol in this data set is an underestimate of the overall number of presentations to emergency departments with alcohol involved. Furthermore, in this data set, the completeness of the reporting of alcohol varies. Thus, these numbers are minimum estimates.
• The dataset consists of reports of presentations rather than patients. It may include repeat admissions of the same patient and, therefore, the observations may not be fully independent. No information is collected to flag and count whether a person has presented in the past. If there are factors that predispose patients to present repeatedly, such patients will be over-represented in the sample of presentations.
• Numbers of cases are small in some hospitals. Therefore, caution should be exercised in the interpretation of percentages, the interpretation of changes and comparisons over time and across centres.
• We define a change in the number of presentations for a given drug as an increase or decrease of at least 10% compared with the previous year. Centres not registering increases or decreases of at least 10% are reported as stable.
• A small number of centres account for a large portion of the overall data, and this should be kept in mind when interpreting the overall data. Local analysis is more informative than the global analysis.
• This monitoring is based on hospital emergency services and provides information only on presentations to these settings. Other acute drug toxicity episodes that do not result in hospital emergency presentations are not captured. Presenting to emergency services may depend on the severity of the adverse effects, but also on the organisation of pre-hospital care and referrals to hospitals in the country.
• The 2024 data collection was incomplete for the centres in Antwerp and Dublin. For 2024, the centre in Tenerife provided data for only 5 months.
• The centres in the Western Balkans and Southern Neighborhood countries (project funded by the European Union under EUDA-implemented technical cooperation projects EU4MD II  and IPA8) provided data in 2024 only for 6 months (July-December).
• Centres with fewer than 12 presentations are not shown in the explorer. For reasons of data protection, we do not show subgroups of 5 or fewer individuals in the age and sex pyramids (Figure 1).