New psychoactive substances – the current situation in Europe (European Drug Report 2023)

Cover of the European Drug Report 2023 NPS

The market for new psychoactive substances is characterised by the large number of substances that have appeared in this area and that new compounds continue to be detected each year. On this page, you can find an overview of the drug situation for new psychoactive substances in Europe, supported by seizure data and information from the EU Early Warning System on substances detected for the first time in Europe. New substances mentioned include synthetic cannabinoids, hexahydrocannabinol, synthetic cathinones, new synthetic opioids, benzimidazole opioids. 

This page is part of the European Drug Report 2023, the EMCDDA's annual overview of the drug situation in Europe.

Last update: 16 June 2023

Health concerns over highly potent substances, continued market adaptation and increasing seizures 

The market for new psychoactive substances is characterised by the large number of substances that have appeared in this area and that new compounds continue to be detected each year. The term ‘new psychoactive substances’ covers a broad range of substance types that are not controlled by international drug control agreements, although some of them may be subject to national regulatory measures. In 2021, a record 8.5 tonnes of new psychoactive substances was seized by EU Member States (see the figure Seizures of new psychoactive substances in the European Union: number of seizures and quantity seized, 2005–2021). Drug producers continue to create new substances to avoid legal controls. The risks to health of these novel compounds are usually unknown, potentially exposing consumers to the risk of serious or even fatal poisonings or other health problems. Legislative controls in Europe and non-EU source countries appear to have contributed to a reduction in the number of new derivatives of some drugs, such as fentanyl. Other substances, however, designed to evade generic definitions in legislation, continue to emerge, with China and India remaining important source countries for these substances or the precursors that are required to produce them.

The 24 new cannabinoids detected accounted for over half of the new substances first reported to the EU Early Warning System in 2022 (see the figure Number of new psychoactive substances reported for the first time to the EU Early Warning System, by category, 2005–2022). The diversity seen in this area may reflect attempts by illicit drug producers to circumvent China’s 2021 class-wide ban on synthetic cannabinoids.

Figure. Number of new psychoactive substances reported for the first time to the EU Early Warning System, by category, 2005–2022
 

There is a growing concern that consumers of cannabis may be at risk of inadvertent exposure to synthetic cannabinoids. In 2021, there was an overall increase in reports of herbal material where THC or other natural cannabinoids were found alongside synthetic cannabinoids, with at least 13 European countries, mostly Germany and Sweden, reporting such cases. It is possible that such adulterated products are more widely available but go undetected. Adulterated cannabis appears similar in appearance to natural cannabis and can be mis-sold as cannabis to unsuspecting consumers. Synthetic cannabinoids are highly potent substances, and adulterated products carry poisoning risks. An additional concern is that cannabis edibles (foods, often in the form of ‘sweets’ that are typically infused with cannabis extract) have become more apparent on the illicit European market since 2021. In addition to the risks that these products pose because of their THC content and the possibility that they may be mistaken for legitimate commercial products, especially by children, there are concerns that some of these products may contain synthetic cannabinoids.

New regulatory challenges and concerns have emerged  about the potential for interaction between the commercialisation of cannabis derivatives and the recreational drug market. In 2022, the appearance of new semi-synthetic cannabinoids reflected these concerns. Hexahydrocannabinol (HHC) was identified in May 2022 and had been reported by 20 EU Member States by March 2023. Three other semi-synthetic cannabinoids, HHC acetate, hexahydrocannabiphorol and tetrahydrocannabidiol, have also been identified on the European drug market. It appears likely that these substances are being produced from cannabidiol extracted from low-THC cannabis. Marketed online and in shops as ‘legal’ replacements for cannabis, they include hemp sprayed or mixed with HHC, which looks and smells like natural cannabis, as well as vapes and edibles. The effects of HHC in humans have not been studied, but anecdotal consumer reports suggest they may be subjectively similar to those of cannabis. However, some of the products are available in forms that may deliver high doses, raising concerns about the possible implications for public health of the availability of these substances.

Synthetic cathinones and new synthetic opioids are relatively well-established in some European drug markets. They are sold as replacements for stimulants such as amphetamine or opioids such as heroin, respectively. In 2022, large quantities of cathinones such as 3-MMC and 3-CMC continued to be seized. Although seizure numbers remain small, the very large quantities of cathinones found in some individual seizures, mostly trafficked from India, suggest that these substances have the potential to play a bigger role in Europe’s stimulant market. These concerns are further heightened by information suggesting that cathinones are increasingly being produced in Europe, with greater sophistication. Developments in this area include the detection of chemically masked non-controlled forms (N-acetyl-3-MMC) being trafficked into Europe for local conversion into the controlled cathinone 3-MMC. While information from indicators such as drug checking services suggests that MDMA products are less subject to adulteration than other illicit drugs they screened in 2021, the adulteration of MDMA products with synthetic cathinones may also increase the risk of unknown effects and potential harms. In 2022, signals of a possible increase in synthetic cathinones mis-sold as MDMA or used to adulterate MDMA were reported to the EU Early Warning System. While the overall scale of this issue is unknown, it has been reported by drug checking services in at least three EU Member States, including Spain, the Netherlands and Austria. The affected products included ecstasy tablets, crystals and powders, typically containing 4-CMC (clephedrone), 3-MMC, 4-MMC (mephedrone) and dipentylone.

Although only one new synthetic opioid was formally notified in 2022, recent signals, mostly from Baltic countries, suggest increased availability and harms (including drug-induced deaths) linked to these substances, particularly the fentanyl derivative carfentanil and the highly potent group of benzimidazole opioids, which includes drugs such as isotonitazene, protonitazene and metonitazene. The benzimidazole opioids emerged following control measures, introduced both in producer countries and elsewhere, to reduce the availability of fentanyl derivatives, including carfentanil. Synthetic opioids are often highly potent, meaning a small amount can be sufficient to produce a large number of typical street doses and can pose an increased risk of life-threatening poisoning. Synthetic opioids have been linked to drug-induced deaths, with recent reports from Estonia and Lithuania indicating that these drugs now account for a significant share of overdose deaths in these countries. New preliminary data from 2023 suggest that mortality linked to benzimidazole opioids is being increasingly detected in Latvia and this represents a worrying development. In 2022, the Estonian police reported seizing mixtures containing the new synthetic opioid metonitazene and bromazolam, a new benzodiazepine, and mixtures containing the new opioids protonitazene and metonitazene and the animal sedative and analgesic xylazine. These mixtures, respectively known as ‘benzo-dope’ and ‘tranq-dope’ have been linked to increases in overdose deaths in Canada and the United States. There is a need to consider and further investigate what harm reduction and prevention measures are effective in reducing mortality risks associated with the use of synthetic opioids. For example, it has been suggested that approaches to providing the opioid antagonist naloxone need to be adapted to respond more effectively to the health risks posed by synthetic opioids.

Key data and trends

New psychoactive substances reported

Figure. Number of new psychoactive substances reported each year following their first detection in the European Union, by category, 2005–2021
 
Figure. Number of opioids reported for the first time to the EU Early Warning System, 2009–2022
 

Seizures of new psychoactive substances

  • In 2021, seizures of low-THC herbal cannabis material containing synthetic cannabinoids amounted to 242 kilograms (37 kilograms in 2020; 200 grams in 2019). The samples were variously reported as ‘hemp’ or ‘cannabis’ or containing THC, CBD or CBG. In addition, seizures of 12 kilograms of cannabis resin were reported as ‘CBD hash’.
  • In 2021, EU Member States accounted for almost 29 400 of the 59 620 seizures of new psychoactive substances reported in the European Union, Norway and Türkiye, amounting to 8.5 of the 10.8 tonnes seized. The increase was driven by a small number of large seizures of cathinones (3-CMC, 3-MMC,4-CMC), as well as ketamine and GBL (see the figure Seizures of new psychoactive substances in the European Union: number of seizures and quantity seized, 2005–2021). In addition, 23 634 litres of liquids containing new psychoactive substances were seized, mainly GBL (21 455 litres) and 4-CMC (1 228 litres).
  • In 2021, just 5 substances accounted for over 80 % of the quantity of new psychoactive substances seized in EU countries: 3 cathinones (3-CMC, 3-MMC and 4-CMC, amounting to 4.0 tonnes), ketamine (0.9 tonnes) and GBL (2.0 tonnes) (see the figure Seizures of new psychoactive substances in the European Union: quantity seized, by substance, 2021).
  • In 2021, 740 seizures of new opioids were reported to the EU Early Warning System, with 45 % containing carfentanil and 22 % containing isotonitazene. A total of 8.2 kilograms of material was seized, with 59 % (4.9 kilograms) containing carfentanil and 23 % (1.9 kilograms) containing isotonitazene. Most of the seizures occurred in northern Europe, with Estonia, Latvia, Lithuania and Poland reporting 97 % of the seizures and 86 % (7.1 kilograms) of the quantity seized.
Figure. Seizures of new psychoactive substances in the European Union: number of seizures, 2005–2021
 
Figure. Seizures of new psychoactive substances in the European Union: quantity seized, 2005–2021
 
Figure. Seizures of new psychoactive substances in the European Union: quantity seized, by substance, 2021
 

Based on all physical forms expressed in kilograms.

Prevalence of new psychoactive substances use

  • National estimates of last year use of new psychoactive substances (excluding ketamine and GHB) among young adults (aged 15 to 34) range from 0.1 % in Latvia to 5.1 % in Romania. Among 15- to 16-year-old schoolchildren, the most recent European survey (see ESPAD 2019), from 2019, estimated that lifetime use of new psychoactive substances ranged from 0.9 % to 6.6 %, with lifetime use ranging from 1.1 % to 5.2 % for synthetic cannabinoids and 0.2 % to 2.5 % for synthetic cathinones.

Hospital presentations related to new psychoactive substances

  • In 2021, 3-MMC was reported in 68 acute drug toxicity presentations in 5 Euro-DEN Plus hospitals.

Source data

The data used to generate infographics and charts on this page may be found below.

List of tables

Table 1. Number of new psychoactive substances reported for the first time to the EU Early Warning System, by category, 2005–2022
Year Cathinones Cannabinoids Opioids Benzodiazepines Aminoindanes Arylalkylamines Arylcyclohexylamines Other substances Phenethylamines Piperazines Piperidines & pyrrolidines Tryptamines Plants and extracts
2005 1         1     3 2   6  
2006         1 1     2 3      
2007       1   2     3 2 1 2 3
2008 6 1           1 1     1 3
2009 4 6 1         2 5   1 2  
2010 14 11     1 3 2 3 3 1 1 1 1
2011 7 23   1 1 5 1 4 4   2    
2012 4 31 3 1   5 3 8 14 1   4  
2013 8 29 4 2 1 6 1 13 14 1 1 1  
2014 31 30 4 4   4   14 9     5  
2015 26 24 4 5   4 2 12 9 3 6 3  
2016 14 11 9 6   3 6 10 5   1 1  
2017 12 10 13 3   1 1 4 4   1 2  
2018 8 11 11 5   1 1 9 5     4  
2019 10 8 8 2   1   13 3 2 1 5  
2020 8 11 10   1 4 3 4       5  
2021 6 15 6 3     5 9 4     4  
2022 5 24 1 2   1 2 3 1 1   1  
Table 2. Number of new psychoactive substances reported each year following their first detection in the European Union, by category, 2005–2021
Year Cathinones Cannabinoids Tryptamines Benzodiazepines Aminoindanes Arylalkylamines Arylcyclohexylamines Opioids Other substances Phenethylamines Piperazine derivates Piperidines and Pyrrolidines Plants and extracts
2005 1 0 13 1 0 1 1   4 8 3   1
2006   0 8 1 1 3 2   3 10 4    
2007 2 0 16 1 1 2 1   4 12 8 1 4
2008 7 2 9 1 0 2 2   6 11 6 1 5
2009 10 6 11 1 2 2 2 1 8 16 6 2 6
2010 22 16 15 1 1 3 3 1 5 21 9 2 6
2011 30 41 16 1 3 6 4 1 10 31 7 3 7
2012 37 55 20 3 3 14 7 5 15 34 7 4 7
2013 45 63 17 5 4 18 7 7 27 47 8 5 7
2014 70 86 19 10 4 19 7 9 37 49 9 4 5
2015 88 92 22 12 4 20 8 12 41 50 10 9 8
2016 95 89 20 19 4 22 12 17 41 45 9 11 7
2017 93 84 29 26 4 19 13 30 41 47 6 13 7
2018 93 90 28 22 3 18 10 29 47 43 8 10 6
2019 90 81 26 18 4 16 12 27 62 47 8 10 6
2020 77 77 23 19 2 13 17 29 47 36 4 11 6
2021 78 98 25 18 3 16 19 28 55 39 6 8 6
Table 3. Seizures of new psychoactive substances in the European Union: total number of material seized, 2005–2021
Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Number of seizures 929 1301 1857 3264 5996 6475 7891 11410 25208 24154 34190 46012 37581 33618 22444 21238 29373
Table 3b. Seizures of new psychoactive substances in the European Union: total number and total quantity of material seized, 2005–2021
Year Number of seizures Quantity material (kg)
2005 929 1.896
2006 1301 22.601
2007 1857 65.771
2008 3264 62.241
2009 5996 944.083
2010 6475 1110.328
2011 7891 676.245
2012 11410 1805.11
2013 25208 1940.076
2014 24154 2925.087
2015 34190 4599.363
2016 46012 3175.676
2017 37581 3018.482
2018 33618 4118.687
2019 22444 2042.918
2020 21238 5133.956
2021 29373 8526.115
Table 4. Number of opioids reported for the first time to the EU Early Warning System, 2009–2022
Year Other opioids Fentanyl derivatives Benzimidazoles
2009 1 0 0
2010 0 0 0
2011 0 0 0
2012 1 2 0
2013 2 2 0
2014 1 3 0
2015 1 3 0
2016 1 8 0
2017 3 10 0
2018 5 6 0
2019 5 2 1
2020 4 1 5
2021 3 0 3
2022 0 0 1
Table 5. Seizures of new psychoactive substances in the European Union: quantity seized, by substance, 2021
Substance Qunaity seized (kg) %
3-CMC 2877 34
GBL 2064 24
Ketamine 866 10
3-MMC 654 8
4-CMC 474 6
Pregabalin 235 3
N-ethylhexedrone 202 2
MDPHP 149 2
ADB-BUTINACA 122 1
MDMB-4en-PINACA 121 1
Other substances 763 9

About this page

Recommended citation: European Monitoring Centre for Drugs and Drug Addiction (2023), European Drug Report 2023: Trends and Developments, https://www.emcdda.europa.eu/publications/european-drug-report/2023_en

Identifiers:

HTML: TD-AT-23-001-EN-Q
ISBN: 978-92-9497-865-3
DOI: 10.2810/161905


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