Cocaine – the current situation in Europe (European Drug Report 2024)

cover of the European Drug Report 2024: cocaine

Cocaine is, after cannabis, the second most commonly used illicit drug in Europe, although prevalence levels and patterns of use differ considerably between countries. On this page, you can find the latest analysis of the drug situation for cocaine in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.

This page is part of the European Drug Report 2024, the EMCDDA's annual overview of the drug situation in Europe.

Last update: 11 June 2024

Growing evidence of the health and social costs of high cocaine availability

Cocaine is, after cannabis, the second most commonly used illicit drug in Europe. Although prevalence levels and patterns of use differ considerably between countries (see Prevalence and patterns of cocaine use), the availability of this drug has been increasing for a number of years. Equally, concern has been growing that the health and social costs associated with this drug are rising significantly. The use of cocaine can result in dependent and compulsive patterns of use and is associated with a number of adverse health consequences, which can include agitation, psychosis, tachycardia, hypertension, arrhythmia, chest pain due to acute coronary syndrome and stroke. Chronic cocaine use is associated with an increased risk of coronary artery disease, cardiomyopathy and stroke. Cocaine and synthetic stimulants can induce or precipitate psychotic states, such as stimulant-induced psychosis. Longer and heavier use of stimulants delays recovery and worsens the prognosis for recovery. Among those using the drug, the combined use of cocaine and alcohol is common. The presence of the two substances in the body creates cocaethylene in the liver, which is associated with greater health risks. The management of psychiatric comorbidity among people with drug use problems remains challenging, as integrated treatment and mental health service responses are often lacking. A recent review of mortality among people with regular or problematic cocaine use found that the risk of death by suicide, accidental injury, homicide and AIDS-related mortality were all elevated when compared with non-cocaine using peers.

Cocaine is usually available in two forms in Europe. The most common is cocaine powder (the salt form) and less commonly available is crack cocaine (a smokable freebase form). Cocaine is produced from the coca plant, grown in South America. It enters Europe through various routes, but the trafficking of large volumes of cocaine through Europe’s seaports in intermodal commercial shipping containers appears a significant factor in the current high availability of this substance. In countries with large container ports known to be utilised for cocaine importation, rising levels of drug-related crime, including the corruption of staff along supply chains, intimidation and violence, have been observed. Elsewhere, there are concerns that competition within the cocaine market, both at the wholesale and retail levels, is now an important driver of drug-related crime, including gang-related violence and homicides in some countries. At the same time, cocaine use, and crack cocaine use in particular, appears to be becoming more common, especially among some marginalised communities. Taken together, this means that the growing availability and use of cocaine in Europe is resulting in greater costs, both in terms of its impact on public health and because of the criminality and violence associated with the cocaine market.

Signs of increased cocaine trafficking and innovative approaches to avoid detection

In 2022, for the sixth year in a row, EU Member States reported a record amount of cocaine seized, amounting to 323 tonnes. Belgium, Spain and the Netherlands remain the countries reporting the highest volumes of seizures, reflecting their importance as entry points for cocaine trafficked to Europe. In 2023, the quantity of cocaine seized in Antwerp, Europe’s second-largest seaport, rose to 116 tonnes from 110 tonnes in 2022. The volume of cocaine seized in Antwerp has increased annually since 2016. In 2023, Spain reported its largest ever seizure of cocaine (9.5 tonnes) in a single shipment, concealed in bananas originating from Ecuador (see Figure 3.1).

Figure 3.1. ‘Operation Nano’, 9.5 tonnes of cocaine seized in August 2023 at the Port of Algeciras (Cadiz), Spain
'Operation Nano’, 9.5 tonnes of cocaine seized August 2023, Port of Algeciras (Cadiz), Policía Nacional and the Spanish Customs Surveillance Force (SVA-DAVA), Spain
'Operation Nano’, 9.5 tonnes of cocaine seized August 2023, Port of Algeciras (Cadiz), Spain

Credit: Policía Nacional and the Spanish Customs Surveillance Force (SVA-DAVA).

The trafficking of illicit drugs is highly dynamic and quick to adapt to geopolitical developments, regional conflicts and changes in commercial trade routes. In this context, developments in Colombia, Brazil and Ecuador are all thought to have contributed to the increase observed in cocaine trafficked to the European Union by organised crime groups (see the European Drug Market Report: Cocaine for an in-depth analysis). In addition to the use of commercial containers, a range of other methods are now used, often in combination, to evade detection (see Figure 3.2).

Figure 3.2. Example range of drug trafficking methods previously reported by law enforcement in Europe

Trafficking methods

  • Infiltration of logistical supply chains
  • Intermodal shipping containers
  • Container switching, code fraud, extraction teams
  • Corruption, intimidation of officials and vessel operators
  • More use of smaller ports
  • Floating GPS-tagged drops
  • Collection from mother ships by small vessels
  • Speedboats, pleasure craft
  • Semi-submersibles (narco subs, torpedoes)
  • Chemical concealment or masking of shipments
  • More use of general aviation, small airfields

As interdiction measures have been scaled up at major known entry points for the drug, it appears that cocaine traffickers are increasingly targeting smaller ports in other EU countries and countries bordering the European Union, which may be more vulnerable to drug trafficking activities. Some northern European countries, including Sweden and Norway, reported record cocaine seizures at seaports in 2023. Together, these developments may help explain the fact that despite the large seizures, reported cocaine purity at the retail level remains high by historical standards and its price is stable. It is now well-established that the illicit processing of cocaine products takes place in several EU Member States, with 39 cocaine laboratories reported to have been dismantled in 2022. Cocaine processing in Europe usually involves the secondary extraction of cocaine that has been incorporated into other materials (e.g. chemically concealed in plastics), creating challenges for its detection in commercial shipments. Some relatively large-scale facilities have been detected recently. For example, a cocaine processing laboratory dismantled in Spain in 2023 was reported to have a daily output capacity of 200 kilograms of the drug (see Figure 3.3).

Figure 3.3. Operation ‘Mourente’, a large-scale cocaine base paste processing laboratory dismantled by Spanish authorities in 2023
Aerial view of the house from Operation ‘Mourente’ a large-scale cocaine base paste processing laboratory dismantled by Spanish authorities in 2023, La Guardia Civil, Spain
Photo of Operation ‘Mourente’: a large-scale cocaine base paste processing laboratory dismantled by Spanish authorities in 2023, La Guardia Civil, Spain

Credit: Policía Nacional.

Impact of cocaine availability on public health increasingly visible

For a number of practical and methodological reasons cocaine-related health problems can be challenging to monitor, but there are increasing signals that the high availability of this drug is having a growing negative impact on public health in Europe. Cocaine is the second most frequently reported illicit drug, both by first-time treatment entrants and in the available data on acute drug-toxicity presentations to sentinel hospital emergency departments. European drug checking services, although not nationally representative, reported that cocaine was the most common substance they screened in 2022. The available data also suggest that the drug was involved in about a fifth of drug overdose deaths in 2022. As cocaine use can aggravate underlying cardiovascular problems, it is likely that the overall contribution this drug makes to mortality in Europe is not sufficiently recognised.

Cocaine residues in municipal wastewater also increased in two thirds of cities with data for 2023 and 2022. This, together with other information, suggests that as cocaine has become increasingly available, so too has its geographical and social distribution. Of particular concern is that cocaine use appears to be becoming more common in more marginalised groups in some countries. Both the smoking and injection of cocaine are associated with greater health problems, and it is therefore worrying that cocaine injection and the use of crack cocaine are reported in a growing number of countries. Stimulants such as cocaine are associated with a higher frequency of injection and have been involved in localised HIV outbreaks among people who inject drugs in 7 European cities over the last decade (see Injecting drug use in Europe – the current situation).

Treating people with problems associated with their cocaine use is challenging, whether they are clients that are more socially integrated and involved in casual or episodic use of powder cocaine, or more marginalised groups injecting the drug or smoking crack cocaine. Most of the chronic harms related to the use of stimulants such as cocaine are associated with intensive, high-dose or long-term consumption. Acute problems can also affect people who use stimulants experimentally, but they are likely to be less common when the stimulant use is infrequent and low-dose. Although our understanding of what constitutes effective treatment for stimulant problems is growing, it remains relatively limited. The current evidence available is indicative of the use of psychosocial interventions, including cognitive behavioural therapy and contingency management. Currently, there is insufficient evidence to strongly support any pharmacological treatment, although some potentially useful new pharmacotherapies are in development. Treating cocaine problems among more marginalised groups can be particularly challenging, as clients may also be experiencing problems with a range of other drugs, including opioids or alcohol. For injecting cocaine and smoking crack, existing harm reduction responses, to a large extent those originally developed for opioid problems, are likely to be appropriate to reduce route-specific harms. However, further work is needed to develop more comprehensive interventions, and greater investment is needed to ensure services are appropriate to the growing needs observed in this area in some countries.

Key data and trends

Prevalence and patterns of cocaine use

  • In the European Union, surveys indicate that almost 2.5 million 15- to 34-year-olds (2.5 % of this age group) used cocaine in the last year (see Figure 3.4). Of the 13 European countries that have conducted surveys since 2021 and provided confidence intervals, 5 reported higher estimates than their previous comparable survey and 8 reported a stable trend.

Figure 3.4. Prevalence of cocaine use in Europe

This data explorer enables you to view our data on the prevalence of cocaine use by recall period and age range. You can access data by country by clicking on the map or selecting a country from the dropdown menu.


Prevalence data presented here are based on general population surveys submitted to the EMCDDA by national focal points. For the latest data and detailed methodological information please see the Statistical Bulletin 2024: Prevalence of drug use.

Graphics showing the most recent data for a country are based on studies carried out between 2013 and 2023.

Prevalence estimates for the general population: age ranges are 18-64 and 18-34 for Germany, Greece, France, Italy and Hungary; 16-64 and 16-34 for Denmark, Estonia and Norway; 18-65 for Malta; 17-34 for Sweden.

  • Cocaine residues in municipal wastewater increased in 49 out of 72 cities with data for both 2023 and 2022, while 13 cities reported no change and 10 cities reported a decrease (see Figure 3.5).

Figure 3.5. Cocaine residues in wastewater in selected European cities, 2023

Red = increase | Green = decrease | Yellow = stable, with respect to previous value | Blue = no previous data

Mean daily amounts of benzoylecgonine in milligrams per 1000 population. Sampling was carried out over a week between March and May 2023.
Taking into account statistical errors, values that differ less than 10 % from the previous value are considered stable in this figure.
Source: Sewage Analysis Core Group Europe (SCORE)
For the complete data set and analysis, see Wastewater analysis and drugs – a European multi-city study.

  • Analysis of 1 849 used syringes by the ESCAPE network of 12 cities in 11 EU Member States between 2021 and 2022 found that, overall, a third of syringes contained residues of two or more drug categories, indicating frequent polydrug use or re-use of injecting paraphernalia. The most frequent combination was a mixture of a stimulant and an opioid. Cocaine was detected in over 50 % of syringes analysed in Athens, Cologne, Dublin and Thessaloniki, with a mixture of cocaine and heroin being the most frequent combination found.

Treatment entry for cocaine use

  • Cocaine was the second most common problem drug among people entering specialist drug treatment for the first time in their lives, cited by an estimated 29 000 clients or 21 % of all first-time entrants (see Figure 3.6).
  • The latest European data reveal a time lag of 13 years between first cocaine use, on average at the age of 22, and first treatment for cocaine-related problems, on average at the age of 35.
Figure 3.6. Cocaine users entering treatment

Apart from the trends, data are for all treatment entrants with cocaine as the primary drug – 2022 or the most recent year available.

Trends in first-time entrants are based on 25 countries. Only countries with data for at least 5 of the 6 years are included in the trends analysis. Missing values are interpolated from adjacent years. Because of disruptions to services due to COVID-19, data for 2020, 2021 and 2022 should be interpreted with caution. Missing data were imputed with values from the previous year for Spain and France (2022) and Germany (2019).

Harms related to cocaine use

  • Cocaine was the second most common substance reported by Euro-DEN Plus sentinel hospitals in 2022, mentioned in 28 % (1 739) of acute drug-toxicity presentations. Where recorded, most presentations were associated with co-ingestion of alcohol.
  • Among the 19 European countries providing data for both years, cocaine, mostly in the presence of opioids, was involved in 996 (23 %) drug-induced deaths in 2022 (807 or 20 % in 2021).
  • In Spain, cocaine was involved in more than half (52 %) of the drug-induced deaths reported in 2021. In France, the forensic network reported that the number of drug-induced deaths involving cocaine doubled from 130 cases (22 % of all drug-induced deaths) in 2020 to 259 cases (39 %) in 2021.

Crack cocaine

  • Just 6 EU countries accounted for 90 % of the estimated 8 100 crack-related treatment entries in 2022 (7 500 in 2021), of which 3 000 were first-time entrants. A caveat here is that the term ‘crack’ may not be used consistently by all countries.
  • The number of first-time treatment entrants with crack cocaine as primary drug increased by about 42 %, from 1 900 clients in 2017 to 2 750 clients in 2022.
  • Data from drug consumption rooms in Lisbon and Porto, Portugal, and in Paris, France, in 2022 indicate that crack cocaine, either alone or with heroin, accounted for a significant proportion of the drug consumption episodes facilitated. In both countries, half of all crack cocaine consumptions involved smoking and the other half involved injecting crack, alone or with heroin. No crack cocaine use was reported by drug consumption rooms in Barcelona, Athens or Bergen in 2022.
  • A 2021 analysis of municipal wastewater in 13 European cities, by the EU-funded EUSEME project, found crack residues in all cities on all sampling days, with the highest loads reported in Amsterdam and Antwerp.

Cocaine market data

  • In 2022, EU Member States reported 84 000 cocaine seizures, amounting to  323 tonnes (up from 303 tonnes in 2021); a record amount for the sixth year in a row. Belgium (111 tonnes), the Netherlands (51.5 tonnes) and Spain (58.3 tonnes) accounted for 68 % of the total quantity seized (see Figure 3.7).
  • The average purity of cocaine at the retail level ranged from 52 % to 83 % across Europe in 2022, with half of the countries reporting an average purity between 64 % and 76 %. While the price of cocaine at retail level has remained stable over the past decade, cocaine purity has been on an upward trend, and in 2022 reached a level 45 % higher than the index year of 2012 (Figure 3.7).
  • In 2022, EU Member States reported dismantling 39 sites related to cocaine production (34 in 2021). In spite of a decrease in seizures of the essential chemical potassium permanganate in 2022 (173 kilograms) compared with 2021 (1 100 kilograms), it is likely that the large-scale processing of cocaine hydrochloride from imported intermediary products continues to take place in the European Union. For example, in 2023, a cocaine processing laboratory dismantled in Spain was reported to have an estimated daily output capacity of 200 kilograms. In addition, some large seizures of unusual substances containing cocaine that must be chemically extracted have been reported, suggesting that secondary extraction of cocaine occurs at significant levels in Europe. For example, in 2022, chemically concealed cocaine was detected in a shipment of 22 tonnes of sugar in France and in 100 kilograms of coal, part of a larger load of coal shipped to Croatia.
  • In 2022, cocaine was cited in 85 800 use or possession offences, about 10 % of all such offences for which the drug is known, continuing the upward trend observed over the previous 6 years. After cannabis, cocaine was the second most frequently cited drug in offences related to use or possession.
  • Among the 18 drug checking services across 8 EU countries that reported testing more than 10 samples, cocaine emerged as the substance most commonly detected by 5 services during the first half of 2022 and by 4 services during the first half of 2023. Over the same period, the purity of cocaine samples analysed by the 18 drug checking services remained high. In the first half of 2022, 50 % of the samples tested exhibited a purity ranging from 80 % to 100 %. By the first half of 2023, this equivalent share was 55 %.

Detailed information on cocaine can be found in the joint EMCDDA-Europol EU Drug Market: Cocaine and the EMCDDA’s Stimulants: health and social responses.

Figure 3.7. Cocaine market in Europe

EU + 2 refers to EU Member States, Norway and Türkiye.

Price and purity: mean national values – minimum, maximum and interquartile range. Countries vary by indicator.


Source data

The complete set of source data for the European Drug Report 2024 including metadata and methodological notes is available in our data catalogue.

A subset of this data, used to generate infographics, charts and similar elements on this page, may be found below.

Prevalence of drug use data tables including general population surveys and wastewater analysis (all substances)

Other data tables including tables specific to cocaine