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

cover of the European Drug Report 2024: synthetic stimulants

Amphetamine, methamphetamine and, more recently, synthetic cathinones are all synthetic central nervous system stimulants available on the drug market in Europe. On this page, you can find the latest analysis of the drug situation for synthetic stimulants 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

Diversity in the availability and use of stimulants

Amphetamine, methamphetamine and synthetic cathinones are all synthetic central nervous system stimulants available on Europe’s illicit drug market. Historically, amphetamine use has always been the most common, with the availability and use of methamphetamine and synthetic cathinones being more limited in most countries. There are, however, signals that patterns of synthetic stimulant availability and use are diversifying. Part of the context for this is that trends in synthetic drug production can be extremely dynamic, and consumers may view different stimulants as functionally similar and be amenable to trying new products based on their availability in the market. There are therefore concerns about increased threats to health and social problems that may be associated with the more widespread availability and use of these substances. At the same time, current information tools are generally not sufficiently well-developed to track trends in use or related problems associated with changing patterns of synthetic stimulant use, meaning that we can be slow to detect important changes in this area. Improving our ability to monitor and respond more rapidly to developments in the use of synthetic drugs in general therefore remains a priority.

Understanding stimulant-related risks to health

Methamphetamine and synthetic cathinones are chemically similar to amphetamine, but are not necessarily equivalent in respect to the risk they pose to public health. The more widespread use of synthetic cathinones, for example, is a relatively new development, and we currently lack a robust evidence base to understand the potential health risks of this phenomenon or what might constitute appropriate interventions. Methamphetamine is available in high-purity forms that are smokable, and there are particular health concerns associated with the use of this drug by this mode of administration. All of these substances may also be available in similar-looking powders or pills, meaning consumers may be unaware of what particular stimulant or mixture of substances they may be consuming. Reports from drug checking services in several EU Member States between 2022 and 2023, and also to the EU Early Warning System, indicate that synthetic cathinones may also be found in MDMA products, reflecting mis-selling and adulteration. This means that forensic and toxicological analysis is particularly important for understanding both consumption trends and the scale and nature of any associated adverse health outcomes.

A more general concern is that all of the stimulants discussed here are also, to some extent, associated with behaviours that can represent health risks. These risks include overdoses, acute and chronic mental health problems and infectious diseases. Problematic and intensive patterns of stimulant use, such as the combination of high-risk drug taking and risky sexual behaviours, known as ‘chemsex’, have also been documented in some populations. There are also particular concerns about the injecting of stimulants, which has been associated with a higher risk of HIV transmission. This could be explained by more frequent use, sharing of injecting material and risky sexual behaviours among people who inject stimulants.

In the last decade, 7 European cities, across 6 countries, have reported localised HIV outbreaks associated with stimulant injecting, mainly among marginalised people who inject drugs involved in open drug scenes (see Drug-related infectious diseases – the current situation in Europe). Syringe residue analysis conducted by the ESCAPE network between 2022 and 2023 confirms the presence of stimulants, such as amphetamine and synthetic cathinones, in many injecting drug scenes. Reports from the Euro-DEN Plus network of sentinel hospitals across Europe in 2022 highlight the continued presence of synthetic stimulants in acute drug-toxicity presentations to emergency departments.

Methamphetamine production and trafficking highlights potential for increased use in Europe

While methamphetamine is a less commonly used synthetic stimulant and is less visible in available data, signals continue to emerge that its production is increasing in Europe. Historically, the use of this drug has been most commonly observed in Czechia and Slovakia and, more recently, some neighbouring countries. Now, however, it is present in more countries, although the overall prevalence of use appears to remain low in most countries. While not representative of the general population, data from wastewater analysis indicate that 15 of the 67 European cities with data for 2022 and 2023 saw an increase in the methamphetamine residues detected.

Available data on the production and trafficking of these stimulants reveal the changing dynamics of the illicit stimulant trade. There were 108 dismantled amphetamine production laboratories reported in the European Union in 2022 (119 in 2021). Following a decline from a peak in 2020 (22.3 tonnes), the quantity of the drug seized in the European Union remained stable at about 7 tonnes between 2021 and 2022. It has been suggested that this fall in the quantities seized may be indicative of a decline in production, possibly resulting from producers switching to other stimulants, such as methamphetamine, which can be highly profitable when trafficked to non-EU markets. Recent data show the quantity of methamphetamine seized in the European Union has remained relatively stable between 2021 and 2022 at about 1.4 tonnes, following a decline from a peak in 2019 (2.3 tonnes) due to large importations from Mexico. The number of methamphetamine production sites reported as dismantled slightly declined in 2022, likely reflecting that, while large-capacity sites are found, most are small-scale, with the number of detections fluctuating annually. The quantity of seized glycidic derivatives of BMK, the precursor used for large-scale methamphetamine production, increased in 2022, while new alternative chemicals to make BMK were also seized (see Synthetic stimulants market data, below). The increased quantities of methamphetamine precursors and related chemicals seized in Europe reflect the globally significant capacity of synthetic drug producing groups in the region, with the drug still predominantly exported to non-EU markets. Data availability issues mean that caution is needed in interpreting the information available, and more work is needed to track production trends and analyse their implications for both public health and security. Türkiye has reported seizing a record quantity of methamphetamine in 2022 (almost 16 tonnes). Among the reasons for this is a potential increase in trafficking of methamphetamine from Afghanistan along established heroin trafficking routes towards Europe. Challenges remain in better understanding methamphetamine trafficking flows and the changes taking place in Afghanistan; and this drug has also been the target of recent measures taken by the Taliban to reduce drug production in the country.

Synthetic cathinones pose a growing challenge

Reports indicate that synthetic cathinones are increasingly trafficked to Europe from India in large shipments. At the same time, they are also produced in Europe, notably in Poland, where 23 laboratories were reported as dismantled in 2022, and 355 kilograms of precursors were seized. Given the volumes of precursor chemicals seized and the interception of unregulated alternative chemicals, it appears likely that large-scale production for both the European and other markets may be taking place.

In summary, as the use of illicit stimulants can lead to a range of health problems, these substances continue to represent a challenge for monitoring efforts, policymakers and service providers in Europe. More frequent injecting associated with stimulant use and the potentially much more severe health complications from injecting and smoking methamphetamine mean that any increase in consumption, especially among vulnerable groups, could represent a growing challenge for harm reduction and emergency health services.

Key data and trends

Prevalence and patterns of synthetic stimulants use

  • Surveys conducted by 24 EU countries between 2017 and 2023, which group amphetamine and methamphetamine together, suggest that 1.5 million young adults (15 to 34) used amphetamines during the last year (1.5 % of this age group). Of the 12 European countries that have conducted surveys since 2020 and provided confidence intervals, 2 reported higher estimates than their previous comparable survey and 10 reported a stable trend (see Figure 4.1 for most recent survey data).
  • Estimates of high-risk methamphetamine use vary between countries, ranging from 0.37 per 1 000 population (corresponding to 225 high-risk users) in Cyprus to 5.22 per 1 000 (34 700 high-risk users) in Czechia, with 2.9 per 1 000 (10 624 high-risk users) in Slovakia.
  • In the 2021 European Web Survey on Drugs, a non-representative survey of people who use drugs, 4 % of respondents reported having used synthetic cathinones in the last 12 months.
Figure 4.1. Prevalence of amphetamines use in Europe

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.

  • Of the 65 cities with data on amphetamine residues in municipal wastewater for 2022 and 2023, 26 reported an increase, 13 a stable situation and 26 a decrease (Figure 4.2).
Figure 4.2. Amphetamine residues in wastewater in selected European cities: changes between 2022 and 2023

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

Mean daily amounts of amphetamine 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.

  • Of the 67 cities that have data on methamphetamine residues in municipal wastewater for 2022 and 2023, 15 reported an increase, 13 a stable situation and 39 a decrease (Figure 4.3).
Figure 4.3. Methamphetamine residues in wastewater in selected European cities: changes between 2022 and 2023

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

Mean daily amounts of methamphetamine in milligrams per 1000 population. Sampling was carried out over a week between March and April 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.

Treatment entry for use of synthetic stimulants

  • Almost 10 000 clients are estimated to have entered specialised drug treatment in Europe in 2022 reporting amphetamine as their primary drug, approximately half of them (4 800) being first-time clients (Figure 4.4).
  • In 2022 or the most recent year available, amphetamine or methamphetamine clients accounted for at least 15 % of first-time treatment entrants in Bulgaria, Czechia, Estonia, Latvia, Poland, Slovakia, Finland and Türkiye.
Figure 4.4. Amphetamine users entering treatment in Europe

Data are for all treatment entrants with amphetamine as the primary drug – 2022 or the most recent year available. Data for first-time entrants are for 2022 or the most recent year available: Czechia, 2020, Spain, France, Finland, Romania, 2021; Netherlands, 2015. Data for Sweden and Norway relate to clients citing stimulants other than cocaine as primary drug.

  • Treatment entrants citing methamphetamine as their main problem drug are concentrated in Czechia, Germany, Slovakia and Türkiye, which together accounted for 92 % of the estimated 12 000 methamphetamine clients entering treatment in 2022, 6 400 of whom were first-time clients (Figure 4.5). In addition, drug consumption facilities in Athens and Barcelona observed an increase in the number of clients reporting methamphetamine smoking in the second half of 2022.
Figure 4.5. Metamphetamine users entering treatment in Europe

Data for client characteristics are for all treatment entrants with methamphetamine as the primary drug – 2022 or the most recent year available. Data for first-time entrants are for 2022 or the most recent year available: Czechia 2020, Spain, France, Finland, Romania 2021; Netherlands, 2015.

  • Available data from countries that report treatment entrants for synthetic cathinones show an increase from 457 clients in 2016 to 1 207 clients in 2022, 90 % of whom are accounted for by France (416 clients, 2021 data), Poland (306 clients), Spain (225 clients, 2021 data) and Belgium (145 clients) (Figure 4.6). The share of synthetic cathinones entrants among all treatment entrants with stimulants other than cocaine as their primary drug increased to 8 % in 2022, from 4 % in 2016.
Figure 4.6. Synthetic cathinone users entering treatment in Europe

Data on entrants into treatment are for 2022 or the most recent year available. Trends in treatment entrants are based on 22 countries. Only countries with data for at least 5 of the 6 years are included in the trends graph. Missing data were imputed with values from the previous year for Spain and France (2022) and Germany (2019). Because of disruptions to services due to COVID-19, data for 2020, 2021 and 2022 should be interpreted with caution

Injecting use of synthetic stimulants

  • Injecting is reported as a common route of administration by those entering treatment with amphetamine as their primary drug in a number of countries, including Finland (78 %), Estonia (71 %) Sweden (65 %) and Latvia (42 %).
  • About 6 % of amphetamine clients entering drug treatment in Europe in 2022, or the most recent year available, reported injecting as the main route of administration, while 68 % reported sniffing, 9 % reported smoking and 17 % reported oral consumption of the drug. Four countries, Belgium, Germany, Poland and Spain, accounted for 65 % of the treatment entrants.
  • 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. The most frequent combination was a stimulant and an opioid. Synthetic cathinones were found in used syringes collected in Paris (89 %), Budapest (34 %), Helsinki (23 %) and Tallinn (19 %). The synthetic cathinones 3-MMC and 3-CMC were detected in Paris, Dublin (3-MMC only) and Prague (3-CMC only).

Harms related to use of synthetic stimulants

  • In 2022, amphetamine was the fifth most common substance reported by 20 Euro-DEN Plus hospitals located in 15 EU countries and Norway. It was present in 9 % (566) of acute drug-toxicity presentations.
  • Methamphetamine was the twelfth most common substance reported by 18 Euro-DEN Plus hospitals in 2022, present in 2.1 % (135) of acute drug-toxicity presentations (2.6 % in 2021).
  • In 2022, the synthetic cathinone 3-MMC was involved in 38 acute drug-toxicity presentations in 6 Euro-DEN Plus hospitals (68 in 2021 in 5 hospitals).
  • Of the 20 countries with post-mortem data available for 2022, 18 reported 1 030 drug-induced deaths where amphetamines were involved (1 073 in 2021 in 23 countries) – post-mortem findings group amphetamine and methamphetamine together.
  • In the 6 EU countries reporting drug-induced deaths involving synthetic cathinones for both years, the number of cases increased from 18 in 2021 to 27 in 2022.

Synthetic stimulants market data

  • In 2022, EU Member States reported 31 000 seizures of amphetamine, amounting to 7.1 tonnes (7 tonnes in 2021) (Figure 4.7). Türkiye seized almost 6 tonnes (3.5 tonnes in 2021), including almost 24 million tablets described as ‘captagon’ (13.8 million in 2021). The average purity of amphetamine at retail level has increased markedly over the past decade (+97 %), while the average price has decreased (−27 %).

Figure 4.7. Amphetamine 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.

  • EU Member States reported 9 900 seizures of methamphetamine amounting to 1.4 tonnes in 2022 (1.2 tonnes in 2021) (Figure 4.8). Türkiye reported 77 700 seizures of methamphetamine in 2022, amounting to 15.8 tonnes and 383 litres (5.5 tonnes in 2021). The large increase in the quantities seized by Türkiye may indicate increased methamphetamine trafficking along established heroin trafficking routes to Europe from Afghanistan via Türkiye. Over the past decade, the average purity of methamphetamine has risen slightly, while the price has remained relatively stable, although declining in recent years.

Figure 4.8. Methamphetamine 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.

  • About 87 % of the total quantity of new psychoactive substances reported as seized by EU Member States in 2022 in all forms, or 26.5 tonnes (4.5 tonnes in 2021), were synthetic cathinones. The main substances were 3-CMC (63 %), 3-MMC (9 %), 2-MMC (5 %) and N-ethylnorpentedrone (3 %). 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.
  • In 2022, 7 EU Member States reported dismantling 108 amphetamine laboratories (119 in 2021): the Netherlands (39), Belgium (35), Poland (22), Spain (5), Sweden (5), Croatia (1) and Romania (1).
  • Nine EU Member States reported dismantling 242 methamphetamine laboratories in 2022 (224 in 2021): Czechia (202), the Netherlands (14), Bulgaria (12), Belgium (6), Poland (4), Greece (1), Spain (1), Slovenia (1) and Sweden (1). 
  • Seizures of the precursors required to synthesise methamphetamine via the ‘ephedrine method’ (ephedrine and pseudoephedrine) amounting to 352 kilograms (both powders and tablets) were reported by 15 EU Member States in 2022 (723 kilograms by 15 EU Member States in 2021). Methamphetamine can also be produced using BMK as a starting material, which may also be used to produce amphetamine. In 2022, 1 329 litres of BMK (close to 5 100 litres in 2021) and 26.6 tonnes of substances that can be used to produce BMK were seized in Europe. These seizures included 25.6 tonnes of glycidic derivatives of BMK (736 kilograms in 2021), 379 kilograms of MAPA (close to 9.7 tonnes in 2021) and over 500 kilograms of APAA and APAAN (50 kilograms of APAA in 2021). Two new alternative chemicals that can also be used to make BMK, DEPAPD and DEPAPD enolate, were reported in Europe (and worldwide) for the first time in 2022 and seized in relatively small amounts. In addition, seizures of tartaric acid, a chemical that allows the retrieval of the most potent and sought-after form of methamphetamine (d-methamphetamine, used for ‘crystal meth’) from mixtures produced by BMK methods, were reported by Belgium, Germany and the Netherlands, amounting to 2.6 tonnes in 2022 (4.5 tonnes in 2021). This suggests that large-scale production of d-methamphetamine continues to take place in Europe.
  • In 2022, 29 synthetic cathinone production sites, some of which were large-scale, were dismantled in the European Union (16 in 2021): 23 in Poland (12 in 2021) and 6 in the Netherlands (2 in 2021).
  • Seizures of synthetic cathinone precursors amounted to 558 kilograms in 2022 (555 in 2021), most of which were seized in Poland (355 kilograms, 311 kilograms in 2021). One shipment of 1 tonne of the 4-CMC precursor 4-chloropropiophenone was stopped in France, originating from China and headed for Poland.
  • While not representative of national drug markets, over 66 % of amphetamine samples screened by European drug checking services in the first half of 2023 contained a psychoactive adulterant. Caffeine was the psychoactive adulterant most commonly found in amphetamine samples analysed by drug checking services. Other stimulants and hallucinogens were also commonly found as adulterants.
  • In 2022 and 2023, reports to the EU Early Warning System suggested the possibility of synthetic cathinones increasingly being mis-sold as MDMA or used to adulterate MDMA. Although the extent of this problem is unknown, drug checking services in 11 EU Member States have detected synthetic cathinones in MDMA products, albeit infrequently. The affected products included ecstasy tablets, crystals and powders, typically containing 4-CMC (clephedrone), 3-MMC, 3-CMC, 4-MMC (mephedrone) and dipentylone.

Detailed information on synthetic stimulants can be found in the joint EMCDDA-Europol EU Drug Markets: In-depth analysis and the EMCDDA's Stimulants: health and social responses.

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 synthetic stimulants