Synthetic stimulants – the current situation in Europe (European Drug Report 2025)

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 2025, the EUDA’s annual overview of the drug situation in Europe.

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Last update: 5 June 2025

High availability of different stimulants creates health concerns

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. Recently, however, a shift appears to have taken place, with synthetic cathinones, a broad family of stimulants, increasingly available in Europe, with unprecedented seizures and imports taking place. Part of the context for this is that trends in synthetic drug production can be dynamic, and consumers may view different stimulants as functionally similar and be willing to try new products. There are therefore concerns about increased health and social problems associated with the more widespread availability and use of these substances. Some existing monitoring tools are better at identifying and tracking changes related to established illicit synthetic stimulant drugs, such as amphetamine, than developments potentially fuelled by new psychoactive substances such as synthetic cathinones, of which there are many individual substances. Data from the EU Early Warning System and other leading-edge indicators are therefore increasingly important for the contextualisation and understanding of these market changes and to consider the implications for policy development.

Health risks from a changing stimulants market

Various synthetic stimulants are produced in Europe for domestic markets and export to non-EU countries; among these are amphetamine, methamphetamine and synthetic cathinones. These substances share a similar chemical structure, but their psychoactive effects and public health consequences may vary significantly. For example, some synthetic cathinones, such as 4-CMC have been shown to have effects and potential harms broadly similar to other psychostimulants such as MDMA and amphetamine. However, the synthetic cathinones are a broad group of drugs containing substances that have different effects or health risks that may be more severe as a result of higher potency, such as the pyrrolidino derivatives, which include alpha-PHiP (α-pyrrolidinoisohexanophenone). The effects of many of these drugs on humans have not been extensively researched. Polysubstance use also increases the risk of adverse health effects. Alongside the potential for rapid shifts in the availability of substances and small numbers of studies of health risks, and a lack of an established pharmacological therapy for cases of dependency, the increased availability of synthetic stimulants creates a challenge for response models. 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.

For all stimulant drugs, health risks include overdoses, acute and chronic mental health problems and the spread of infectious diseases. The combination of high-risk drug taking and risky sexual behaviours, known as ‘chemsex’, has 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 in 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 2023 highlight the continued presence of synthetic stimulants in acute drug-toxicity presentations to emergency departments.

Europe’s methamphetamine production and trafficking highlights risk of increased use

While amphetamine is more widely used in Europe, there are some signals that methamphetamine consumption, which was geographically limited in the past, is now present in more countries. Both of these drugs can be manufactured from various substances, with benzyl methyl ketone (BMK) a key precursor chemical for both drugs. Other substances that can be used to make BMK are chosen by criminal networks in an attempt to evade detection. Seizures of both BMK and substances for making it have been increasing in Europe. The production sites for these drugs are, historically, mostly concentrated in a few countries. For example, large-scale production of both amphetamine and methamphetamine takes place in the Netherlands. Some amphetamine production also takes place in Germany and Poland, while smaller-scale methamphetamine facilities serving only the domestic market are reported in Czechia. A recent concern is the trafficking of amphetamine base oil from the Netherlands and Belgium to other countries for conversion into consumer products.

Illicit drug production facilities for making one or both of these substances continue to be detected in the European Union. Drug production sites capable of switching between various substances are known as ‘combination-laboratories’ or ‘combi-labs’. The use of combi-labs likely appeals to criminal networks because it allows them to meet changing market preferences easily and produce more valuable products for export, such as crystal methamphetamine, alongside less lucrative ones for domestic consumers, such as amphetamine and other synthetic stimulants. Despite many production facilities being small- to medium-scale, larger, industrial-capacity sites are detected each year, and while the available data make it hard to comment with certainty on their actual output, law enforcement information indicates that large-scale production continues.

In addition, increases in the quantities seized for both drugs were reported in 2023. This includes large seizures of methamphetamine, often of Mexican origin, that indicate transhipment of the drug through Europe to other destinations, including Australia. As noted elsewhere in this report, criminal networks use a range of modi operandi to traffic drugs. EU Member States may be an appealing option for traffickers seeking to tactically route drug shipments concealed in maritime shipping containers through locations less associated with international drug trafficking prior to onward shipping to their intended destination. This is evident from the results of investigations by European law enforcement agencies, such as in Ireland in 2023, where the quantities seized far exceed those likely required to supply EU or national demand (see Figure 4.1).

Note: Seizure made in February 2024 at the Port of Cork, Ireland, by the Garda Síochána (police) and Revenue.

Together, this information suggests that the production and trafficking of amphetamine and methamphetamine in Europe continues, both for domestic demand and for export to more profitable non-EU markets for the drugs. This brings with it the risk of increased use of these stimulants within the European Union, both in the countries where the drugs are produced and in those through which they are trafficked. This is because this production and trafficking creates the potential for increased availability of these drugs on local stimulant markets can, at times, experience dynamic shifts in the products available to consumers. In addition, uncertainty about the effects of events in Afghanistan on the EU heroin market and any potential shift to replacement substances, temporarily or not, remains a concern for policymakers.

Increased drug market integration of synthetic cathinones

In some parts of Europe, synthetic cathinones have established themselves on the illicit drug market as affordable alternatives to other synthetic stimulants. As a result, synthetic cathinones are now likely to be increasingly available. While some indicators may suggest that the market for these substances appears to be growing, monitoring a broad group of compounds is challenging for tools originally designed to track long-established illicit drugs, such as cocaine. Although only 7 new synthetic cathinones were notified for the first time to the EU Early Warning System in 2023, more than 60 previously reported synthetic cathinones were detected on the EU drug market in the same year, and 178 have been identified.

Imports and seizures of synthetic cathinones have greatly increased year on year. In 2023, imports and seizures of these substances amounted to three times the combined quantity of amphetamine and methamphetamine seized. Most of this involved a small number of bulk imports from India, primarily through the Netherlands. Significant levels of synthetic cathinone production also occur in Europe, where large-scale laboratories have been dismantled and large quantities of precursor chemicals seized. Many of these laboratories were dismantled in Poland (Figure 4.2), where cooperation between Polish and Ukrainian criminal networks has been reported, but also in the Netherlands and, to a lesser extent, Belgium and Germany. The fact that synthetic cathinones can be produced relatively easily from unscheduled chemicals may have facilitated their production in the European Union. Recognising this, the European Commission requested the EUDA to assess the risks associated with eight cathinone precursors, as well as an amphetamine precursor, with a view to scheduling these chemicals at EU level.

Note: Seizure by the Central Bureau of Police Investigation.

While some level of unintentional consumption of synthetic cathinones in drug mixtures and tablets remains a concern, data from drug checking services support the view that some consumers purchase cathinones intentionally. For example, in the majority of cases where cathinones were identified by European drug checking services, they were the substance expected by the person submitting the sample for analysis.

Nonetheless, exposure to unexpected substances was evident from submitted samples sold as 3-MMC and containing 2-MMC instead.

At present, the number of clients entering treatment for problems related to the use of synthetic cathinones in EU Member States remains relatively small, at just under 2000, but it increased by 356 % between 2018 and 2023. Over a fifth of those seeking treatment for problems related to cathinones report injecting as the main route of administration, and the same proportion used the drug daily before entering treatment.

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. Increased cathinone consumption highlights the role of forensic and toxicological analysis for understanding consumption trends and the scale and nature of any associated adverse health outcomes. The EUDA has recently undertaken risk assessments of three new synthetic cathinones (see Risk assessments).

Key data and trends

Prevalence and patterns of synthetic stimulants use

• Surveys conducted by 24 EU Member States between 2017 and 2024 suggest that 1.6 million young adults (aged 15 to 34) used amphetamines (amphetamine and methamphetamine) during the last year (1.6 % of this age group). Of the 14 European countries that have conducted surveys since 2022 and provided confidence intervals, 2 reported lower estimates than their previous comparable survey, 4 reported higher estimates, and 8 reported a stable trend (see Figure 4.3 for the most recent survey data).
• In the 2024 ESPAD school survey, 10 % of the 15- to 16-year-old ESPAD students in EU Member States rated amphetamine as easily obtainable, while 7.9 % rated methamphetamine as easily obtainable. On average, 1.8 % of the students reported having used amphetamine at least once in their lifetime, and 1.4 % reported having used methamphetamine. Less than 1 % reported having used either of these substances for the first time at age 13 or younger.
• Among the few countries that report estimates of high-risk use of methamphetamine, prevalence estimates vary, ranging from 0.71 per 1000 population (corresponding to 429 high-risk users) in Cyprus to 5.48 per 1000 (37 900 high-risk users) in Czechia, with 3.9 per 1000 (14 056 high-risk users) in Slovakia.
• In the 2024 European Web Survey on Drugs, a non-representative survey of people who use drugs, 17 % of respondents living in the European Union or Norway reported having used amphetamine, while 9 % had used synthetic cathinones and 5 % had used methamphetamine. Polysubstance use was common among those using amphetamine and methamphetamine, with only 9 % of those who used amphetamine and 13 % of those who used methamphetamine indicating having used it with no other substance, including tobacco and alcohol, in the last episode of use. Of those who used amphetamine, 86 % usually snorted it, using powders/crystals. On average, one tablet was consumed per day of use. Of those who used methamphetamine, 71 % snorted it and 26 % smoked it in pipes, using powders/crystals. On average, one tablet was consumed per day of use. Of those who used amphetamine, 66 % reported that they used it to ‘get “high”/for fun’, and over half ‘to stay awake’. For methamphetamine, just over half reported that they used the drug to ‘get “high”/for fun’ and 44 % ‘to stay awake’.

• Of the 68 cities with data on amphetamine residues in municipal wastewater for 2023 and 2024, 34 reported an increase, 20 a stable situation and 14 a decrease (Figure 4.4).

• Of the 71 cities with data on methamphetamine residues in municipal wastewater for 2023 and 2024, 32 reported an increase, 12 a stable situation and 27 a decrease (Figure 4.5).

Treatment entry for use of synthetic stimulants

• About 9200 clients are estimated to have entered specialised drug treatment in Europe in 2023, reporting amphetamine as their primary drug, approximately half of them (4300) being first-time clients (Figure 4.6).

• In 2023 or the most recent year available, amphetamine clients accounted for at least 10 % of first-time treatment entrants in Bulgaria, Estonia, Latvia, Lithuania, Hungary, Poland, Finland and Sweden. In Czechia, Slovakia and Türkiye, over 30 % of first-time clients entered treatment for problems related to methamphetamine.
• Treatment entrants citing methamphetamine as their main problem drug are concentrated in Czechia, Germany, Slovakia and Türkiye, which together accounted for 91 % of the estimated 12 000 methamphetamine clients entering treatment in 2023. Türkiye, where the number of treatment entrants quadrupled, rising by 305 %, between 2018 and 2023, accounts for 43 % of the 5900 first-time clients (Figure 4.7). In addition, harm reduction services in Greece and Spain report significant numbers of clients smoking methamphetamine during 2023.

• Available data from countries that report treatment entrants for synthetic cathinones show an increase from 425 clients in 2018 to 1930 clients in 2023, 90 % of whom are accounted for by France (607 clients, 2022 data), Spain (346 clients, 2022 data), Poland (330 clients), the Netherlands (310 clients) and Belgium (162 clients) (Figure 4.8). The share of synthetic cathinones entrants among all treatment entrants with stimulants other than cocaine as their primary drug increased to 12 % in 2023, from 3 % in 2018.

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 (77 %), Estonia (73 %) and Sweden (72 %).
• About 5 % of amphetamine clients entering drug treatment in Europe in 2023, or the most recent year available, reported injecting as the main route of administration, while 67 % reported sniffing, 10 % reported smoking and 18 % reported oral consumption of the drug. Six countries (Belgium, Germany, Hungary, Netherlands, Poland, Spain) accounted for almost 80 % of the treatment entrants.

• Analysis of 3276 used syringes by the ESCAPE network of 19 cities in 13 EU Member States and Norway in 2023 found that overall, half of the syringes contained residues of two or more drug categories. The most frequent combination was an opioid and a stimulant.

• In the ESCAPE data, synthetic cathinones were commonly detected in Budapest (69 %), Paris (65 %), Madrid (46 %), and to a lesser extent in Amsterdam (15 %) and Helsinki (14 %). A total of 13 distinct cathinones were identified across participating cities, with 3-CMC, N-ethylnorpentedrone, mephedrone, 4-CMC and alpha-PVP being the most frequently detected.
• Methamphetamine was detected in the majority of syringes from Prague (66 %) and a quarter of syringes from Athens (25 %).
• Amphetamine was detected in the majority of syringes in Tallinn (67 %) and Oslo (52 %).

Harms related to use of synthetic stimulants

• In 2023, amphetamine was the fourth most common substance overall, reported by 21 Euro-DEN Plus hospitals located in 15 EU Member States and Norway. It was present in 11 % (718) of the acute drug-toxicity presentations.
• Methamphetamine was reported by 18 Euro-DEN Plus hospitals in 2023, and was present in 2.4 % (163) of the acute drug-toxicity presentations (2.1 % in 2022).
• In 2023, cathinones were reported by 13 Euro-DEN Plus hospitals located in 10 EU Member States and Norway. Cathinones were present in 1.5 % of the acute drug toxicity presentations. In 2023, the synthetic cathinone 3-MMC was involved in 30 acute drug-toxicity presentations in 4 Euro-DEN Plus hospitals (38 in 2022, in 6 hospitals). The majority were reported by the hospitals in Belgium (Antwerp and Ghent).
• Of the 21 EU Member States with post-mortem data available for 2023, 19 reported 907 drug-induced deaths where any amphetamine-type stimulants, including MDMA, were involved (936 in 2022 in the same countries).
• In 2023, 7 countries reported deaths involving synthetic cathinones, with a total of 39 cases. This number is a minimum estimate as these substances may not be systematically searched for in routine post-mortem toxicology analysis in some countries.

Synthetic stimulants market data

• In 2023, EU Member States reported 30 000 seizures of amphetamine, amounting to 10.2 tonnes (7.1 tonnes in 2022) (Figure 4.9). Türkiye seized almost 3.5 tonnes (6 tonnes in 2022), including almost 14 million tablets described as ‘captagon’ (24 million in 2022). The average purity of amphetamine at retail level has increased markedly over the past decade (+88 %), while the average price has decreased (−19 %).

• EU Member States reported 9800 seizures of methamphetamine amounting to 1.8 tonnes in 2023 (1.4 tonnes in 2022) (Figure 4.10). Türkiye reported 65 800 seizures of methamphetamine in 2023, amounting to 11.5 tonnes and 10 415 litres (15.8 tonnes and 383 litres in 2022). The average purity of methamphetamine increased by 30 % between 2013 and 2020. Since then it has decreased, and in 2023 was 16 % higher than in 2013.

• The total quantity of synthetic cathinones reported as seized or imported by EU Member States in 2023, in all forms, amounted to 37 tonnes (27 tonnes in 2022, 4.5 tonnes in 2021). The main substances were 3-CMC, 2-MMC and N-ethylnorpentedrone.
• In 2023, 10 EU Member States reported dismantling 93 amphetamine laboratories (108 in 2022): the Netherlands (38), Germany (21), Poland (19), Belgium (5), Austria (3), Lithuania (2) Sweden (2), Bulgaria (1), Czechia (1), Finland (1).
• Seven EU Member States reported dismantling 250 methamphetamine laboratories in 2023 (242 in 2022): Czechia (189), the Netherlands (29), Bulgaria (18), Germany (5), Poland (5), Belgium (3), Austria (1).
• Seizures of the precursors required to synthesise methamphetamine via the ‘ephedrine method’ (ephedrine and pseudoephedrine) amounted to 7.8 tonnes in 2023 (352 kilograms in 2022). The large increase is mainly due to the dismantling of a trafficking operation from an apparently legitimate pharmaceutical company in Romania.
• Both amphetamine and methamphetamine can also be produced using BMK as a starting material. Seizures of BMK reached 5453 litres in 2023 (1329 litres in 2022). In addition, 66.2 tonnes of substances (26.6 tonnes in 2021) that can be used to produce BMK were seized in Europe that same year.
• 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, reached 10.9 tonnes in 2023 (2.6 tonnes in 2022) and were reported by Belgium and the Netherlands.
• In 2023, 53 synthetic cathinone production sites, some of which were large-scale, were dismantled in the European Union (29 in 2022): the large majority were seized in Poland (40 sites), with the rest accounted for by the Netherlands (8 sites), Germany (2), Belgium (1), Austria (1) and Sweden (1).
• Seizures of synthetic cathinone precursors amounted to 2.1 tonnes in 2023 (558 kilograms in 2022), most of which was seized in the Netherlands (1416 kilograms) and Poland (735 kilograms). These are likely to be underestimates as precursors for cathinones are unscheduled.
• While not representative of national drug markets, about 60 % of amphetamine samples screened by European drug checking services in 9 EU Member States in the first half of 2024 contained a psychoactive adulterant. Caffeine (57 %) was the psychoactive adulterant most commonly found in amphetamine samples analysed by drug checking services. Other stimulants (5 %), including MDMA, cocaine and cathinones, and hallucinogens (less than 1 %) were also found as adulterants.
• Data from 12 drug checking services in 10 EU Member States from the first half of 2024 show that of all analysed samples containing cathinones, another drug (mostly MDMA) was expected in 12 % (77) of samples, while 88 % (558) were submitted as such. Samples sold as 3-MMC often contained 2-MMC instead.

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

Source data

The complete set of source data for the European Drug Report 2025, 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