Drug-induced deaths – the current situation in Europe (European Drug Report 2026)
Estimating the mortality attributable to drug use is critical for understanding the public health impact of drug use and how this may be changing over time. On this page, you can find the latest analysis of drug-induced deaths in Europe, including key data on overdose deaths, substances implicated and more.
This page is part of the European Drug Report 2026, the EUDA’s annual overview of the drug situation in Europe.
Last update: 9 June 2026
Enhanced understanding of drug-related mortality trends will improve responses to overdoses
Estimating the mortality attributable to drug use is critical for understanding the changing public health impact of drug use. Understanding the factors driving trends is key for developing effective policies and responses. A key component is drug-induced deaths, defined as deaths directly attributable to drug use and often referred to as drug overdose deaths. However, this measure captures only a share of the overall mortality associated with drug use, as it excludes deaths from accidents, violence, suicides by means other than drug poisoning or chronic disease, where drug use may also have played a role.
An assessment of drug-induced deaths remains a key measure for understanding drug-related harms, albeit challenging to interpret due to methodological and data availability issues. Data for the most recent reporting year (2024) are available for only 22 of the 29 countries, and estimated values are calculated to derive an overall EU estimate. Improving the timeliness and completeness of data will help develop better responses to overdoses at a time when Europe’s drug problems are increasingly diverse and new drug threats can rapidly emerge, straining existing response models.
Several important caveats frame the available data. Because of methodological limitations, the numbers of drug-induced deaths represent minimum estimates. Moreover, as reporting capacity varies between countries, national comparisons must be made cautiously. The scarcity of detailed toxicological information in some countries limits our overall understanding of the role played by different drugs and polysubstance use in driving rates of drug-induced deaths over time. Most fatal overdoses involve the use of more than one substance, and drug consumption patterns, including polysubstance use, are increasingly complex.
Drug-induced mortality is driven by polysubstance use and diverse opioids
The provisional overall estimate for the European Union of almost 7 600 drug-induced deaths in 2024 is stable compared to the revised 2023 estimate, although it represents an increase of 6.5% on the consolidated 2022 estimate. The largest annual increases in the number of drug-induced deaths in 2024 were reported by Bulgaria, Germany, the Netherlands and Türkiye.
Opioids, usually in combination with other substances, remain the group of substances most implicated in drug-induced deaths. Heroin was involved in an estimated 1 600 deaths in the European Union in 2024 and was commonly identified in opioid-related deaths in some western European countries. However, in 2024, it was present in the majority of overdose deaths only in Luxembourg and Austria (heroin and morphine are not reported separately in Austria). Opioids other than heroin, including methadone, buprenorphine, highly potent synthetic opioids and pain-relief medicines containing opioids, are detected in a substantial share of overdose deaths in some countries (Figure 11.1).
Where detailed toxicological information is available on drug associations, it usually shows the presence of multiple substances, indicating that polysubstance toxicity is the norm.
In all countries, most drug-induced deaths are among males (Figure 11.2). The data are indicative of an ageing opioid-using cohort in Europe, with the number of drug-induced deaths among 50- to 64-year-olds having doubled between 2014 and 2024 (Figure 11.3 below).
The available data also suggest that deaths where stimulants are implicated are rising in some countries (see also Cocaine – the current situation in Europe and Synthetic stimulants – the current situation in Europe). Data from 20 countries suggest that one quarter of the drug-induced deaths reported in 2024 involved cocaine. It should be noted that stimulant deaths may be under-reported and their role may be underappreciated, as other drugs, including opioids, are often detected in deaths where stimulants are implicated.
Europe’s changing synthetic opioid market creates potential for overdose outbreaks and deaths
Highly potent synthetic opioids such as the nitazenes have been associated with outbreaks of fatal and non-fatal poisonings in Europe. However, except in some Baltic countries, these drugs are not prominent in the routine data at EU level. Nonetheless, sudden drug market shifts can lead to the rapid emergence of other highly potent synthetic opioids, such as orphines (see also New psychoactive substances – the current situation in Europe), while limitations in toxicological detection can delay identification, making it harder to assess and respond to the threat. To support consistent testing and reporting in Europe, in 2025, the EUDA laboratories network launched an analytical reference standards toolkit containing 14 samples of nitazenes and orphines.
In addition to the key role played in Estonia and Latvia, nitazene opioids were involved in localised poisoning outbreaks in Ireland in 2023 and 2024 and in France in 2023. Deaths and acute toxicity linked to nitazenes have been reported in 2024 in Germany (9), as well as in Sweden (31) and Norway (21). Since 2019, at least 21 EU Member States have reported the presence of one or more nitazenes. Because nitazenes degrade in post-mortem blood samples, deaths involving these substances are likely to be underestimated.
Over the period 2024-2025, fentanyl has been associated with over 100 drug-induced deaths in Bulgaria. Fentanyl-related deaths and hospitalisations, initially reported mainly in Sofia, were observed in other Bulgarian cities in 2025. In the context of limited harm reduction service provision, including the absence of take-home naloxone programmes, the diffusion of highly potent synthetic opioids in Bulgaria is particularly concerning.
Some EU Member States have responded to the presence of highly potent synthetic opioids on their drug markets by strengthening existing harm reduction and treatment responses. Measures taken include the development of overdose warning systems, rapid alert media warnings, national warnings, increasing access to naloxone, prioritising nitazenes in narcotics classification and increasing police efforts targeting online sellers.
Preventing self-harm from poisonings requires targeted interventions
Many overdose deaths are reported as accidental, and for others the intent is undetermined. Where information on intentionality is available, a relatively high proportion of reported overdose deaths (1 in 7 overall in 2024) were classified as intentional, that is, with a suicidal intent. Current data reveal a higher proportion of overdose deaths with a suicidal intent among women than men. Addressing overdose deaths with a suicidal intent requires targeted interventions, including tailored mental-health and suicide-prevention services for people experiencing drug problems and co-occurring mental health conditions.
Improved access to services and integrated care can help reduce overdoses and deaths
Responses aimed at reducing opioid-related deaths include interventions to reduce vulnerability, prevent overdoses and prevent death when overdoses occur (see also Harm reduction – the current situation in Europe). These interventions are challenged, however, by changes over time in the population and characteristics of people consuming opioids, their patterns of use, the social context of their drug taking and the substances consumed. Enrolment in opioid agonist treatment is strongly evidenced as a protective factor against opioid overdose and some other causes of death. However, in many EU Member States, treatment coverage and access remain below the levels recommended by the World Health Organization.
Growing evidence suggests that increasing the availability of opioid antagonists can help prevent fatal opioid overdoses. While all countries provide naloxone in clinical settings, by 2025, take-home naloxone programmes were also reported in 19 European countries, although availability varies between and within countries. In addition, drug consumption rooms, also designed to reduce overdose deaths, were operational in 12 EU Member States and Norway in 2025 (see also Harm reduction – the current situation in Europe and Health and social responses: drug consumption rooms). However, the presence of highly potent synthetic opioids, such as nitazenes, can complicate overdose reversal and challenge the effectiveness of these interventions. When offered within drug consumption rooms, drug checking can reach more vulnerable groups and may help reduce overdose risk linked to unexpected or potent opioids and polysubstance use.
Drug-induced deaths represent only a portion of the overall mortality associated with drug use. Opioid dependence is typically a chronic condition, characterised by multiple episodes of treatment and relapse. People consuming opioids over many years are likely to have accumulated other health problems related to their substance use, which often includes alcohol and tobacco consumption, and the cumulative effects of economic and social marginalisation on their general health. Among these are infectious diseases (e.g. HIV, HCV infections), liver damage, cancer and mental health conditions. Improving access to general healthcare through multidisciplinary care and integrated pathways is key both to helping people with opioid problems manage illness and to reducing preventable mortality.
Key data and trends
Mortality rates due to overdose
- The mortality rate due to overdose in the European Union in 2024 is estimated at 25 deaths per million population aged 15 to 64.
- Mortality rates rate due to overdose were highest among people aged 40-44, for both females and males (Figure 11.3).
Overdose deaths
- A minimum estimate of 7 589 fatal overdoses involving drugs occurred in the European Union in 2024 (7 653 in 2023; see Figure 11.4 below).
- The number of overdose deaths reported in the European Union among those aged 50 to 64 is estimated to have more than doubled between 2014 and 2024 overall, increasing by 99% among women (from 169 to 337 deaths) and by 132% among men (from 458 to 1 063 deaths). In the same period, the number of overdose deaths among teenagers (aged 15 to 19 years) has almost tripled among young females (from 14 to 44 deaths) and almost doubled among young males (from 49 to 82) (Figure 11.3).
Established and new substances associated with drug-induced deaths
- Opioids, including heroin and its metabolites, often in combination with other substances, were estimated to be present in around 7 out of 10 fatal overdoses in the European Union in 2024 (Figure 11.4 and Figure 11.5).
- Heroin continues to be involved in large numbers of deaths in some European countries, with over 698 cases in Germany, 121 in Austria (heroin or morphine) and 63 in Sweden. Based on provisional data, heroin was estimated to be involved in at least 1 600 deaths in 2024 in the European Union (1 700 in 2023). Data from the 20 EU Member States providing data for 2024 may indicate a downward trend in heroin-related deaths, declining from around 1 300 in 2022 to 1 200 in 2023 and 1 100 in 2024.
- Among the 20 EU Member States providing data for 2023 and 2024, cocaine, mostly in the presence of opioids, was involved in 1 133 overdose deaths (27%) in 2024, and in 1 053 deaths (26%) in 2023. In 2024, cocaine was involved in the majority of overdose deaths in Spain, Cyprus, Luxembourg, Malta and Portugal.
- Of the 21 countries with post-mortem data available for 2024, 20 reported deaths where non-cocaine stimulants (e.g. amphetamines) were involved. Other stimulant-related deaths, such as those associated with cardiovascular problems, may go undetected.
- In 2024, synthetic cathinones were reported in 38 drug-induced deaths in 7 countries, with Finland accounting for 19.
- In 8 of the 21 countries with post-mortem toxicological data available for 2024, at least 1 in 4 drug-induced deaths involved methadone. There is no information on whether methadone was prescribed, misused or illicitly produced, and its presence in toxicology findings does not imply that it caused the poisoning, as overdoses often involve multiple substances.
- Available data from 15 EU Member States indicate that the number of deaths related to fentanyl and fentanyl derivatives increased significantly, with the drugs being linked to 208 overdose deaths in 2024 (129 in 2023). Germany reported the largest number of fentanyl-related deaths (95). Some of these fatalities might be associated with diverted fentanyl medicines rather than illicitly produced fentanyl.
- Nitazene opioids were linked to drug-induced deaths in 2024 in Estonia (43 out of 97 deaths) and Latvia (36 out of 77 deaths).
- Between June 2024 and January 2026, 5 EU Member States reported 5 cases of acute non-fatal poisoning and 18 deaths with confirmed exposure to orphines, mostly cychlorphine (See also New psychoactive substances in Europe – the current situation in Europe).
- In countries with data available for 2024, oxycodone was reported as being involved in 248 drug-induced deaths in 9 countries.
- In 2024, benzodiazepines, together with other substances, primarily opioids, were detected in most overdose deaths in Denmark, Estonia, Luxembourg, Austria, Slovenia and Finland; pregabalin was involved in at least a quarter of the cases in Denmark, Austria and Finland.
- Deaths linked to synthetic cannabinoids more than tripled from 61 cases in 2023 to 202 in 2024 in Türkiye (up from 8 in 2022). Preliminary data suggest a further increase in 2025.
Overall mortality
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An Austrian national cohort study followed 26 000 individuals who had ever been prescribed opioid agonist treatment for almost 20 years and recorded approximately 2 400 deaths. All-cause mortality among cohort members was more than 7 times that of the Austrian general population, with greater excess among women (12-fold) than men (7-fold). Age-specific analyses showed that by the age of early to mid-40s, deaths from non-communicable diseases collectively exceeded those from drug-related causes.
Additional detailed information can be found in the EUDA’s Opioid-related deaths: health and social responses and Frequently asked questions (FAQ): drug-induced deaths in Europe.
Source data
The data used to generate infographics and charts on this page may be found below.
The complete set of source data for the European Drug Report 2026, 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.