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Eur Addict Res 1 February ; 3 2 : 83— Prior to the collapse of the communist regime in , there was a very low level of illicit drug use in Slovakia. Health registers and a population survey revealed that those most affected by illicit drug use, namely heroin, are young people in the capital city, Bratislava. The records indicate a sharp increase in new patients with heroin-related problems at the end of and in As the detected median of the time period between the first experience with heroin and the first visit to a health facility varies between 2 and 3 years, the beginning of the epidemic can be established around the year The availability of drugs rather than unemployment seemed to play an important role in the beginning of the epidemic in Slovakia. Sign In or Create an Account. Search Dropdown Menu. Advanced Search. Skip Nav Destination Close navigation menu Article navigation. Volume 3, Issue 2. Article Navigation. Research Articles November 11 Lubomir Okruhlica Lubomir Okruhlica. Centrum liecby drogovych zavislosti Bratislava, The Slovak Republic. This Site. Google Scholar. Eur Addict Res 3 2 : 83— Article history Published Online:. Cite Icon Cite. Abstract Prior to the collapse of the communist regime in , there was a very low level of illicit drug use in Slovakia. You do not currently have access to this content. View full article. Sign in Don't already have an account? Buy Token. This article is also available for rental through DeepDyve. View Metrics. Email alerts Online First Alert. Latest Issue Alert. Citing articles via Web Of Science 1. Karger International S. Karger AG P. Karger AG, Basel. Close Modal.

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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. On this page, you can find the latest analysis of the drug situation for heroin and other opioids in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more. European Drug Report — home. The drug situation in Europe up to Drug supply, production and precursors. Synthetic stimulants. Heroin and other opioids. Other drugs. New psychoactive substances. Injecting drug use in Europe. Drug-related infectious diseases. Drug-induced deaths. Opioid agonist treatment. Harm reduction. Between and , the mean age of all clients entering specialist drug treatment for heroin use and for those doing so for the first time increased, as did the proportion of older clients see Figure 6. Changes in the characteristics of those seeking help increasingly mean that services must respond to the needs of clients presenting with an increasingly complex range of health and social support needs. As well as directly responding to drug-related problems, these include the need to provide care and support to prevent or treat age-related illness and a corresponding requirement to establish effective multi-agency partnerships and referral pathways with general health and social support services. While heroin continues to be involved in many opioid-related deaths see Drug-induced deaths — the current situation in Europe , the number of countries in which this is the case has decreased; at the same time, other opioids have become more prominent. In addition, although heroin remained the most commonly reported opioid in acute drug toxicity presentations at Euro-DEN sentinel hospitals in , in some cities other opioids — often those used for opioid agonist treatment, but also in some locations, medicines containing opioids used for pain relief or potent new synthetic opioids — have now overtaken heroin as a driver of presentations. While this data set is not nationally representative, it provides a window on how opioid problems may be changing at the local level. This data also needs to be interpreted with care, as some changes in this area appear to reflect the positive impact of long-term policies to reduce the demand for heroin, discourage new initiation and provide adequate and effective treatment responses. Nonetheless, greater attention may now be merited on measures to reduce the risk that opioids intended for therapeutic use may be diverted onto the illicit market. An important caveat here is that the pursuit of this objective should not create additional barriers to the provision of effective treatment for those with opioid problems. Moreover, it must be recognised that access to opioid agonist treatment remains inadequate in many countries. Changes in the route of administration of heroin have also been observed. Among presentations to treatment services, injecting among both first-time and previously treated heroin clients has decreased over the last decade see Figure 6. This change could reflect the influence of various factors, including the impact of harm reduction and prevention efforts and changes in drug availability that may affect patterns of use. This development is important, as injecting drug use is particularly associated with a range of negative health outcomes. Less positively, as discussed elsewhere in this report, overall, people who inject drugs appear to be injecting a wider range of substances, with stimulants in particular being more commonly reported. Due to COVID restrictions within specialist drug treatment services, data for , and should be interpreted with caution. Trends are based on the 19 EU Member States providing data over the period; only those with data for at least 9 of the 10 years are included. Missing values are interpolated from adjacent years. While it is too early to determine the full impact of this development on European drug markets, if sustained, it is likely to affect the availability of heroin in Europe in the coming years. The most recent aggregate data presented here are from and predate this development. These show a slight decrease in the overall quantity of heroin seized in the European Union. Also in , a slight decline can be observed in indexed trends in retail-level prices, with purity estimates slightly rising. At the same time, conflicts in Ukraine and the Middle East may affect the routes used by criminals to traffic illicit drugs to Europe. More generally, it is thought that stocks of opium existing within Afghanistan and the relatively high value of the European market would make supplies to Europe somewhat resilient in the short to medium term. Nonetheless, should the ban be sustained and rigorously enforced, we would expect to see an impact on the availability of heroin in the future. It is also possible that we might also see in the future some more limited supply of this drug to Europe from other producing regions in South-East Asia. It is therefore prudent to consider now what might be the implications of any changes in this area for drug polices and responses in order to be better prepared to mitigate any possible adverse consequences. One important implication would be the need to ensure the adequate availability of drug treatment provision for those seeking help, as disruptions to the illicit opioid market could increase demands in this area. A second implication would be the need to monitor and respond appropriately to reduce any possible additional harms that might result if other substances are used as substitutes for heroin. Experience suggests that these may include not only other opioids but also other drug classes, including stimulants such as cocaine or synthetic cathinones. In the same year, outbreaks of poisonings and overdoses involving nitazene opioids were reported in 5 countries. There were also reports of nitazene opioids being mis-sold as heroin in Ireland and France. An increase in the availability of synthetic opioids and of associated harms, including drug-related deaths was reported in by some northern and Baltic countries, with preliminary data from some countries confirming this trend. Historically, concerns in this area have been focused on fentanyl derivatives, such as the highly potent carfentanil, which continues to be seized in some EU countries. However, in the last few years, the nitazenes, highly potent opioids derived from 2-benzyl benzimidazole, have be detected in Europe. The most commonly identified nitazenes include protonitazene, metonitazene and isotonitazene. In , 14 countries reported seizures of nitazenes to the Early Warning System, amounting to 3 kilograms. These substances are discussed in more detail in New psychoactive substances — the current situation in Europe. Given the potential negative consequences of this, Europe needs to improve its preparedness for the harm reduction and other challenges that such a market shift could bring. Concerns in this area include the adulteration of heroin with new synthetic opioids, the mis-selling of new synthetic opioids and, in an extreme scenario, the replacement of heroin by new synthetic opioids. Such developments could increase the risk of overdose and drug-related death among opioid consumers. It is of note in this context that North America has seen a dramatic increase in opioid-related mortality in recent years, driven by potent synthetic opioids, principally fentanyl derivatives. However, based on previous examples of shocks to the heroin market, it is also possible that stimulants such as cocaine and synthetic cathinones may also have the potential to be used as replacement substances for heroin. It is therefore of concern that, as noted elsewhere in this report, the use of cocaine, and crack cocaine in particular, appears to be increasing among more marginalised groups and spreading to more countries. While increased polydrug use and substance-switching are likely outcomes of any reduction in heroin availability, a key means to pre-empt this scenario would be to expand rapid access to opioid agonist treatment and related supports, as well as needle and syringe programmes. It also remains important to develop sufficient access to naloxone to prevent overdoses and drug-related deaths. Most supplies of new synthetic opioids, such as nitazenes, are believed to originate in China and to be trafficked to Europe. However, some limited synthetic opioid production is known to have occurred within Europe, and it is not impossible to imagine that existing illicit synthetic drug production capacity could potentially be used for the production of synthetic opioids, should market conditions become favourable. It is estimated that 0. This apparent decrease, compared to previous years, is mainly due to a change in the indirect statistical method used to estimate the population of people who use heroin in Italy. Apart from trends, data are for all treatment entrants with heroin as the primary drug — 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. Because of disruptions to services due to COVID, data for , and should be interpreted with caution. Missing data were imputed with values from the previous year for Spain and France and Germany Data source : Euro-DEN. Indexed trends show the price and purity of brown heroin base: national mean values — minimum, maximum and interquartile range. Countries covered vary by indicator. Show source tables. The complete set of source data for the European Drug Report 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. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. This make take up to a minute. Once the PDF is ready it will appear in this tab. Sorry, the download of the PDF failed. Table of contents Search within the book. Search within the book Operator Any match. Exact term match only. For the latest data and detailed methodological information please see the Statistical Bulletin Prevalence of drug use. Graphics showing the most recent data for a country are based on studies carried out between and Main subject. Target audience. Publication type. European Drug Report main page. On this page. Prevalence data presented here are based on general populaton surveys submitted to the EMCDDA by national focal points.

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