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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. Much of our knowledge about cocaine trafficking routes results from law enforcement activity and intelligence. Information on types and quantities of drugs seized and information on the origin and destination of shipments give indications of the main routes and modes of transport. However, such information is affected by factors such as law enforcement strategies, resources and priorities, as well as temporary changes to routes and practices in response to interdiction efforts or new opportunities. Hence, caution is needed in interpreting these data. The 1 tonnes of cocaine seized worldwide in was the highest ever to be reported. As in previous years, the vast majority of the global total was seized in the Americas, followed by western and central Europe. Although small in comparison with the Americas and Europe, quantities seized in emerging cocaine markets in Africa and Asia also reached record highs in UNODC, a see Figure Global quantity of cocaine seized. The source data for this graphic is available in the source table on this page. Record levels of cocaine production have been matched by record quantities seized, especially from containers handled in the numerous ports along the transatlantic cocaine routes. Most of the cocaine seized in the EU is transported by sea, primarily in maritime shipping containers. Cocaine is shipped to the EU directly from the countries of production but also from neighbouring countries of departure in South and Central America as well as the Caribbean. Based on quantities of cocaine seized in European ports and in ports elsewhere destined for Europe see Box Detailed analysis of cocaine seized in or destined for EU , Brazil about 71 tonnes , Ecuador The latter is a relative newcomer in the top countries of origin for shipments destined for Europe, confirming that Central America now has a more significant role EMCDDA and Europol, This is likely to reflect a diversification of trafficking routes within the Americas. In total, 25 countries in the Americas reported seizures of cocaine with Europe as the intended destination in In addition to the countries previously listed, also mentioned are Paraguay There have traditionally been two main areas through which maritime and air shipments of cocaine transit en route to Europe: the Caribbean, and the West African mainland and neighbouring islands of Cape Verde, Madeira and the Canaries. While these are likely to remain significant transit areas, there are indications that North Africa continues to grow in importance and that transhipment through the Western Balkans, while remaining more limited in scope, may also have increased. From the Caribbean, cocaine is typically shipped on pleasure craft via the Azores, or by air, either on direct flights or via a variety of transit points. The quantities of cocaine seized in the West African mainland and neighbouring islands, together with those seized in Europe coming from the region appear to be small in comparison to the amounts seized at departure points in the Americas. Data reported at the international level indicate that cocaine seizures in West Africa totalled This includes a finding that more than 16 tonnes of cocaine was seized in the region that year, reversing the dearth of seizures recorded since Bird, Large seizures were also reported in This includes a shipment of 2. According to media reporting, Gambian drug authorities were searching for the owner of the consignment, a French national, in connection with the incident News24, ; Reuters, Although considerably less cocaine was seized in North Africa 1. However, developments in the last four or five years suggest that the region, particularly its coasts on the Atlantic and the Mediterranean, is a growing transit and storage hub for cocaine both arriving by sea directly from South America and coming via West Africa by land for onward transport to Europe or elsewhere, for instance the Middle East EMCDDA and Europol, ; GI TOC, The main cocaine hub of North Africa is probably Morocco. The country has traditionally seized the largest quantities of cocaine in the region, which continued in with seizures totalling 1. There are indications that the Moroccan total could be even higher. For instance, in October , more than 1. The drugs were concealed in a container on a ship that had departed from Brazil and was bound for Antwerp, Belgium, and Portbury, a middle-sized port in Bristol, United Kingdom Kundu, On a much smaller scale than Morocco, international cocaine trafficking activities in Algeria and Libya reported in the last edition of this report EMCDDA and Europol, ; Micaleff, appear to have continued in the recent period. In , Algeria reported seizing about kilograms UNODC, a , while there are indications that Libyan seizures amounted to over 44 kilograms. In December , there were two significant seizures from containers bound for Libya: one in Ecuador on a container bound for Libya and Syria kilograms , and another in Malta from a container originating in Ecuador kilograms Dixon, This area is a known hub for the transhipment of drugs at sea, particularly cannabis resin from Morocco, on ships bound for Europe or Libya, while significant quantities of cocaine have been seized in the port of Oran recently Ben Yahia and Farrah, For instance, non-routine data reported by the European Border and Coast Guard Agency Frontex on drug seizures at a number of border posts between the EU and the Western Balkans in and indicate that comparatively small amounts of cocaine enter the EU from that region. Meanwhile, Frontex data confirm the large quantities of cocaine seized in Spain, a traditional entry point for cocaine into the EU Frontex, Nevertheless, individual seizures in and could suggest that cocaine trafficking through ports in the Western Balkan region, particularly in Albania and Montenegro, may have increased. For example, kilograms was seized in the port of Durres, Albania in April Exit. Montenegrin authorities also suspect that more than 3 tonnes were smuggled through the port of Bar in the second half of Kajosevic, Furthermore, Kosovo seized a shipment of kilograms of cocaine in May after it had been smuggled through the Albanian port of Durres Halili, For the fourth consecutive year, record amounts of cocaine were seized in Europe in At Meanwhile, new records were also established elsewhere in , including Greece 1. This indicates that entry points of cocaine shipments are diversifying and that cocaine consumer markets are developing in eastern Europe including Turkey see Cocaine retail markets: multiple indicators suggest continued growth and diversification. Source: The source data for this graphic is available in the source table on this page. Data available for a few key countries indicate that even larger quantities of cocaine were seized in the EU in For instance, data on cocaine seizures in Belgium indicate that almost 92 tonnes of cocaine was seized in , almost all in the port of Antwerp. If seizures made elsewhere of shipments that were destined for Antwerp are taken into account, then close to tonnes of cocaine was seized in connection with Antwerp in Belgian Federal Police, personal communication. The preliminary data available from a few countries indicates that more than tonnes of cocaine were seized in the EU in , exceeding the previous record European total Cocaine traffickers flexibly use a wide range of innovative trafficking methods, which evolve over time in response to enforcement efforts and other factors. Although cocaine also enters the EU by air, the main route used to smuggle the drug into Europe is still the maritime route from South America to western Europe, especially taking advantage of the licit containerised trade. Maritime transport allows the smuggling of large quantities, and the nature of international commercial maritime traffic means that a vast number of routes can be and are used. In addition, smaller, private sailing boats or even semi-submersible vessels are capable of bringing in large quantities of cocaine in single shipments, entering Europe at many points see Box First two semi-submersible drug-smuggling vessels captured in Europe. Criminal networks involved in cocaine trafficking now also more frequently employ methods of transport such as mother ships, pleasure craft, fishing vessels, cruise ships and the drop-off method. Major European container ports have recorded many seizures of large cocaine shipments in recent years. In addition to targeting major ports, organised criminal networks are now increasingly shipping larger amounts of cocaine from South America to smaller ports in the EU or neighbouring countries, where security measures may be easier to circumvent. Corruption of maritime and aviation port employees and security officials throughout Europe is, in most cases, a key condition for the successful use of these facilities for cocaine importation by criminal networks. Most of the cocaine available in Europe continues to be smuggled into the largest container ports of the EU located in Belgium Antwerp , the Netherlands Rotterdam and Spain Valencia and Algeciras. The German authorities have attributed the recent increase in seizures in the port of Hamburg to the activities of Balkan and Albanian-speaking organised crime networks BKA, The use of these ports shows how criminal networks continue to exploit established commercial maritime routes between Latin America and Europe to smuggle cocaine into the EU. Taking advantage of the large volume of containerised trade in goods between the two regions, criminal networks are able to conceal large quantities of cocaine in individual shipments. As a result, the main European container ports have recorded increasing numbers of large-volume cocaine seizures in recent years. While these main container ports continue to be targeted, it is likely that law enforcement activities at these facilities have pushed some criminal networks to find alternative smuggling routes, resulting in a recent intensification of cocaine shipments to smaller ports in the EU or in neighbouring countries where security measures may be viewed as easier to evade. The available data suggest that cocaine trafficking towards the EU continued during the COVID pandemic without any apparent disruption. At least tonnes of cocaine destined for Europe was seized in Some tonnes was seized at departure ports located in Latin America, and approximately tonnes was seized at EU ports. As in previous years, the largest quantity of cocaine in the EU was seized in Belgian ports 69 tonnes , followed by Dutch 45 tonnes and Spanish ports 26 tonnes. In Latin America, the largest amount was seized at ports in Brazil 45 tonnes , Ecuador 24 tonnes and Colombia 18 tonnes see Figure Top 10 countries for quantity of cocaine destined for Europe seized at ports in A total of 60 tonnes of cocaine was seized in such secondary EU ports in see Figure Top 10 EU seizing ports for quantity of cocaine. For a description of different concealment methods, see Figure Maritime trafficking: diversification of modus operandi. The available data indicates that in Latin America, the largest quantities of cocaine destined for Europe were seized in Guayaquil, Ecuador 23 tonnes , and Santos, Brazil 21 tonnes. If all seizures departing from these ports are taken into consideration, totalling about 61 tonnes shipped from Guayaquil and 31 tonnes from Santos, it becomes clear that these two ports are used intensively by cocaine trafficking criminal networks. Analysis of concealment methods emphasises some key features that enable large quantities of cocaine to be smuggled to the EU. Criminal networks are creative and appear to be able to rapidly adapt to avoid detection, which explains why a range of modi operandi are implemented. The data indicate that the port of Antwerp is probably the main entry point for cocaine smuggled into the EU. Europol intelligence suggests that most of the cocaine entering Antwerp is destined initially for the Netherlands, where further distribution is arranged. Focusing exclusively on cocaine seized outside Europe and destined for Belgian ports in the period, a variety of modi operandi can be observed in the 10 main shipping ports see Figure Top 10 source ports for quantity of cocaine destined for Belgian ports. The reasons for this are unclear and require additional research and closer monitoring. That said, Ecuador, which shares land borders with both Colombia and Peru, two of the main cocaine-producing countries, seems to have transformed in the last decade or so from a transit country into a major trafficking hub. Furthermore, it is now also reportedly emerging as a cocaine-producing country Pichel, Such transformation is thought to have fuelled recent violence between local gangs rumoured to be used by important cocaine trafficking networks from Colombia and Mexico. A recent surge in assassinations, which nearly doubled between and , including violent prison gang riots in which hundreds of inmates died in , are reportedly linked with cocaine trafficking in the country, particularly in the port of Guayaquil. Only the top 5 ports with data available for all years are shown. Operations supported by Europol have exposed the role played by corruption in the functioning of drug markets in Europe, a factor that may have been underestimated in the past. Corruption is a crime enabler for all types of criminal activities and is a significant facilitator of drug trafficking activities. In this regard, corruption is used by traffickers to gain entry to ports, to access drugs hidden in containers, to set up or ensure control over businesses used as covers for smuggling activities, such as renting transport vehicles or storage premises, and also to facilitate money laundering, among others. Indeed, various modi operandi used to smuggle cocaine through EU ports require corruption, and recent investigations in some EU ports have provided valuable insights on the methods used by criminal networks to retrieve cocaine shipments from containers in the EU. Of course, the threat of corruption is not restricted to EU ports, since it is also used in most other ports targeted by criminal groups globally. Subsequently, criminal actors will need to introduce the drugs into the container and replace the seal that has been broken during this process with a counterfeited one. Usually, this operation takes place after customs have cleared the container. In the destination port, the criminal network will, again, need inside help and information as they usually require the targeted container to be placed in a specific location in order to facilitate access to it, for instance on the ground and with unimpeded access to the doors. Additionally, they must receive confirmation that the container has been placed in the desired location and, depending on the type of rip-off method used, extract the cocaine from the container and transport it outside the port area. Other modi operandi may also require corruption as a facilitator. Concealing cocaine within shipments of legitimate goods can also use corruption, for instance in order to be informed and take necessary action if the container has been selected for physical inspection, or to receive customs clearance without such inspection. According to a law enforcement official from Seaport Police, a unit of the Dutch Police, interviewed in the press in , acts of corruption involving staff from shipping companies were identified in the port of Rotterdam in the previous two and a half years Driessen and Meeus, An investigation that led to the seizure of An ex-governor, a harbour master, three police officers and a lawyer were among the 22 suspects arrested during this operation Eeckhaut, Workers in other large EU ports such as Le Havre, France, or Alicante, Spain, have been targeted by criminal networks and engaged to facilitate cocaine importation. Recruitment into corrupt activities is usually carried out by offering large sums of cash or other valuable assets and services, but can also be achieved using violence and intimidation Gil, Kidnappings and murders of port workers have been reported in various EU ports in recent years Auvray, ; Europol, e. Cocaine smuggling by air primarily involves the use of commercial passenger flights, cargo aircraft and general aviation private aircraft. Fairly large shipments of cocaine are smuggled directly from South America and the Caribbean to western Europe by private business aircraft, and use of this method is expected to increase in the future. Stricter border controls and more effective security checks may encourage criminal networks to use secondary international airports and small airfields see Box Private jets: the Achilles heel in the fight against cocaine trafficking by air. With some travel restrictions remaining in place and significantly reduced air passenger traffic, it is likely that the use of air couriers will remain limited compared to the pre-COVID period. In the pre-pandemic period, smaller quantities of cocaine were smuggled using commercial flights. Couriers flew from airports in South and Central America and the Caribbean to major European airports, either directly or after stopovers in countries such as Morocco, Nigeria and the United Arab Emirates. After arrival at the main EU distribution hubs, cocaine shipments are primarily trafficked by road in passenger vehicles and lorries to local markets. Intra-EU trafficking of cocaine also involves commercial flights, light aircraft and helicopters, railway, sea transport, and post and parcel services. Cocaine loads are often hidden in sophisticated concealed compartments in cars, trucks and other vehicles, sometimes with shipments of other drugs. These compartments are also used to transport cash back to the distribution hubs. In addition, Europol intelligence indicates that some European criminal networks orchestrate cocaine shipments directly from South America to Asia without the drugs ever entering the EU. In , cocaine was the most frequently seized substance from air couriers intercepted at European airports and the third most frequently detected drug at European mail centres, after cannabis and other psychotropic substances Council of Europe, The COVID pandemic accelerated an expansion in the use of post and parcel services to fulfil orders placed online. Postal and parcel services are exploited for the distribution of drugs such as cannabis, cocaine, synthetic drugs Council of Europe, , new psychoactive substances, counterfeit currency, stolen and fraudulent documents, and many other illicit commodities. The distribution of illicit goods using post and parcel services is set to increase further in line with the expected growth of online retail activity. Consult the list of references used in this resource. 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. On this page. Europe and the global cocaine trade. PDF is being prepared. 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. Last update: 6 May

Counting on a Colon Cleanser? Here are 5 Better Choices

Buying blow Colon

Expensive prescription drugs are rarely the answer. Simple over-the-counter options like Miralax, Ex-Lax, or Ducolax usually do the trick. Based on all the ads for prescription laxatives, you may think that the country is gripped by an epidemic of hard-to-treat constipation. And the Food and Drug Administration seems to think so, too. It has approved five new prescription medications for the problem in the past four years. But while constipation can be serious and require medical intervention, in many cases lifestyle and diet changes suffice. Instead, over-the-counter drugs such as polyethylene glycol Miralax and generic , bisacodyl Dulcolax laxative tablets and generic , or senna Ex-Lax, Senokot, and generic are a far better choice. They tend to work at least as well, often have more evidence for their safety, and are much cheaper. But having fewer than three bowel movements per week, excessive straining, a sense of not being finished, or having hard, lumpy stools are signals you may have constipation. About 15 percent of Americans suffer from the condition for months and even years, studies show. Women are three times as likely as men to experience constipation, and seniors are also at high risk. But for some people the condition becomes chronic, with uncomfortable symptoms lasting three months or longer. Dietary fiber from foods such as vegetables, fruits, whole grains, and nuts helps create softer, bulkier stools that pass through your gut more quickly. Those containing psyllium, such as Metamucil, Konsyl, and generics, may work better than other forms, research suggests. All of them are safe and effective for most patients. But you may find that one type works better for you or causes fewer side effects. Occasional constipation usually lasts only a few days and will resolve on its own, Lacy says. For chronic constipation that has gone on for months, Lacy advises giving a drug time to work. In some cases, your doctor may recommend combining different types of medications. Polyethylene glycol MiraLax and generic works by pulling water into the colon, which softens the stool and stimulates the walls of the intestine to move it along. Its safety and effectiveness make it a first choice for many doctors and patients. A recent analysis of 41 studies of OTC laxatives published in The American Journal of Gastroenterology found robust evidence that polyethylene glycol works well for chronic constipation while causing minimal side effects. The analysis found that it worked better than prescription laxatives. Lacy recommends taking it after dinner so that it kicks in after your breakfast the next morning. It can take a couple of days before you notice a difference in your bowel movements. Stimulant laxatives such as bisacodyl Dulcolax laxative tablets and generic and senna Ex-Lax, Senokot, and generic trigger rhythmic contractions in the intestinal muscles that push stools through more quickly. That action stimulates sluggish bowels and keeps stools soft as the colon has less time to absorb the moisture. The recent review of OTC drugs found good evidence to recommend senna for chronic constipation and moderate evidence for bisacodyl. The downside to stimulant laxatives, according to the review, is that they can cause side effects such as abdominal pain and diarrhea. The American Journal of Gastroenterology review found moderate evidence to support the use of magnesium laxatives for chronic constipation. Senna and magnesium-based laxatives were equally effective, according to a randomized clinical trial of 90 people with chronic constipation published in January in The American Journal of Gastroenterology. Those taking senna were more likely than people taking a magnesium laxative to reduce their dose because of side effects. The kidneys help process magnesium. So people with kidney disease should avoid anything other than the occasional use of magnesium-based laxatives to prevent a buildup of dangerously high levels of the mineral in the body. By making stools easier to pass, these drugs can help in certain situations—after surgery, for example, when you want to avoid straining to have a bowel movement. Suppository laxatives such as Fleet Glycerin Suppository and Dulcolax Medicated Laxative Suppository usually take effect in less than an hour. Your doctor may be able to determine an underlying cause for your symptoms. For example, medical conditions such as diabetes or an underactive thyroid can cause constipation, as can many common medications, including certain antacids, antidepressants, antihistamines, blood pressure drugs, pain relievers, and drugs for urinary incontinence. Your doctor can also advise you on doses and timing of OTC products to get better results. Prescription drugs to treat constipation are relative newcomers to the market. Since the FDA has approved plecanatide Trulance , tenapanor Ibsrela , prucalopride Motegrity , and lactitol Pizensy as well as naldemedine Symproic for opioid-induced constipation. In addition, prescription drugs cost much more than their OTC counterparts. And with the exception of some older osmotic laxatives, none of those drugs are available yet as a low-cost generic. So even with insurance, you may be on the hook for a sizable co-pay. Secretory laxatives including linaclotide Linzess , lubiprostone Amitiza , and plecanatide Trulance work by causing the intestines to secrete more fluid and may also help block abdominal pain. All the drugs in this category are also FDA-approved for treating irritable bowel syndrome with constipation. About 5 percent of people taking Linzess experience severe diarrhea, research suggests, compared with about 1 to 2 percent with the other drugs in this class. Amitiza is more likely than the other drugs to cause nausea. Nearly 30 percent of people taking the recommended dose of the drug reported feeling nauseous compared with only 3 percent in the placebo group. Taking the drug with food can reduce that side effect, Lacy says. Prucalopride Motegrity stimulates muscles in the G. Common side effects include abdominal pain, diarrhea, headache, and nausea. Most people experiencing diarrhea or headache reported that the symptoms got better in a few days. In addition, Motegrity carries a warning that it could cause suicidal thoughts or behavior, although the FDA has not conclusively linked the drug to that risk. Few studies have compared constipation medications head-to-head. To get an idea of relative effectiveness, researchers from the U. Opioid pain relievers such as Vicodin, Percocet, and Oxycontin are known not only for their risk of addiction but also for constipation. Forty to 80 percent of people taking opioids for long-term pain experience constipation, according to the American Gastroenterological Association. The FDA has approved three drugs specifically for constipation caused by taking prescription opioids for pain: methylnaltrexone Relistor , naldemedine Symproic , and naloxegol Movantik. These medications, called peripherally acting mu-opioid receptor antagonists or Pamoras, relieve constipation by preventing opioids from attaching to receptors in the intestines. But patients with opioid-induced constipation should still try OTC laxatives before considering a prescription drug, according to AGA guidelines published in As with other prescription constipation drugs, one big drawback of Pamoras is price. The AGA gave methylnaltrexone a conditional recommendation based on a lack of good evidence supporting the drug. The group also noted that it costs far more than other drugs in its class. Amitiza is FDA-approved for treating opioid-induced constipation as well as chronic constipation. Teresa Carr is an award-winning journalist with a background in both science and writing, which makes her curious about how the world works and eager to tell you about it. She is a former Consumer Reports editor and Knight Science Journalism Fellow at MIT and has more than two decades' experience reporting on science, health, and consumer issues. We respect your privacy. All email addresses you provide will be used just for sending this story. Best Drugs for Constipation Expensive prescription drugs are rarely the answer. By Teresa Carr. September 26, More on Digestive Health. How to Relieve Constipation. Ease Heartburn and Other Tummy Troubles. What Counts as Constipation Anyway? Fiber First. Wald also recommends getting more physical activity, which can help get the bowels moving. OTC Laxatives. Prescription-Drug Options for Constipation. Drugs for Constipation From Opioids. Teresa Carr Teresa Carr is an award-winning journalist with a background in both science and writing, which makes her curious about how the world works and eager to tell you about it. Sharing is Nice. Yes, send me a copy of this email. Oops, we messed up. Try again later. Trending in Constipation.

Buying blow Colon