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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. Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. On this page, you can find the latest analysis of harm reduction interventions in Europe, including key data on opioid agonist treatment, naloxone programmes, drug consumption rooms and more. European Drug Report — home. The drug situation in Europe up to Drug supply, production and precursors. Synthetic stimulants. Heroin and other opioids. New psychoactive substances. Other drugs. Injecting drug use in Europe. Drug-related infectious diseases. Drug-induced deaths. Opioid agonist treatment. Harm reduction. The use of illicit drugs is a recognised contributor to the global burden of disease. Interventions designed to reduce this burden include prevention activities, intended to reduce or slow the rate at which drug use may be initiated, and the offer of treatment to those who have developed drug problems. A complementary set of approaches goes under the general heading of harm reduction. Here the emphasis is on working non-judgmentally with people who use drugs in order to reduce the risks associated with behaviours that are mostly associated with adverse health outcomes, and more generally to promote health and well-being. Probably the best known of these is the provision of sterile injecting equipment to people who inject drugs, with the aim of reducing the risk of contracting an infectious disease. Over time these sorts of approaches appear to have contributed to the relatively low rate, by international standards, of new HIV infections now associated with injecting drug use in Europe. Over the last decade, as patterns of drug use have changed and the characteristics of those who use drugs have also evolved, to some extent, harm reduction interventions have needed to adapt to address a broader set of health outcomes. Among these are reducing the risk of drug overdose and addressing the often-considerable health and social problems faced by more marginalised populations. Chronic and acute health problems are associated with the use of illicit drugs, and these are compounded by factors that include the properties of the substances, the route of administration, individual vulnerability, and the social context in which drugs are consumed. Chronic problems include dependence and drug-related infectious disease, while there is a range of acute harms, of which drug overdose is the best documented. Although relatively rare, the use of opioids still accounts for much of the morbidity and mortality associated with drug use. Injecting drug use also increases risks. Correspondingly, working with opioid users and those who inject drugs has been historically an important target for harm reduction interventions and also probably the area where service delivery models are most developed and evaluated. Reflecting this, some harm reduction services have become increasingly integrated into the mainstream of healthcare provision for people who use drugs in Europe over the last two decades. In the last two decades, approaches to harm reduction have been broadened in some EU countries to encompass other responses, including supervised drug consumption rooms and take-home naloxone programmes intended to reduce fatal overdoses. In some countries, there are also drug checking facilities, set up to enable people to understand better what substances the illicit drugs they have bought contain. Tablets, for example, purchased as MDMA, may also contain adulterants and other drugs, such as synthetic cathinones. With many synthetic stimulants and new psychoactive substances now available on the illicit market in similar looking powders or pills, consumers may be increasingly at risk of being unaware what particular stimulant or mixture of substances they may be consuming. Some of these interventions remain controversial for reasons that include their legal status and the evolving nature of their evidence base. Coverage of these newer interventions therefore remains uneven within and between countries, and where they do exist, they are often most commonly found only in large cities. Overall, coverage and access to harm reduction services more generally, including those service models that are long-established and relatively well evidenced, varies considerably between EU countries, and in some countries remains inadequate in comparison to estimated needs. Some indicators now suggest that synthetic opioids and synthetic stimulants have a growing potential to cause drug-related harms in Europe, as inadvertent consumption of these substances in powders or mixtures sold as other drugs can lead to poisonings and deaths. This, together with more complex patterns of polydrug consumption, adds to the already considerable challenges of developing effective responses to reduce drug overdose deaths and drug-related poisonings. An example of this growing complexity, albeit currently on a relatively small scale, comes from Estonia where mixtures have been identified containing new synthetic opioids and new benzodiazepines and also the tranquilliser xylazine. The presence on the market of such mixtures highlights the need to review current approaches to the delivery of some harm reduction interventions. For example, these mixtures may need consideration to be given to reviewing distribution and administration of the opioid antagonist naloxone. Reducing the risks associated with injecting drug use has always been an important target for harm reduction interventions, and the service models are relatively well developed and evidenced. However, even in this area, changes in drug consumption are creating new challenges for effective service delivery. In the last decade, there have been HIV outbreaks associated with the injection of illicit synthetic stimulants in 6 major European cities, across 5 EU countries. A potentially increased frequency of injection is associated with stimulant use compared to heroin use, while crushing and dissolving crack cocaine and other tablets for injection also brings additional health risks. These consumption patterns raise questions regarding, for example, the type and adequacy of needles and syringes provided to people in street-based open drug scenes, typically characterised by polydrug use. An additional concern exists that service restrictions during COVID lockdowns adversely impacted on testing for drug-related infections, such as HIV and HCV, and on conduits to care among more vulnerable and marginalised populations of people who use drugs, including those experiencing homelessness. The use of illicit stimulants and other drugs to facilitate group sexual encounters, sometimes of an extended duration, among men who have sex with men is known as chemsex. This high-risk sexual practice can involve participants having multiple sexual partners, with whom they engage in unprotected sexual activity, placing them at risk of sexually transmitted infections. Group chemsex sessions can be associated with the use of social media apps, where access to illicit drugs and group sex may be combined by some organisers. High-risk consumption of some of these drugs, including injecting drug use, places people at risk of infectious diseases such as HIV and HCV, as well as acute drug toxicity, fatal overdose, acute psychiatric complications, substance use disorder and other psychiatric problems such as anxiety and depression. In , a monkeypox outbreak was documented for the first time in Europe. Descriptive studies showing a potential association between monkeypox infection and specific exposures chemsex, tattooing have raised questions on the implications and specific harm reduction needs of some groups of people who use drugs. While it is difficult to estimate the prevalence of chemsex, information from research studies and treatment centres suggest it is an issue that is present, albeit at a small scale and among specific subgroups of people who use drugs, across Europe. It must be noted that this group of people are generally not present as clients in drug treatment clinics. Providing effective harm reduction responses for people engaged in these high-risk behaviours remains a challenge and the development of tailored harm-reduction interventions is needed. In Europe, treatment services for drug and sexual health problems are usually funded separately, have different eligibility criteria and are rarely co-located. This makes it difficult to provide integrated care for people exposed to the dual risks of unprotected sex and high-risk drug use in a chemsex context. Ongoing research is aimed at identifying the most appropriate service model to engage clients, such as integrating drug services into existing sexual health services for men who have sex with men. Cannabis users in Europe often smoke the drug with tobacco, and an undeveloped area for the development of harm reduction approaches is the consideration of what might constitute effective inventions to reduce smoking-related harm in this group. More generally, as the types and forms of cannabis products available in Europe continue to change, so too have considerations about the implications this has for harm reduction responses. For example, natural cannabis products sprayed with potent synthetic cannabinoids, but mis-sold as natural cannabis, place consumers at risk of health complications. Generally, cannabis products, both resin and herb, are now of a higher potency than they were historically, while the diversity of product types has expanded, with edibles, e-liquids and extracts all now available. The newness of these cannabis forms raises issues around consumer safety, particularly where little information exists about their impact on human health and creates a complex harm reduction messaging challenge. Among these are substances such as nitrous oxide and ketamine. While these drugs are associated with episodic or recreational use in specific contexts, such as nightlife or entertainment settings, they are linked with a range of possible health harms, of which the people using them may not be aware. While some harm reduction responses remain controversial in some countries in Europe, the overall concept that evidence-based measures to reduce harm are an important component of balanced drug policies is largely accepted. The contexts within which harm reduction services operate, the evidence base that supports them, and what constitutes standards for quality of care in this area therefore remain key areas for policy consideration. Health and social responses to drug problems: a European guide contains detailed information for those wanting to find out more about the evidence that exists for the relative effectiveness of harm reduction and other forms of intervention. The coverage is based on the latest national estimates of injecting drug use and high-risk opioid use matched by harm reduction activity data within a maximum of 2 years. The estimate of coverage of opioid agonist treatment for Belgium is derived from a subnational study conducted in Show source tables. Back to list of tables. 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. A more recent version of this page exists: Harm reduction — the current situation in Europe European Drug Report Table of contents Search within the book. Search within the book Operator Any match. Exact term match only. Source data The data used to generate infographics and charts on this page may be found below. Show source tables List of tables Table 1 number of European countries implementing harm reduction interventions, up to Table 2 availability of take-home naloxone in Europe Table 3 needle and syringes distribution and opioid agonist treatment coverage in relation to WHO targets, or latest available estimate Table 4 location and number of drug consumption facilities throughout Europe Table 1. Number of European countries implementing harm reduction interventions, up to Year Drug checking Drug consumption rooms Methadone maintenance treatment Needle and syringe programmes Take-home naloxone 1 2 3 4 5 6 2 3 6 8 7 8 9 11 11 13 12 1 15 14 16 16 17 19 20 21 2 22 5 23 25 26 26 27 7 27 28 1 2 8 4 1 6 9 2 7 6 9 10 8 11 9 13 12 15 12 10 27 28 Table 2. Table 3. Needle and syringe distribution and opioid agonist treatment coverage in relation to WHO targets, or latest available estimate Country Proportion in opioid agonist treatment Syringes per person who injects drugs Number people who inject drugs Croatia 0. Table 4. Location and number of drug consumption facilities throughout Europe City Country lat lon Number of facilities Brussels Belgium Hidden tables for page ID Term 10 WHO target for opioid agonist treatment provision 20 Proportion of high-risk opioid users receiving opioid agonist treatment 30 WHO target for needle and syringe distribution 40 Number of sterile syringes per person who injects drugs per year 45 Number people who inject drugs 50 Click to zoom in. Number of sites: 90 Number of countries 60 sites. Main subject. Target audience. Publication type. European Drug Report main page. On this page.

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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. Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. On this page, you can find the latest analysis of harm reduction interventions in Europe, including key data on opioid agonist treatment, naloxone programmes, drug consumption rooms 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. The use of illicit drugs is a recognised contributor to the global burden of disease. Interventions designed to reduce this burden include prevention activities, intended to reduce or slow the rate at which drug use may be initiated, and the offer of treatment to those who have developed drug problems. A complementary set of approaches goes under the general heading of harm reduction. Here the emphasis is on working non-judgementally with people who use drugs in order to reduce the risks associated with behaviours that are mostly associated with adverse health outcomes, and more generally to promote health and well-being. Probably the best known of these is the provision of sterile injecting equipment to people who inject drugs, with the aim of reducing the risk of contracting an infectious disease. Over time these sorts of approaches appear to have contributed to the relatively low rate, by international standards, of new HIV infections now associated with injecting drug use in Europe. Over the last decade, as patterns of drug use have changed and the characteristics of those who use drugs have also evolved, to some extent, harm reduction interventions have also needed to adapt to address a broader set of health outcomes and risk behaviours. Prominent among these are reducing the risk of drug overdose and addressing the often-considerable and complex health and social problems faced by people who use drugs in more marginalised and socially excluded populations. Chronic and acute health problems are associated with the use of illicit drugs, and these can be compounded by factors such as the properties of the substances, the route of administration, individual vulnerability and the social context in which drugs are consumed. Chronic problems include dependence and drug-related infectious disease, while there is a range of acute harms, of which drug overdose is perhaps the best documented. Although relatively rare at the population level, the use of opioids still accounts for much of the morbidity and mortality associated with drug use. Injecting drug use also increases risks. Correspondingly, working with opioid users and those who inject drugs has been historically an important target for harm reduction interventions and also the area where service delivery models are most developed and evaluated. Reflecting this, some harm reduction services have become increasingly integrated into the mainstream of healthcare provision for people who use drugs in Europe over the last three decades. Recent joint EMCDDA-ECDC guidance on the prevention and control of infectious diseases among people who inject drugs recommends providing opioid agonist treatment to prevent hepatitis C and HIV, as well as to reduce injecting risk behaviours and injecting frequency, in both the community and prison settings. The guidelines also recommend the provision of sterile injecting equipment alongside opioid agonist treatment to maximise the coverage and effectiveness of the interventions among people who inject opioids. In the last three decades, approaches to harm reduction have been broadened in some EU countries to encompass other responses, including drug consumption rooms and take-home naloxone programmes intended to reduce fatal overdoses Figure Interventions to reduce opioid-related deaths include those aimed at preventing overdoses from occurring and those aimed at preventing death when an overdose does occur Figure Show a text version of the above graphic. Note: Interventions where there is evidence of benefit and where we can have high or reasonable confidence in the available evidence are highlighted in a bolder frame. Much of the current evidence on interventions listed in this figure is either emerging or deemed insufficient, in part because of the practical and methodological difficulties of conducting research, especially in developing randomised controlled trials see Spotlight on Understanding and using evidence and also because service delivery models often differ considerably. In some countries, there are drug checking facilities, which have been established with the aim of enabling people to understand better what substances the illicit drugs they have bought contain. Tablets, for example, purchased as MDMA, may also contain adulterants and other drugs, such as synthetic cathinones. With many synthetic stimulants and new psychoactive substances now available on the illicit market in similar looking powders or pills, consumers may be increasingly at risk of being unaware of what particular stimulant or mixture of substances they may be consuming. The increasing integration of the markets for new psychoactive substances and illicit drugs is creating new public health challenges, such as herbal cannabis mixed with synthetic cannabinoids, stimulants mixed with cathinones and ketamine or new synthetic opioids mixed with or mis-sold as heroin. As poisoning events can evolve rapidly, understanding what constitutes the delivery of effective of risk communication has become more important. Although the range of services provided may differ, all drug checking services undertake some form of health risk communication activity, often by issuing alerts on analysed drug products and sharing data with other stakeholders. The aim is to prevent or reduce harm at the level of the individual the person submitting the substance for checking and of the population others who may be exposed to the same substance. Future steps in this field may include moves towards harmonisation and the building of consensus among European drug checking services on the determination of criteria and thresholds for when and how to issue alerts, as well as the adoption of evidence-based standard operating procedures for health risk communication. Some of these interventions remain controversial for reasons that include their legal status and the evolving nature of their evidence base. Coverage of these newer interventions therefore remains uneven within and between countries, and where they do exist, they are often most commonly found only in large cities. Overall, coverage and access to harm reduction services more generally, including those service models that are long-established and relatively well evidenced, varies considerably between EU countries, and in some countries remains inadequate in comparison to estimated needs. Potent synthetic substances have a growing potential to cause drug-related harms in Europe, as inadvertent consumption of these substances in powders or mixtures sold as other drugs can lead to poisonings and deaths. This, together with more complex patterns of polydrug consumption, adds to the already considerable challenges of developing effective responses to reduce drug overdose deaths and drug-related poisonings. An example of this growing complexity, albeit currently on a relatively small scale, was seen in Estonia in , where mixtures were identified containing new synthetic opioids and new benzodiazepines and also the tranquilliser xylazine. More recently, the highly potent benzimidazole opioids nitazenes , which are more potent than fentanyl, have also been involved in localised poisoning outbreaks in parts of Europe see also New psychoactive substances — the current situation in Europe. During a recent outbreak in Ireland, a rapid risk communication exercise was undertaken, with the support of low-threshold services, which included leaflet drops to open drug scenes and distribution of information on social media and news platforms. This is an example of how services may need to respond both more rapidly and more intensively to outbreaks of drug poisoning than in the past Figure The presence of such mixtures and mis-sold substances on the market highlights the need to review current approaches to the delivery of some harm reduction interventions. For example, the distribution and administration of the opioid antagonist naloxone may need to be reviewed in the context of these mixtures and mis-sold substances. More generally, given possible developments in the synthetic opioid market, it would be prudent to review current plans to prepare for and respond to any possible increase in the availability and use of synthetic opioids or in the harm associated with these substances. This could include enhancing toxicological analysis capabilities, alert messaging and frontline responder preparedness. Where drug consumption rooms are operational, the possible benefits and risks from also providing drug checking services may be an issue for consideration. Most drug consumption rooms in Canada, for example, offer drug checking for fentanyl. This is currently uncommon in the European Union, but a consumption room in Copenhagen has recently started providing this service, and other pilot projects are reported to be in development elsewhere in Europe. Reducing the risks associated with injecting drug use has always been an important target for harm reduction interventions, and the service models are relatively well developed and evidenced. However, even in this area, changes in drug consumption are creating new challenges for effective service delivery. In the last decade, there have been HIV outbreaks associated with the injection of illicit synthetic stimulants in 7 European cities, across 6 EU countries. A potentially increased frequency of injection is associated with stimulant use compared with heroin use, while crushing and dissolving crack cocaine and other tablets for injection also brings with it additional health risks. These consumption patterns raise questions regarding, for example, the type and adequacy of needles and syringes provided to people in street-based open drug scenes, which now are typically characterised by polydrug use. An additional concern exists that service restrictions during COVID lockdowns adversely impacted on testing for drug-related infections, such as HIV and HCV, and on conduits to care among more vulnerable and marginalised populations of people who use drugs, including those experiencing homelessness. While this definition is imprecise, it is usually used to refer to settings or events where both high-risk drug taking and high-risk sexual behaviour may occur. While it is difficult to estimate the prevalence of chemsex, information from research studies suggests it is an issue that is present, albeit at a small scale and among specific subgroups of people who use drugs, across Europe. Engaging with and providing effective harm reduction responses for people engaged in these forms of high-risk behaviours remains a challenge, and the development of tailored harm-reduction interventions is likely to be needed. Also likely to be needed in this area are strong multi-agency partnerships between those providing sexual health services and those services providing drug-related harm reduction. Cannabis users in Europe commonly smoke the drug with tobacco, and an undeveloped area for the development of harm reduction approaches is the consideration of what might constitute effective inventions to reduce smoking-related harm in this group. More generally, as the types and forms of cannabis products available in Europe continue to change, so too have considerations about the implications this has for harm reduction responses. Overall, cannabis products, both resin and herbal, are now of a higher potency — they contain more THC — than they were historically, and high-potency cannabis products are associated with more acute and chronic harms. In addition, the diversity of product types has expanded, with edibles, e-liquids and extracts all now available. These changes create new potential challenges to identify what constitutes effective harm reduction interventions and opportunities to implement them to reduce harm. Cannabis is not the only area in which harm reduction approaches have the potential to play a greater role. These substances do have the potential to cause possible harm, and some patterns of use are likely to increase the risk of adverse consequences occurring, creating potential opportunities for harm reduction approaches. While some harm reduction responses remain controversial in some countries in Europe, the overall concept that evidence-based measures to reduce harm are an important component of balanced drug policies is largely accepted. The contexts within which harm reduction services operate, the evidence base that supports them, and what constitutes standards for quality of care in this area therefore remain key areas for further development and policy consideration. Needle and syringe programmes are also a widely available and standard component of harm reduction services. Needle and syringe coverage and access remain a challenge, with only 5 of the 17 EU countries with available data reaching the WHO service provision targets in Figure The coverage is based on the latest national estimates of injecting drug use and high-risk opioid use matched by harm reduction activity data within a maximum of 2 years. The estimate of coverage of opioid agonist treatment for Belgium is derived from a subnational study conducted in Opioid agonist treatment can be considered as an effective form of drug treatment and also as a service delivery model that addresses some harm reduction objectives. Opioid agonist treatment is a well-established intervention that is implemented in all European countries and is acknowledged as a protective factor against overdose deaths. Up to , 16 European countries have reported the implementation of take-home naloxone programmes, which includes pilot projects, to prevent overdose deaths and 10 countries report having opened at least one drug consumption room, intended to facilitate safer use and prevent various health problems Figure Twelve European countries report the existence of some type of drug checking service. These services aim to prevent harms by allowing people to find out what chemicals are in the illicit substances they have bought, and, in some cases, provide access to counselling or brief interventions. The analytical techniques used by services range from sophisticated technology that can provide information on strength and content of a wide variety of substances, to methods that simply show the presence or absence of a particular drug Figure While drug consumption rooms have become a more accepted harm reduction response, establishing them remains problematic in some countries. In , 10 EU countries and Norway had operational facilities Figure Where multicultural and new immigrant populations are present, increased own-language harm reduction messaging is desirable for people engaged in high-risk drug use. Initiation of opioid agonist treatment in prison was not allowed in 2 countries Bulgaria, Slovakia. Needle and syringe programmes were available in prisons in 3 countries: in all prisons in Spain and Luxembourg 2 prisons , and in one female prison in Germany. 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. Hidden tables for page Term Colour Available 92c Not available da Unknown a3a3a3 ID Term 10 WHO target for opioid agonist treatment coverage 20 Proportion of high-risk opioid users receiving opioid agonist treatment 30 WHO target for needle and syringe distribution 40 Number of sterile syringes per person who injects drugs per year 45 Number people who inject drugs 50 Click to zoom in. Number of sites: 90 Number of countries 60 sites 70 Availability of interventions in prison settings 80 Select an intervention from the dropdown list below. Main subject. Target audience. Publication type. European Drug Report main page. On this page.

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