New health risks for Europeans in a rapidly changing drug market
(9.6.2026, LISBON) People in Europe who use drugs face new health risks as drug markets are rapidly changing and becoming increasingly complex. This warning is given by the European Union Agency for Drugs (EUDA) in the European Drug Report 2026: Trends and Developments published today (1).
This annual report is based on 29 countries (EU-27, Norway and Turkey) refers to risks to public health arising from the wide availability and use of an increasingly diverse range of substances, often with high efficiency or purity. New cannabis products continue to emerge on the market and the supply of opioids and stimulants is also growing. Polysubstance use is also common, with people combining drugs in ways that increase risk and make it difficult to provide assistance. Europe's ability to respond to these complex challenges will depend on stronger service delivery systems and sustainable investment in prevention, treatment, harm reduction and social reintegration.
New psychoactive substances (NPLs) continue to emerge, about one per week. In 2025, 50 NPLs were first reported in Europe, increasing the total number of substances monitored by EUDA to 1 050. These include new strong synthetic opioids, which pose an increased risk of life-threatening poisoning. The use of vaporisers or e-cigarettes, including nicotine-containing products, is now a common part of substance use among adolescents in Europe (ESPAD, 2024). In EU Member States, vaporisers containing other substances, such as synthetic and semi-synthetic forms of cannabis, have been captured, which raises concerns that they could become a means of distributing other harmful substances, including new synthetic opioids.
In addition to harm to health and social vulnerability, the report also highlights the continuing impact of drug markets on Europe's security. Drug-related intimidation and violence, including the abuse and recruitment of vulnerable young people by criminal groups for illicit drug trafficking and violence, continue to cause concern.
Magnus Brunner, European Commissioner for Home Affairs and Migration, said: "The European drug report reveals the human price of drug use, with the latest annual data showing at least 7 600 deaths due to overdose. We must use all available means to prevent the market from being flooded with dangerous new products, and use all available legal instruments to disrupt the illicit trade model. Thanks to the EU's early warning system, we can identify new trends in time. Through our Action Plan against drug trafficking, we have provided clear guidance to the European authorities and, by strengthening international cooperation, we are building a global front in the fight against this trafficking.
Dr. Lorraine Nolan, Executive Director of EUDA, adds: "Drug markets are developing at a fast pace and the variety of substances available on European streets is becoming increasingly unpredictable. This increases the risk: people can use extremely effective drugs, often without being aware of it. More than ever, reliable data matters. The European Drug Report provides the evidence needed to make policy makers, practitioners and communities well prepared. At the same time, EUDA is strengthening its monitoring and preparedness systems to better protect European citizens and promote effective responses. A balanced approach that takes both supply and demand into account is crucial. In addition to being science-based, it must also focus on human rights and public health.
Canabis: changing business routes, stronger products, new health risks
Routes of illicit supply of cannabis and methods of trafficking are constantly evolving, increasing the volume of plant cannabis smuggled from outside Europe, in particular from Canada and from United KingdomStates, to a lesser extent Thailand. Overproduction, lower prices and strong competition in the cannabis market North America lead to an excess of cheaper products with higher efficiency. Consignments from Canada to Europe are usually hidden in maritime containers, while shipments from United States are most often revealed in postal transport.
This trend is also confirmed by seizures in major ports. In 2025, the authorities intercepted approximately 21 tonnes of plant cannabis in the ports of Rotterdam and Antwerp, most of which were Canada. Health concerns are also growing with these flows. In 2025, the Agency issued EUDA by European systemDrug warnings its first warning on cannabis from North America, which identified the risks associated with potentially hazardous pesticides. This underlines the need for targeted action and continued international cooperation.
Cannabis is the most commonly used illicit drug in Europe. It is estimated that 24.9 million European adults (15-64 years old) have taken it in the past year. The wider availability of more diverse, more effective cannabis products increases health risks, which complicates the solution to this issue. Cannabis is the main drug among a third (33%) of people entering drug treatment in Europe, representing around 104 000 clients in 2024. Of these, 62,000 underwent treatment for the first time. Cannabis, including high-efficiency products, extracts and edible products, is associated with admissions to hospital emergency services. Counterfeiting of cannabis products by adding strong synthetic cannabinoids and the wide availability of semi-synthetic cannabinoids increase the risk of health damage. Both groups of substances are sold in the form of vaporisers and edible products, which raises concerns about their use among new and potentially younger consumers.
Opioids: new synthetic opioids endanger public health, but the heroin market remains resilient
Opioids, usually combined with other substances, remain the main cause of drugrelated deaths in Europe. Agency EUDA estimates that there were at least 7 600 overdose deaths in the EU in 2024, with in most cases a combination of several substances. Opioids other than heroin, including highly effective synthetic opioids, drugs used in opioid substitution and painkillers, are detected in a significant proportion of overdose deaths in some countries.
Flat ban on Nitras in China of July 2025 can redirect the market to alternative opioids. There are reports of orphins in Europe. Nine new orphins have been identified since 2024, two of which (cyclomorphine and spirochlorfin) are currently the subject of an EU investigation. Between June 2024 and January 2026 18 Orphine-related deaths were reported.
Fentanyl-related deaths, a particularly effective synthetic opioid, stress the need for vigilance. V Bulgaria fentanyl was associated with more than 100 drug-related deaths reported between 2024 and 2025. The key to addressing current opioid problems as well as to strengthening preparedness and resilience to changes in the opioid market remains to improve the availability to large-scale substitution opioid treatment, to needle and syringe exchange programmes and to naloxone for home use. The home use programmes of Þnaloxone are available in an increasing number of countries (19 European countries had them in 2025).
At the same time, the European heroin market is proving resilient. Advanced handling and counterfeiting practices as well as tactical management of large-scale supplies appear to be Afghan opium stocks (estimated at around 12 000 tonnes of opium in 2025) by illicit trafficking networks mitigated the consequences of a sharp drop in poppy cultivation and opium production following a Taliban ban in 2022. At the same time, production shifts to other areas. Pakistan has become a new source of opium and heroin, with opium poppy growing on more than 9 000 hectares in 2025, matching Afghanistan's production. In Asia, opium poppy cultivation was achieved in Myanmar a ten-year maximum of over 45 000 hectares in 2025.
Cocaine: increasing damage, crack use and changing illicit trafficking tactics
Today's report shows that cocaine use remains high across Europe, with some 4.3 million adults in European adults (aged 15-64). At the same time, its geographical scope is broadening and the extent of the damage it causes. Recent municipal analyses waste water show that out of 85 places for which data are available for both 2024 and 2025, 48 (57%) reported increases in cocaine residues. The number of people entering treatment continues to increase due to cocaine-related problems. In 2024, cocaine was the second most commonly used illicit drug among people who first entered specialist drug treatment, reported by around 37 000 clients (39% increase since 2018). Overall, 74,000 people entering treatment reported cocaine as their main drug.
Available data from 20 countries in 2024 suggest that cocaine accounted for more than a quarter (27%) of all drugrelated deaths. Cocaine also remained the most commonly reported substance on admission to the hospital emergency services sentinel departments, where it was in 26% of cases. Residue analysis programmes in syringes and application rooms for drug users also highlight high-risk cocaine use patterns, including injecting and combination with opioids.
After years of record seizures, cocaine seized in Europe fell to 330 tonnes in 2024 from the original 419 tonnes in 2023. However, the number of seizures has increased to 97 000 (as opposed to 95 000 in 2023), indicating that drug traffickers can switch to smaller and more fragmented shipments in order to avoid detection. Although large-scale shipments via sea ports continue to be a major resource, there are indications of diversification of trade routes and methods. There are increasing reports of the use of smaller ports as well as of more sophisticated methods of hiding or transhipment at sea.
Illegal treatment of cocaine products is also taking place directly in Europe, particularly in the Netherlands. In 2024, six EU Member States destroyed at least 42 cocaine-related facilities (34 in 2023). These included facilities for the secondary extraction of cocaine chemically hidden in other materials, such as plastics. Overall, customs and law enforcement authorities face increasingly complex challenges, requiring stronger interinstitutional and cross-border cooperation and partnerships.
Ketamine: increasing health risks due to the increasing relocation of this drug to the illegal market
Ketamine, a basic medicine used for anaesthesia and pain reduction, is now increasingly being abused in Europe as a psychoactive substance. Although overall consumption remains relatively low, its use becomes more common in some groups of young people and in an environment of nightlife where it is usually snorted in powder form. Health risks range from acute poisoning to chronic damage such as severe bladder damage associated with intensive use.
Several indicators suggest that ketamine is becoming a more stable part of the European drug environment. In 2024, 14% of respondents reported European web survey on drugs, who have used drugs in the past year to take ketamine, usually in combination with alcohol or other drugs (e.g. ecstasy). From the latest European analysis of municipal waste water ketamine residues have been shown to increase at 40 of 66 sites for which data are available for 2024 and 2025.
Health services are beginning to experience the consequences of this trend. Although the number of people entering specialised treatment for ketamine-related problems remains low, it has quadrupled in recent years from 413 cases in 2019 to 1 796 in 2024. Most cases are reported by six EU Member States, which is likely to reflect a longer history of availability and a higher rate of illegal use of ketamine in some parts of Europe. The availability of treatment remains uneven across Europe, stressing the need for appropriate services, targeted prevention and risk communication for those who may not be aware of the health risks associated with use.
Most of the ketamine seized on the European illicit drug market comes from legal pharmaceutical production, in particular from India. It is imported legally into the EU, mostly through Germany, and subsequently lice is redirected to illegal distribution channels (see EUDA study). This link between legal supply chains and illegal distribution is an increasing challenge for public health, regulators and law enforcement authorities.
Dr Franz Pietsch, Chairman of the EUDA Management Board, concluded: "The European Drug Report provides an annual view of the drug problem in Europe and provides a valuable basis for policy and response development. For more than 30 years, it has supported policy makers and practitioners through thorough evidence-based analyses to guide their decision-making. As the drug situation continues to evolve, the report not only provides an overview of current measures but also helps shape responses for the future. This year's edition highlights the added value that EUDA brings to EU Member States and strengthens our preparedness in this area through emphasis on scientific research and advanced risk assessment.
Notes
(1) More information on the European Drug Report 2026 find at https://www.euda.europa.eu/edr2026 The report describes the drug situation by the end of 2025, based on data from 2024 or the last available year.