 is a voluntary, anonymous survey run by the Agency and its partners. It is one of the Agency’s targeted ‘leading-edge’ monitoring methods and a key ingredient in the EMCDDA’s responsiveness to the ever-shifting drugs problem. Web-based surveys have the benefit of reaching people who use drugs directly. They are quick and relatively inexpensive, provide new data rapidly and can help spot emerging trends. If the same questions are used, along with a rigorous translation process, then these surveys can also allow for cross-national comparisons.

European Web Survey on Drugs: patterns of use

This report is based on information provided to the EMCDDA by the EU Member States, the candidate country Türkiye, and Norway, in an annual reporting process.

The purpose of the current report is to provide an overview and summary of the European drug situation up to the end of 2023. All grouping, aggregates and labels therefore reflect the situation based on the available data in 2023 in respect to the composition of the European Union and the countries participating in EMCDDA reporting exercises. However, not all data will cover the full period. Due to the time needed to compile and submit data, many of the annual national data sets included here are from the reference year January to December 2022. Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour such as drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Although considerable improvements can be noted, both nationally and in respect to what is possible to achieve in a European-level analysis, the methodological difficulties in this area must be acknowledged. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Caveats relating to the data are to be found in the online Statistical Bulletin 2024, which contains detailed information on methodology, qualifications on analysis and comments on the limitations in the information set available. Information is also available there on the methods and data used for European-level estimates, where interpolation may be used.

European Drug Report 2024: Trends and developments

The project findings revealed distinct geographical and temporal patterns of drug use across European cities (see the 

The annual SCORE wastewater sampling presented here, from 88 cities, showed that, overall, the loads of the different stimulant drugs detected in wastewater in 2023 varied considerably across study locations, although all illicit drugs investigated were found in almost every city that participated. For the first time, data from outside Europe is also shown and compared against European cities.

The BE loads observed in wastewater indicate that cocaine use remains highest in western and southern European cities, in particular in cities in Belgium, the Netherlands and Spain. Low levels were found in the majority of the eastern European cities, although the most recent data continues to show signs of increase.

The loads of amphetamine detected in wastewater varied considerably across study locations, with the highest levels being reported in cities in the north and east of Europe, as in previous years. Amphetamine was found at much lower levels in cities in the south of Europe, although with the most recent data showing some signs of increase.

The highest loads were found in cities in Sweden, Belgium, Germany, the Netherlands and Finland.

Methamphetamine use, generally low and historically concentrated in Czechia and Slovakia, was also present in Belgium, the east of Germany, Spain, the Netherlands and Türkiye. The observed methamphetamine loads in the other locations were very low, although most recent data show signals of increases in central European cities.

The highest mass loads of MDMA were found in the wastewater in cities in Belgium, France, Germany, the Netherlands and Spain.

The highest mass loads of the cannabis metabolite THC-COOH were found in wastewater in cities in Czechia, Spain, the Netherlands and Slovenia.

For the second time, ketamine loads are being published. The highest mass loads were found in the wastewater in cities in Belgium, France, the Netherlands, and Spain.

Seventeen countries participating in the 2023 monitoring campaign included two or more study locations (Austria, Belgium, Cyprus, Czechia, Germany, Estonia, Finland, Italy, Lithuania, Luxembourg, Netherlands, Portugal, Spain, Slovakia, Slovenia, Sweden and Türkiye). The study highlighted differences between these cities within the same country, which may be explained in part by the different social and demographic characteristics of the cities (universities, nightlife areas and age distribution of the population). Interestingly, in the majority of countries with multiple study locations, no marked differences were found when comparing large cities to smaller locations for all substances.

In addition to geographical patterns, wastewater analysis can detect fluctuations in weekly patterns of illicit drug use. More than three quarters of cities show higher loads of amphetamine, BE, ketamine and MDMA in wastewater during the weekend (Friday to Monday) than during weekdays. In contrast, cannabis (THC-COOH) and methamphetamine use was found to be distributed more evenly over the whole week.

Seventy-three cities have participated in at least five of the annual wastewater monitoring campaigns since 2011. This allows for time trend analysis of drug consumption based on wastewater testing.

Wastewater analysis and drugs — a European multi-city study

Please join us on Monday 13 May at 12.00 CET for the launch of the 

2024 Manifesto for a Progressive EU Drug Policy

 through a conversation on the future of European drug policy that will feature Members of the European Parliament and keynote European civil society speakers.

Please kindly register for the event through 

More than 260 European drug policy NGOs and 130 drug policy experts from 25 EU Member States have already signed the 2024 Manifesto for a progressive EU drug policy. We are coming together to call for a pragmatic and innovative EU drug policy that makes Europe safer, healthier, and more just.

If you want to support the manifesto, please make sure to:

Encourage your drug policy networks and colleagues to sign the manifesto.

Share the manifesto on social media with the hashtag #FutureDrugPolicyEU24.

If you want to get more involved in the campaign by translating the manifesto to your language or organizing a local launch event, please reach out to arogialli@correlation-net.org and kschiffer@correlation-net.org.

You can find the manifesto in Czech, English, Estonian, French, German, Italian, Hungarian, Lithuanian, Romanian, and Spanish, and the list of signatories, 

Thank you very much for your support, and we are looking forward to seeing you on Monday 13 for the launch of the manifesto.

Manifesto for a Progressive EU Drug Policy 2024 - Launch event

The use of the new psychoactive substances (NPS) became widespread in Hungary in the 2010s. Synthetic cannabinoids are the second most tried substance among young people after real cannabis. Still, regular use of these drugs is more prevalent among people of lower social status, who live in rural areas. According to 

, a neuroscientist, the problem with synthetic cannabinoids is not the molecule itself, but rather the dose and frequency of use. These drugs are often mixed so strongly that the typical effect will be overdose; we see this on the streets and in public squares.

The biggest problem with the use of "herbal" and "crystal" is seen in segregated areas in Hungary, where mostly Roma people live. Even in wealthier settlements, such as Halmajugra, the use of "crystal", or synthetic cathinone, is already a serious problem, mainly due to the increase in petty theft. According to 

, the mayor of the settlement, even though not all new psychoactive substance users are Roma, this is more noticeable among poorer people, so the stigma surrounding drug use impacts Roma people. Meanwhile, affected families feel that they cannot count on any external help and that they do not know whom to turn to.

Over the past 14 years, services helping drug users have been cut down and underfunded by the Hungarian state, drug prevention specialists have been banned from schools, and low-threshold services have ceased or are vegetating. According to sociologist 

, coverage of the care system has become so poor that it is simply impossible to know what is happening to these people. There is hardly any contact with people in rural areas who have drug problems. If they do get into treatment, 

 says, services are currently not differentiated enough to meet the new types of needs.

Two employees of the Laurus association, 

, are doing heroic work in the segregated district of the Miskolc Iron Factory. They maintain a community space and provide therapeutic help to people living with drug problems. Additionally, they support local children, which they consider one of their most important tasks. They want young people to know that they have someone to turn to when they have problems, and by doing so, they aim to reduce the re-emergence of segregation. 

, their peer worker, was able to start a new life with the help of Laurus and stop injecting “crystal”. According to Helga's family, the greatest opportunity to break out of the segregation of the ironworks was the emergence of job opportunities provided by factories and the European Union.

, a social worker and assistant professor at ELTE, without reforming the educational, health care and child protection systems and investing in infrastructural developments, such as transport solutions and repairing roads, they will not be able to deal with problematic new psychoactive drug use in segregated areas.

As long as there is a demand for drugs, there will be dealers. In the hope of making quick money, 

 from Komló became a dealer from being a Cash-in-Transit security guard. He quickly climbed to the top, earning the price of his car in one evening. However, in order to cope with the constant strain of this work, he got hooked on his own drugs. He got so deep that he even became homeless for a while. Yet, he believes that society is holding up a twisted mirror to us and that the media does not present a realistic picture of drug users. According to him, users of synthetic cathinones do not typically end up in the state synthetic cannabinoid users are often portrayed in the media – lying in an underpass, hunched over, and fainting. The drug can give and take, but he thinks that as an adult, one can decide what they want, and he holds himself responsible for his own fate. When he had enough, he stopped using intravenous drugs on his own and went back to work; still, he lost his family. According to Benjámin, this area should not necessarily be seen as a problem, as some synthetic drugs could be regulated. If you can do it with cannabis, you can do it with these as well.

The primary response of the Hungarian state is criminalisation. The use of drugs is a criminal offence, and the use of NPS is a misdemeanour. However, acknowledging the senseless and excessive nature of imprisonment, the state introduced the institution of ‘diversion treatment’, which one can choose instead of punishment. But this can only be chosen once in two years. However, in the case of designer drugs, since possession of these is "only" a misdemeanour, this is not allowed even once.

ABANDONED: Designer Drugs on the Margins of Hungarian Society

There are ongoing concerns among policymakers, law enforcement, and civil society organisations (CSOs) about the emergence of New Psychoactive Substances (NPS) in general (European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2023; United Nations Office on Drugs and Crime (UNODC), 2023a), about the appearance of NPS in more traditional illicit substances available in global and European markets, and about the emergence of new drug trends in general. International agencies continue to warn about the potential health risks (such as overdose) associated with illicit substances, including synthetic opioids. CSOs, particularly those working closely with people who use drugs, play a pivotal role in notifying signals of change with respect to the use of new substances, changing patterns of drug use, or in changes in local drug markets. This calls for new approaches to rapidly update data on drug trends that include qualitative data provided by people who use drugs and by experts who are in contact with people who use drugs. Data from CSOs are considered complementary to other sources, providing useful intelligence on emerging drug trends. This report aims to explore the latest insights with respect to the emergence of new illicit substances in cities where Focal Points (FPs) of Correlation – European Harm Reduction Network (C-EHRN)1are located, as well as other developments in drug use patterns, including polydrug use, routes of administration, and changes in local drug markets.The focus extends beyond NPS to allow for afull understanding of current local drug market developments.

New drug trends: Insights from focus group discussions

To monitor new drug trends in Europe and complement the information gained through focus group discussions, C-EHRN’s 2023 Civil Society-led Monitoring of Harm Reduction in Europe includes two reports via the Trans European Drug Information Network (TEDI), drawing from data collected from drug checking services.

Drug checking observations and European drug checking trends via TEDI

This blog item is a cross-post with the Rights Reporter Foundation and was originally 

The EU’s drug monitoring agency organised a meeting with civil society in Lisbon to discuss future cooperation outlined in its new mandate. Read this short report about the meeting by 

The transformation of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) into a new agency, the European Drug Agency (EUDA), is a major development in European drug policies in 2024. The EMCDDA, the Lisbon-based agency that is in charge of collecting and analysing data about drugs and feeding them to decision makers, received a 

 from the EU Commission and Parliament in June 2023 and will become the EUDA from July 2024. This is more than just a simple name/brand change: the agency will receive considerably more power and budget to support decision makers in three areas: monitoring, preparedness and competence development.

Part of the new EUDA’s mandate is the commitment to establish a new partnership with civil society. In the past, the relationship between the EMCDDA and civil society has traditionally been close and cordial, but rather informal and ad hoc. For example, during the COVID-19 crisis, the EMCDDA organised several online meetings with civil society – including us, Drugreporter – to collect data on drug trends/access to services during lockdown (

we wrote extensively about this issue on Drugreporter

). Now the new mandate has opened the doors for a new opportunity to create a formal platform and mechanism for the EUDA to work more systematically and formally with civil society and community organisations.

As members of the Core Group of the EU Civil Society Forum on Drugs (CSFD), the expert group of the European Commission on drug affairs, we were invited by the EMCDDA to Lisbon to discuss how this new partnership may take shape between civil society and the EUDA. The meeting was a hybrid event: other EMCDDA researchers and civil society representatives from several European countries joined us online.

Danilo Ballotta, the EMCDDA’s Principal Drug Policy Analyst, presented the framework created by the new mandate. The document requires the EUDA to work with civil society in three forms: first, with civil society organisations, second, with communities affected by drug crime, and third, with communities of people with lived experience/people who use drugs.

Alexis Goosdeel, the Director of the EMCDDA/EUDA, assured civil society representatives that the process of involvement will be fully transparent and open. It will also facilitate the inclusion of civil society in consultations with third countries and international relations.

On behalf of the CSFD, we presented the work of the working groups of the Forum, including the one I chair on civil society involvement. We pointed out that the CSFD produced several guidelines and studies in recent years that will prove to be very helpful for the EUDA as it designs its own mechanism to work with civil society. For example, our 

Quality Standards for Civil Society Involvement

 report includes recommendations on how to ensure that the engagement is meaningful for both parties.

Civil society representatives pointed out that one of the key barriers identified by our studies is the lack of funding: most organisations have very limited resources for advocacy and consultations with decision makers. Unfortunately EU funding has been significantly curtailed by the EU Commission after the EC JUST Drug Policy Program was ended, with available funding since then having almost exclusively been allocated to supply reduction and drug prevention projects (

). Although Mr. Goosdeel emphasised that the EUDA will not be able to solve the funding crisis, many of us argued that even limited funding from EUDA could make a big difference for us.

According to the mandate, the EUAD will work with civil society in three ways: first, it should provide information to civil society, second, it should create a pool of knowledge, gained from civil society, and third, it should consult with civil society. The EUDA will create a dedicated communications platform, where civil society will be able to submit information. A contact person will be appointed by the Agency to coordinate the dialogue with civil society.

A possible area of cooperation is communications: civil society and the EUDA can mutually support each other to improve the dissemination of their findings and messages among the general population. The EUDA will create a new e-learning educational and training platform, PLATO, as well as a platform to provide information on safer festivals (SAFestivals). These two platforms already provide plenty of opportunities for civil society to feed into the work of the EUDA.

Another important avenue for collaboration between the EUDA and civil society relates to international cooperation (with the UN as well as third countries), for which the EUDA will now have dedicated resources. The EUDA has the opportunity to bring a stronger focus on human rights and health to the positions usually adopted by EU institutions, with support from the CSFD (which has a dedicated working group on international policy) and other civil society representatives.

In fact, a key issue highlighted by civil society as fundamental for the EUDA to push for within its new mandate relates to human rights, in particular the need for a systematic assessment of the impacts of drug policies on the lives, well-being and freedoms of affected communities. And in general, most civil society organisations would like to see more impact assessment of drug policies through 

 (including the negative public health and social impacts of drug control), rather than just focusing on the usual process evaluations (such as how much drugs are seized, or how many people are arrested and incarcerated for drug offences).

For example, when a new substance is brought under control after a risk assessment conducted by the EMCDDA/EUAD, there is no follow up: did the measures taken by governments to respond to new substances reduce access to the drugs or did they only replace one drug with another, potentially more risky, substance? Were the health and social risks identified prior to the reforms reduced in any way? How did government measures affect the drug market overall, and the health and well-being of people who use drugs?

These questions lead us to another urgent, but largely ignored issue: how do we measure the success of supply-side interventions? Unlike with demand and harm reduction interventions, where relatively strict indicators are required, and where health and human rights indicators have slowly started being used by governments in various countries, there is no such thing happening for supply reduction interventions. Civil society representatives present at the meeting made it clear that a human rights impact assessment of supply-side policies was urgently needed, and the EUDA can play a fundamental role in pushing this agenda forward in the coming years.

One thing is clear: civil society, including the International Drug Policy Consortium and Rights Reporter Foundation, stand ready to support the EUDA as it is delineating the framework of their new mandate. At a time where the EU is shifting towards a 

, the EUDA will surely play a key role in ensuring that EU drug policy continues to prioritise health, social justice and human rights as its core – and this will only be possible with the strong and meaningful participation of civil society and communities.

The new EU drug agency seeks stronger partnership with civil society

Several actors in the field of drug policy have indicated that a punitive approach is counterproductive to achieving the health and welfare of humankind. The 2016 UN General Assembly Special Session (UNGASS) on the World Drug Problem confirmed that this is an important step towards active drug policies that are based on human rights and health approaches.

Since then, many UN agencies have reported the negative impact of criminalisation on people who use drugs and on their surrounding communities. Recommendations have also been brought that favour a decriminalisation process in drug policies. This process aims to remove the stigma against people who use drugs as well as to ensure that they have access to a broad range of support and health services, including prevention, treatment, recovery, and harm reduction.

The decriminalisation of drug use and related activities is a policy option that is widely supported by the United Nations as a core component of a human rights- and health-based approach towards people who use drugs.

The UN System Common Position on drugs – the UN overarching policy document on drug policy – and the more recent UN System Common Position on Incarceration, have also recommended decriminalisation of drug use and possession. The International Narcotics Control Board, which supports UN Member States in implementing the international drug control treaties, has even concluded that decriminalisation is aligned with the drug conventions.

In addition, an increasing number of UN entities and experts have recently come out in favour of decriminalisation as a critical enabler for ensuring the promotion and protection of human rights. This includes the World Health Organization, the United Nations Development Programme, UN Women, the High Commissioner for Human Rights, the Committee on Economic, Social and Cultural Rights, the UN Working Group on Arbitrary Detention and the UN Special Rapporteur on the right to health. Adding to these calls, on 24 June 2023, 16 UN Human Rights Special Mandates concluded that ‘drug use and possession for personal use should be decriminalised as a matter of urgency’.

In 2023, the UN Office of the High Commissioner for Human Rights (OHCHR) Report ‘Human rights challenges in addressing and countering all aspects of the world drug problem’, published as an official contribution to the 2024 mid-term review of the 2019 Ministerial Declaration on Drugs, strongly stresses the importance of decriminalisation as a crucial factor to limit human rights violations in drug policies. The OHCHR concluded that ‘if effectively designed and implemented, decriminalization can be a powerful instrument to ensure that the rights of people who use drugs are protected’. The report includes decriminalisation as a key recommendation, calling on policymakers to ‘review convictions and/or sentences and, where appropriate, quash, commute, or reduce convictions and/or sentences’.

One of the focus areas of UNAIDS “Save lives: decriminalize”, includes a strong position that “Decriminalization is a critical element to end AIDS by 2030”. This UN agency also states that “Punitive laws have been shown to block HIV service access and increase HIV risk” and that “Countries that criminalize key populations [including people who use drugs] saw less progress towards HIV testing and treatment targets over the last five years – with significantly lower percentages of people living with HIV knowing their HIV status and achieving viral suppression than in countries that avoided criminalization”.

The UNAIDS statement on the 75th anniversary of the Universal Declaration of Human Rights reaffirms its commitment to keep human rights at the centre of its approach to ending the AIDS pandemic. The statement also calls on all governments to uphold human rights, through removal of laws that cause harm and infringe on people’s rights and enactment of laws that uphold the rights of every person, including people in marginalized communities.

The current EU Drug Strategy 2021-2025 endorses alternatives to coercive sanctions as the approach that respects the human rights of people who use drugs.

While some EU member states retain a stance of criminalisation of personal use and related behaviours in their national legislations, several member states have already decriminalised use and possession for personal use, and various EU member states have bills in their parliament to take that step as well.

The Civil Society Forum on Drugs, an expert group of the European Commission, is of the opinion that the perspective established by the EU Strategy 2021-2025 – a balanced, human rights-based approach to drug policy – needs to be improved at the EU level and in member states.

Civil Society Forum on Drugs in the EU: Position paper on decriminalisation

The objective of the study is to assess the practice and quality of community-based and community-led communicable diseases (Human Immunodeficiency Virus (HIV), viral hepatitis, sexually transmissible and – where relevant – tuberculosis) testing and linkage to care services for People Who Use Drugs (PWUD) in Europe. For the study, focus groups were developed and prepared with people who use drugs and are at risk from HIV and / or viral hepatitis in the countries of the four Lighthouse Project implementations (Belgium, Czechia, Finland, and Italy).

Values and preferences study: Communicable diseases and people who use drugs in Europe

This project aimed to improve leadership transitions, institutional memory, and long-term strategy in the participating organisations through the development and implementation of a youth-work Sustainability Framework designed with best practices from both the youth-work sector and the drug policy/harm reduction sector. The key results include The Development of the Framework, The Implementation of the Framework, and the increased stability of the participating organisations in the European Union (EU).

“Youth In Power” (YIP) was and is intended to continually improve the overall sustainability stability of three participating youth-led organisations, SSDP International, Young Wave, RISE, by addressing key areas: 1. Leadership transitions, 2. Institutional knowledge/memory, 3. Long-term strategy. The goal incorporate tools best practices from both youth work sector drug policy/harm reduction develop implement a Sustainability Framework that addresses these issues. To achieve our improving organisational through its implementation, we organised 3-day strategy meeting. This will also be shared utilised across allow for benefits this applied on wider scale ensure sustained robust policy sector.

'Youth in power': Addressing sustainability of youth-led drug related organisations

The BOOST project, a collaborative effort aimed at combating HIV/AIDS and viral hepatitis in Europe, supports EU and neighboring countries through community-based and led harm reduction initiatives. This response, vital due to the disproportionate impact of these diseases on people who use drugs (PWUD) and marginalized populations, is structured around four main pillars: Inform, Improve, Support, and Connect & Act, which focus on data collection, capacity building, best practice enhancement, and advocacy, respectively.

This Advocacy Strategy provides an overarching framework and sets priorities for regional harm reduction and community-led networks working for EU and neighboring countries. The objectives of the Strategy will serve as a basis for developing joint regional advocacy actions for comprehensive health and harm reduction services for people who use drugs.

The Strategy aims to enhance the quality, accessibility, and coverage of harm reduction services. It focuses on increasing political will and financial sustainability, promoting community-driven harm reduction, ensuring access to specific health services, and advocating for comprehensive health and social care. The strategy emerged from an inclusive consultation process, including extensive online dialogues, surveys, and strategic meetings, which identified key barriers to service access and outlined objectives for improving harm reduction efforts across the continent.

Through this collective approach, the BOOST project and its partners aim to address the critical health needs of people who use drugs, advocating for changes that support harm reduction, health rights, contribute to the priorities of the EU Drugs Strategy 2021-2025, and ultimately, the goal of eliminating HIV/AIDS and viral hepatitis as public health threats by 2030.

South East Europe