EMCDDA – Drug situation in Europe up to 2023 : Resume

An analysis of the supply-related indicators for the commonly used illicit drugs in the European Union suggests that availability remains high across all substance types. The market is now characterised by the relatively widespread availability of a broader range of drugs, which are often available at high potency or purity.

Cannabis remains the most commonly consumed illicit substance, and in 2021 the quantities of cannabis resin and herbal cannabis seized reached their highest level in a decade, indicating the continuing high availability of this drug.

Diversity on the cannabis market increased further in May 2022, when the first semi-synthetic cannabinoid, hexahydrocannabinol (HHC), was identified as being available in Europe. HHC is chemically similar to delta-9-tetrahydrocannabinol (delta-9-THC), the main psychoactive substance in cannabis, and it appears to have broadly similar effects. However, neither the pharmacology nor the toxicology of HHC in humans has been studied in detail. During 2022, HHC was identified in two thirds of EU Member States, and it has been commercially marketed in some EU Member States and sold as a ‘legal’ alternative to cannabis.

Historically high cocaine availability

Man in a yellow vest standing in front of shipping containers

In 2021, EU Member States seized a record 303 tonnes of cocaine. The trafficking of large volumes of cocaine through Europe’s major seaports, in intermodal commercial shipping containers, is a significant factor in the high availability of this drug in Europe today. The impact of high cocaine availability is reflected in concerns about an increase in both health-related problems and levels of crime, including violent crimes associated with drug market activities.

Cocaine is now the second most frequently reported drug, both by first-time treatment entrants and in the available data on acute drug toxicity presentations to sentinel hospital emergency departments. The available data also suggest that the drug was involved in about a fifth of overdose deaths in 2021.

Synthetic stimulants – more diversity in the illicit drug market linked to risks for public health

White powder, tablets, spoon and syringe on black table

Alongside cocaine, the consumption of synthetic stimulants is associated with risks to both physical and mental health. Most indicators suggest that amphetamine remains the most commonly used illicit synthetic stimulant in Europe. However, there is increasing diversity in the drug market in this area, with signs that both methamphetamine and synthetic cathinones are now contributing more significantly than in the past to Europe’s stimulant-related problems. Consumers may view different stimulants as functionally similar and be willing to try new products based on their availability in the market. As synthetic stimulants may also be available in similar-looking powders or pills, consumers may sometimes be unaware what particular stimulant or mixture of stimulants they are consuming. These drugs can also be found in tablets marketed as MDMA.

Despite a continued decline in injecting drug use over the past decade in Europe, this behaviour remains responsible for a disproportionate level of the harm associated with illicit drugs. Historically, heroin has been the main drug associated with injecting.

Signals of increased volatility in the MDMA market but concerns still exist about the availability of high-purity products

Bag with MDMA tablets of different shapes and colours

Current data suggest an overall relatively stable situation in respect to MDMA consumption, although there is considerable heterogeneity at national level. With a typical MDMA content of 161 to 173 milligrams, the overall strength of tablets remains high by historical standards

Signs that ketamine has become an established drug of choice among some groups

White powder and vial with a liquid

The quantity of ketamine seized and reported to the EU Early Warning System on new psychoactive substances varies considerably over time, but has remained at relatively high levels in recent years. This, along with other information, suggests that ketamine is likely to be consistently available in some national drug markets and has become a more established drug of choice for some groups. Ketamine is commonly snorted, but can also be injected.

Ketamine may also be found added to other drug mixtures, including MDMA powders and tablets. It is also found in mixtures sold as ‘pink cocaine’, a product that appears to be attracting increasing consumer interest. In Europe, the term pink cocaine usually refers to mixtures of ketamine with other synthetic drugs, such as amphetamines or MDMA

Health concerns triggered by the use of nitrous oxide among young people

Disposed silver laughing gas cartridges on a wooden table

A recent EMCDDA review noted that in a number of EU Member States, there are signs of an increase in the use of nitrous oxide, also known as laughing gas, for the purposes of intoxication. Nitrous oxide has a number of commercial uses, and there is a debate on the extent to which this substance is associated with negative health risks, especially in episodic users.

Signals that the availability and production of synthetic cathinones in Europe is increasing

A syringe lying on a black table next to a white powder

Marketed as replacement substances for drugs such as amphetamine and MDMA, synthetic cathinones, such as 3-MMC and 3-CMC, are also sometimes mis-sold as other substances. Although seizure numbers remain relatively low, very large quantities of synthetic cathinones have been found in some individual seizures, usually originating from India. This, together with evidence that synthetic cathinones are also being produced in Europe, suggests that these substances are becoming more available in Europe, where they have the potential to play an increasing role in the stimulant market in the future.

Possible adverse consequences of growing interest in the therapeutic potential of psychedelic drugs

Color MRI Scan Human Brain

Both clinical and public interest has been growing in the possible therapeutic use of some psychedelic substances, including novel and little-known substances. A growing number of clinical studies are exploring the potential of a range of psychedelic substances to treat different mental health conditions. Some research appears promising, however, generalising in this area is difficult, partly because much of the research is still in its infancy, partly because of the large number of chemicals under review and partly because of the wide range of conditions that are being studied.

Europe’s opioid problems are evolving

A used spoon and syringe lying on the ground

Heroin remains Europe’s most commonly used illicit opioid and it also remains the drug responsible for a large share of the health burden attributed to illicit drug consumption. However, the data available also suggest that heroin no longer plays as central a role as it once did and synthetic opioids appear to be playing a more significant role in opioid-related problems in some countries. The quantity of heroin seized by EU Member States more than doubled in 2021 to 9.5 tonnes, while Türkiye seized a record 22.2 tonnes.

Interactions between new benzodiazepines and opioids

Bag with yellow pills

A lack of toxicological information currently means that the role benzodiazepines play in opioid-induced deaths is not sufficiently understood. Non-controlled and new benzodiazepines are available in Europe; however, data limitations make it difficult to comment on the scale of their use.

New synthetic opioids

A male hand holding a small plastic bag with a blue pill

Drug problems in North America provide an example of how changes in patterns of opioid availability and use can have important implications for public health. In this world region, potent fentanyl derivatives have, to a large extent, displaced prescription opioids and heroin to become the main driver of an epidemic in opioid-induced deaths. New synthetic opioids are reported in Europe and may be becoming more common in some areas, but currently the patterns of availability and use are very different to those found in North America, with significant problems with these drugs mostly restricted to some northern and Baltic countries.


Continue at:  https://www.emcdda.europa.eu/publications/european-drug-report/2023/drug-situation-in-europe-up-to-2023_en

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Manostaxx – Industrial Management Consulting

See:  https://manoxblog.com/2023/11/22/hhc-the-first-semi-synthetic-cannabinoid-appears-on-the-european-illicit-drug-market/


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