Europe Grapples with Rising Synthetic Drug Use Amidst Unknown Health Risks

Europe is facing an increasingly complex drug landscape, with the rising use and production of synthetic drugs posing significant public health concerns. While cocaine remains the most popular illicit stimulant, the availability and consumption of synthetic substances like cathinones, fentanyl, and nitazenes are on the rise, and experts are still trying to understand the long-term health implications.

The Shifting Stimulant Market

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been tracking the rise of synthetic stimulants. Amphetamine has historically been the most common synthetic stimulant in Europe, but recently, synthetic cathinones have become increasingly available. These substances share similar chemical structures, but their psychoactive effects and public health consequences can vary significantly. For example, some synthetic cathinones, like 4-CMC, have effects similar to MDMA and amphetamine.

This shift is concerning because existing monitoring tools are better at tracking established synthetic stimulants like amphetamine than new psychoactive substances like synthetic cathinones. The increased availability and use of these substances could lead to increased health and social problems.

Domestic Production on the Rise

Historically, synthetic drugs consumed in Europe were largely trafficked from countries like India, China, or the Middle East. However, there's been a recent surge in domestic production within Europe. Large-scale production of amphetamine and methamphetamine takes place in the Netherlands, with smaller-scale methamphetamine facilities in Czechia and amphetamine production in Germany and Poland. A growing concern is the trafficking of amphetamine base oil from the Netherlands and Belgium to other countries for conversion into consumer products.

This increase in local production is driven by the demand for synthetic drugs, according to Andrew Cunningham, head of policy, crime and markets at the EUDA.

The Threat of Deadly Synthetic Opioids

While cocaine remains Europe's most popular illicit stimulant, synthetic opioids are a growing concern. The EUDA estimates that there were 7,500 drug-induced deaths in Europe in 2023, the majority of which were due to opioid drugs. Fake medicines containing synthetic opiates called nitazenes increased in at least 12 European countries in 2024. Some nitazene compounds are even stronger than fentanyl, which itself is 50 times stronger than heroin and has an extremely high risk of overdose.

Drug seizures in Europe have found nitazenes in fake prescription drugs, mimicking oxycodone or benzodiazepines bought on the illegal drug market. These fake pills have much higher potency and carry a significant risk of drug poisoning and overdose, especially as people do not know the drugs they are taking contain nitazenes. The EUDA report shows authorities seized 10 kilograms of nitazenes powder in 2023 — potentially sufficient to make millions of pills containing enough nitazenes to cause an overdose.

Polysubstance Use and its Dangers

The European Drug Report 2025 indicates that more Europeans are taking multiple drugs at the same time. Polysubstance use is the leading cause of drug deaths in Europe. The combination of different substances can have unpredictable and dangerous effects, increasing the risk of overdose and other health complications.

In Canada, a robust market for diverted pharmaceuticals has also been widely infiltrated by synthetic mixtures. For example, of approximately 4000 pills tested as part of a drug checking programme in British Columbia between 2018 and 2024, nearly 50% contained unexpected substances. Notably, 20% of pills tested contained a benzodiazepine—including pharmaceutical benzodiazepines and novel synthetic benzodiazepines, such as etizolam, flualprazolam, and bromazolam—which considerably increase overdose risk when taken alongside synthetic opioids.

Calls for Increased Monitoring and Harm Reduction

Experts are calling for increased monitoring of drug use trends and the implementation of harm reduction strategies. Many advocate for more drug checking services to detect which substances are circulating on the drug scene. This allows public warnings to be issued when dangerous compounds are found in substances.

The rise of synthetic drugs in Europe presents a complex challenge. While cocaine remains a popular choice, the increasing availability and use of synthetic stimulants and opioids, coupled with the dangers of polysubstance use, demand a comprehensive and informed response. Further research is crucial to understand the long-term health risks associated with these substances, and harm reduction strategies are needed to protect public health.