New psychoactive substances – the current situation in Europe (European Drug Report 2024)

The market for new psychoactive substances is characterised by the large number of substances that have emerged, with new ones being detected each year. On this page, you can find an overview of the drug situation for new psychoactive substances in Europe, supported by information from the EU Early Warning System on seizures and substances detected for the first time in Europe. New substances covered include synthetic and semi-synthetic cannabinoids, synthetic cathinones, new synthetic opioids and nitazenes. 

This page is part of the European Drug Report 2024, the EMCDDA's annual overview of the drug situation in Europe.

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Last update: 11 June 2024

Appearance of potent new substances and inadvertent consumption raising health concerns

The market for new psychoactive substances is characterised by the large number of substances that have emerged, with new ones being detected each year. The term ‘new psychoactive substances’ covers a broad range of substances that are not controlled by international drug control conventions, although some of them may be subject to national regulatory measures. In 2022, EU Member States seized a record 30.7 tonnes of new psychoactive substances (see Seizures of new psychoactive substances, below).

The most recent data shows that drug producers continue to create new substances to avoid legal controls, although the rate at which new psychoactive substances are now entering the market appears to be slowing. Between 2016 and 2022, typically around 50 new psychoactive substances appeared on the market for the first time each year; this fell to 26 in 2023. In addition, around 400 previously reported new substances are detected on the market each year.

In general, the risks to health of these novel compounds are usually unknown, although some clearly pose an acute risk to consumers of experiencing serious or even fatal poisonings or other health problems. Over time, legislative controls and other regulatory measures taken in Europe and non-EU source countries appear to have contributed to a reduction in the number of new derivatives of some drug types, particularly those that have been specifically targeted, such as fentanyl. Other substances, however, designed to evade generic definitions in legislation, continue to emerge, with China and India remaining important source countries for these substances or the precursors that are required to produce them.

Cannabis consumers risk inadvertent exposure to synthetic cannabinoids

The 9 new cannabinoids detected, 4 of which are semi-synthetic cannabinoids, accounted for approximately one third of the new substances first reported to the EU Early Warning System in 2023 (see New psychoactive substances reported, below).

The continuing emergence of new substances in this area adds to concerns that consumers of cannabis may be at risk of inadvertent exposure to synthetic cannabinoids. Adulterated cannabis may appear similar to unadulterated cannabis and can be mis-sold as cannabis to unsuspecting consumers. It is therefore possible that such adulterated products are more widely available but often go undetected.

Synthetic cannabinoids are often highly potent substances, and adulterated products carry poisoning risks. An additional concern is that cannabis edibles (foods, often in the form of sweets that are typically infused with cannabis extract) have become more available on the illicit market in Europe since 2021. In addition to the risks posed by these products due to their THC content and the possibility that they may be mistaken for legitimate commercial products, especially by children, there are concerns that some of these products contain synthetic cannabinoids. Since 2019, at least 5 countries have reported the identification of edibles containing synthetic cannabinoids in the form of sweets (jelly ‘gummies’). Cases of severe poisonings after the ingestion of sweets infused with synthetic cannabinoids have been recorded in the European Union.

Synthetic cannabinoids also sometimes appear in samples of other drugs. In May 2023, for example, an unusual and unexpected outbreak of non-fatal poisonings involving more than 20 people was reported in Paris, France, caused by heroin adulterated with synthetic cannabinoids. Around the same time, in April 2023, Lithuania reported the seizure of a similar adulterated heroin sample.

Health risks from HHC and other semi-synthetic cannabinoids remain poorly understood

New regulatory challenges and concerns have emerged about the potential for interaction between the commercialisation of cannabis derivatives and the recreational drug market. In 2022, semi-synthetic cannabinoids, not controlled under international drug laws, started to appear on the European drug market for the first time. The first was HHC (hexahydrocannabinol), which was identified in May 2022 and had been reported by 23 EU Member States and Norway by December 2023. HHC has been listed as a controlled drug in at least 18 EU Member States, as of March 2024. Five other semi-synthetic cannabinoids, HHC acetate, hexahydrocannabiphorol, tetrahydrocannabidiol, tetrahydrocannabiphorol and hexahydrocannabihexol, have also been identified on the European drug market. It appears likely that these substances are being produced from cannabidiol extracted from low-THC cannabis. Initially, semi-synthetic cannabinoids were trafficked from the United States. However, there are now signs that they are also being produced in Europe. Marketed online and in shops as ‘legal’ replacements for cannabis, they include hemp sprayed or mixed with HHC, which looks and smells like cannabis, as well as vapes and edibles. The effects of HHC in humans have not been sufficiently studied, but anecdotal consumer reports suggest they may be subjectively similar to those of cannabis. Some of the products available, however, are in forms that may deliver high doses, raising concerns about the possibility of adverse health effects. More research is needed on the implications of consuming these substances, especially at higher doses, and currently a lack of robust monitoring data makes the availability, and any risks associated from the use of these substances, difficult to assess.

Synthetic cathinones becoming more significant in Europe’s stimulant market

Synthetic cathinones have appeared and become established as replacements for stimulants such as amphetamine in some parts of Europe.

In 2022, large quantities of cathinones such as 3-CMC and 3-MMC, mostly trafficked from India, continued to be seized in Europe, indicative of the important role these drugs now play in some countries. This is a cause for concern, compounded by information suggesting that cathinones are also now increasingly being produced in Europe. Cathinones are also sold alongside or as other drugs, potentially increasing the risk of harm. In 2022 and 2023, the EU Early Warning System noted an increase in reports of synthetic cathinones mis-sold as MDMA or used to adulterate MDMA.

Nitazenes: a new and growing threat to health

New synthetic opioids are often highly potent, meaning a small amount can be sufficient to produce a large number of typical street doses and can pose an increased risk of life-threatening poisoning. In North America, the synthetic opioid fentanyl has been the major driver of a public health emergency characterised by high levels of mortality. Although these drugs have not figured prominently in the European drug problem to date, there are now concerns that risks in this area are growing. New synthetic opioids have been linked to drug-induced deaths in Europe with recent reports from Estonia, Latvia and Lithuania indicating that these substances now account for a significant share of overdose deaths in these countries. At least 163 deaths were associated with fentanyl and fentanyl derivatives in Europe in 2022. Many of these were associated with fentanyl diverted from medical use as opposed to fentanyl produced for the illicit drug market.

Seven new synthetic opioids were formally notified in 2023 to the EU Early Warning System, with 6 of them belonging to the highly potent group of benzimidazole (nitazene) opioids. This is the highest number of nitazene opioids notified in a single year. Since 2019, at least 20 EU countries have now reported the presence of a nitazene. The nitazene opioids appear to have emerged following control measures, introduced both in producer countries and elsewhere, to reduce the availability of fentanyl derivatives. Preliminary reporting from 2023 suggests an increase in deaths linked to nitazenes in Estonia and Latvia. In addition, localised outbreaks of poisonings caused by nitazenes mis-sold as heroin were reported in Ireland and France.

There are also some reports that suggest an increase in the detection of fake medicines containing nitazene opioids. The appearance of nitazenes has also been accompanied by other developments in the market, where new synthetic opioids are found in combination with other substances. These include the emergence in 2021 of ‘tranq-dope’, in which new synthetic opioids are mixed with the animal sedative and analgesic xylazine, and ‘benzo-dope’ in 2022, in which new synthetic opioids are mixed with new benzodiazepines (such as bromazolam).

The European opioid market may also be affected by developments elsewhere. Of particular note in this context is the recent ban on opium poppy cultivation in Afghanistan, which appears to have resulted in a dramatic reduction in opium production. While it is still too early to be definitive, this may result in a reduced supply of heroin to Europe. Should this happen, a concern exists that new synthetic opioids could be among the replacement drugs for heroin, potentially increasing the risks associated with opioid use.

More generally, the appearance of highly potent synthetic opioids requires us to review if the current approaches used to prevent, treat and reduce the harm of opioid-related problems remain fit for purpose. For example, it has been suggested that approaches to providing the opioid antagonist naloxone need to be reviewed, as models of care may need to be adapted to more effectively respond to those who have consumed new synthetic opioids or mixtures that contain new synthetic opioids and other substances.

Key data and trends

New psychoactive substances reported

• At the end of 2023, the EMCDDA was monitoring over 950 new psychoactive substances, 26 of which were first reported in Europe in 2023 (Figure 7.1 and Table 7.1).
• Approximately 400 new psychoactive substances were detected in seizures in 2022 (Figure 7.2).
• In 2023, the EU Early Warning System received reports of 9 new cannabinoids, bringing the total number being monitored to 254.
• Since 2009, a total of 81 new opioids have been identified on the European drug market, with 7 new substances notified in 2023 (1 in 2022, 6 in 2021), 6 of which were highly potent nitazene opioids, which can, in some cases, be hundreds of times more potent than heroin. To date, 16 nitazenes have been identified in Europe (Figure 7.3).

Seizures of new psychoactive substances

• In 2022, 24 countries reported seizing 281 kilograms (385 kilograms in 2021) of synthetic cannabinoids as herbal material. Low-THC herbal cannabis products accounted for around 30 % of these seized materials, amounting to 76 kilograms (242 kilograms in 2021), reported by 10 countries. The samples were variously reported as ‘hemp’ or ‘cannabis’ or containing THC, CBD or CBG.
• In 2022, EU Member States accounted for almost 26 390 of the 38 860 seizures of new psychoactive substances reported in the European Union, Norway and Türkiye, amounting to 30.7 of the 31.8 tonnes seized (Figure 7.4). The increase was driven by a small number of large seizures of cathinones (3-CMC, 3-MMC, 2-MMC) and ketamine (Figure 7.5). In addition, 1 472 litres of liquids containing new psychoactive substances were seized, mainly GBL (1 115 litres) and HHC (96 litres).
• In 2022, just 5 substances accounted for over 90 % of the quantity of new psychoactive substances seized in EU countries: 4 cathinones (3-CMC, 3-MMC, 2-MMC and N-ethylnorpentedrone, amounting to 24.8 tonnes) and ketamine (2.8 tonnes, up from 0.87 tonnes in 2021) (Figure 7.5).
• In 2022, 749 seizures of new opioids were reported to the EU Early Warning System, with 40 % containing carfentanil and 22 % containing tramadol. A total of 16.6 kilograms of material was seized, with 50 % (8.2 kilograms) containing carfentanil and 31 % (5.2 kilograms) containing tramadol. Most of the seizures occurred in northern Europe, with Estonia, Latvia, Lithuania, Sweden and Finland reporting 87 % of the seizures and 67 % (11.1 kilograms) of the quantity seized.

Prevalence of new psychoactive substances use

• National estimates of last year use of new psychoactive substances (excluding ketamine and GHB) among young adults (aged 15 to 34) range from 0.1 % in Latvia and Norway to 5.1 % in Romania. Among 15- to 16-year-old schoolchildren, the most recent European survey (see ESPAD), carried out in 2019, estimated that lifetime use of new psychoactive substances ranged from 0.9 % to 6.6 %, with lifetime use ranging from 1.1 % to 5.2 % for synthetic cannabinoids and 0.2 % to 2.5 % for synthetic cathinones.

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