Frequently asked questions (FAQ): drug overdose deaths in Europe
Page last updated: 30 August 2024
This page provides answers to the questions most often asked about drug overdose deaths in Europe. Also known as ‘drug-related deaths’ or more specifically ‘drug-induced deaths’, they are deaths directly attributable to the use of illicit drugs. The information presented here is based on the latest data from the 27 Member States of the European Union and the European Union Drugs Agency (EUDA) affiliates Norway and Türkiye. It draws on contributions from specialists from these countries, as well as on information provided by the countries in an annual reporting exercise.
Introduction
The latest European Drug Report (EMCDDA, 2024) estimated that 6 400 deaths involving one or more illicit drugs were reported in 2022 in the European Union. This estimate rises to around 7 000 deaths when Norway and Türkiye are included. Men accounted for 4 out of every 5 drug-induced deaths. It should be noted that the data for 2022 are provisional and are an underestimate, due to reporting delays and other limitations in reporting capacity apparent in some countries.
All of these deaths were premature, predominantly affecting people in their thirties and forties, representing decades of life lost.
Opioids, often heroin, were involved in three quarters of the drug-induced deaths reported in Europe, although this is not true for all countries. Opioids used in agonist treatment can also be found in post-mortem analyses in some countries. Deaths related to medications, such as oxycodone and tramadol, are also reported. Deaths associated with fentanyl and its analogues are rarely reported. There were 163 fatal overdoses with the drug involved in 2022, and Germany reported 73 of these. Some of these fatalities might be associated with diverted medicine rather than with illicit fentanyl. Fentanyl deaths might also be underestimated in some countries. Deaths related to stimulants such as cocaine and amphetamines have been reported in recent years in several countries. Most drug-induced deaths involve polydrug use.
Aim and objectives
This page aims to raise awareness about the nature and scale of the drug overdose deaths problem in Europe. This topic does not receive sufficient attention, despite the high number of lives lost, the dramatic consequences for families and communities and the fact that all of these deaths are preventable and avoidable. Enhancing the monitoring and responses to drug-induced deaths is also a priority of the European Union Drugs Action Plan 2020-2025 and of the EUDA. This pages pulls together the most recent epidemiological data and highlights the gaps in the information available in this area across Europe.
We are updating this page to mark International Overdose Awareness Day on 31 August 2024.
What this page contains
This page contains up-to-date information on overdose deaths in the 27 EU Member States, Norway and Türkiye, focusing on selected recent concerns and threats, the demographics (who is dying) and the time trends in the overdose situation. It also summarises the common situations that increase the risk of overdose (risk factors for overdose) and presents an overview of the current state of interventions aimed at preventing overdose deaths in Europe. Finally, background information is given on the methodology, the sources of information and their limitations, together with references and links to resources.
Questions
Emerging concerns and threats
This year, three concerns and potential threats are highlighted: the outbreaks of deaths linked to highly potent synthetic opioids – nitazenes mainly – in Estonia and Latvia, in particular; deaths associated with the co-use of drugs and medicines; and the high and increasing proportion of drug-induced deaths with cocaine involved in some countries. More information on these three topics can be found in the drug-related deaths section of the 2024 European Drug Report.
Overdose situation
This section with the definitions used across Europe. It also presents the most recent data available, together with graphics, and maps on the number and the rates of drug-induced deaths in Europe.
- What is a drug-induced death?
- How many people die from drug overdoses each year in the European Union, Norway and Türkiye?
- What is the most recent year for which data on overdose deaths are available?
- Are the numbers of drug-induced deaths and estimated mortality rates similar between countries?
- Is the drug-induced deaths rate (deaths/population) similar between countries?
- Is the sex difference in drug-induced deaths similar between countries?
- How has the distribution of drug-induced deaths among age groups changed in recent years?
- Is the age distribution of drug-induced deaths similar across sex and different countries?
- What substances are involved in drug-induced deaths?
- Where have numbers of drug-induced deaths increased over the last 10 years?
Risk factors for overdose deaths
There are identified circumstances and risk factors associated with drug-induced deaths, and this section provides an overview of the evidence in this area. Special focus is given to overdose with suicidal intent among women, and to the needs of people in prison or being released from prison.
Preventing overdose deaths
The use of illicit drugs is a recognised contributor to the global burden of disease. Interventions designed to reduce this burden include prevention activities, intended to reduce or slow the rate at which drug use may be initiated, and the offer of treatment to those who have developed drug problems. A complementary set of approaches goes under the general heading of harm reduction. There is a range of evidence-based and integrated interventions available to reduce the risk of overdoses, including fatal overdoses. This section presents strategies, recent best practice guidelines in hospital settings, the current state of implementation of several services and responses in Europe; and the directions for improvement identified during an investigation of the circumstances around the deaths of young persons aged less that 25 in Finland in 2023.
- How can overdose deaths be prevented?
- How should emergency departments assess and treat adults presenting with acute opioid toxicity?
- What is the level of implementation of harm reduction interventions?
- What does a study in Finland tell us about improving overdose prevention for young people?
- What interventions are available in prisons?
Methodology
The national focal points and their experts in the 27 EU Member States, Norway and Türkiye report data annually to the EUDA through standard tables and workbooks. The annual Statistical Bulletin contains the most recent available data on the drug situation in Europe provided by the EU Member States, Norway and Türkiye. These data sets underpin the analysis presented in the European Drug Report. This section provides information on the methods, sources and definitions used to monitor drug-induced deaths in Europe, as well as the strengths and limitations of the surveillance in place. This section also provides methods and references to recently published findings on the overall mortality – due to drug-induced deaths and other causes – among people who use drugs.
- Where do the data come from?
- What cases are included?
- What sources of information are used in different countries?
- What is the preferred source of data chosen by the countries for use in EUDA publications?
- Are the data comparable between countries?
- How do we measure the overall and the cause-specific mortality rates related to drug use?
List of figures
A list of all figures in this publication is available below.
- Overdose situation
- Figure 1.1. Year of most recent overdose data
- Figure 1.2. Drug-induced deaths among adults (15-64) in the European Union, Norway and Türkiye, 2022
- Figure 1.3. Sex and age as factors in drug-induced mortality rates (deaths per million population), by country, 2010-2022 or more recent data available
- Figure 1.4. Drug-induced mortality rates per million among adults (15-64): selected trends
- Figure 1.5. Drug-induced mortality rates per million among adults (15-64), females, males and total
- Figure 1.6. Proportion of males among drug-related deaths in the European Union, Norway and Türkiye, 2022
- Figure 1.7 Distribution of drug-induced deaths reported in the European Union in 2012 and 2022 or most recent year, by age band
- Figure 1.8. Distribution of drug-induced deaths reported in 2022, or most recent year, by age group and country
- Fgure 1.9. Proportion of drug-induced deaths among older (40+ years) people in the European Union, Norway and Türkiye, 2022 (or most recent data available)
- Figure 1.10. Proportion of drug-induced deaths among younger (under 30 years) people in the European Union, Norway and Türkiye, 2022 (or most recent data available)
- Figure 1.11. Proportion of drug-induced deaths with opioids involved in the European Union, Norway and Türkiye, 2022
- Figure 1.12. Countries included in the south-east and north of Europe for this trend analysis
- Figure 1.13. Indexed trends in the number of deaths in selected countries in the south-east of Europe, 2013-2022
- Figure 1.14. Indexed trends in the number of deaths in selected countries in the north of Europe, 2013-2022 (2013 = 100)
- Preventing overdose deaths
- Methodology
- Figure 3.1. Sources used by the countries to report drug-induced deaths to the EUDA, 2022 (or most recent data available)
- Figure 3.2. Sources preferred by the countries to report drug-induced deaths to the EUDA, 2022 (or most recent data available)
- Figure 3.3. Mortality cohort studies among people using drugs in Europe: countries with studies conducted within the last 10 years or earlier
PDF version of this publication
This publication was designed as a digital-first product, structured by sections, and optimised for online reading. Within each chapter, you may download a PDF version of the page. We are also making available here a PDF version of the full report. Please note that some errors may have occurred during the transformation process and that it is possible that this version does not contain all corrections made since the report was first published (please check the last updated date).
Download full PDF version of Frequently asked questions (FAQ); on drug overdose deaths in Europe (2.2 MB, last updated 30.09.2024)
Resources and references
This section provides a selection of EUDA resources along with the details of the works cited in the text.
More information and resources
- More resources on the topics covered by this publication may be found in the Drug-related deaths and mortality topic hub page.
- For further methodological information and the most recent EUDA data in this area consult the Statistical Bulletin 2024 – methods and definitions for overdose deaths.
- The European network of drug-related deaths experts supports the EUDA’s work on the DRD key epidemiological indicator. The network meets each year to share and discuss new data, studies and experiences at regional, national and European level (The findings of the 2019 meeting were published as a Rapid Communication publication).
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Source data
Links to all source data tables used in the report to create data visualisations may be found at the bottom of each chapter, as well as, in most cases, beneath each graphic. The entire source data set for the report, including data for tables which appear within the report, may be found using the link below. All data provided may be reused under a Creative Commons Attribution 4.0 International (CC BY 4.0) licence.This means that reuse is allowed provided appropriate credit is given and any changes are indicated.