Location of Euro-DEN Plus centres
Description
This map shows the location of hospitals participating in the European Drug Emergencies Network (Euro-DEN — Euro-DEN Plus) project. This project involves the collection of data on emergency department presentations with acute drug toxicity in participating countries in Europe. More centres are currently being recruited to increase the European value, representativeness and utility of this data source. The project aims to provide more detailed information on the nature and extent of harms associated with the use of drugs such as cannabis, cocaine, heroin and other opioids, amphetamines, prescription medicines and synthetic drugs.
Last updated: June 2023
The source data for this graphic is available in the source table on this page.
| Country | City | Coordinates | Centre | Type of service | Catchment area | Type of people using drugs | Number of beds | Estimates population served (n) | Emergency department and referral | Other comment |
|---|---|---|---|---|---|---|---|---|---|---|
| Belgium | Antwerp | 51.2,4.4 | ZNA Stuivenberg | ED in general hospital | Central and northern. Antwerp Metropolitan Area 40 km² | Urban ED. With both long-term drug users and recreational use | 250 | 500000 | Patients managed by ED. With referral to ICU, internal medicine or psychiatry as required. | Part of Ziekenhuis Netwerk Antwerpen (ZNA), a 2500 bed hospital on 10 sites in Antwerp Metropolitan Area |
| Belgium | Ghent | 51.1,3.7 | Ghent University Hospital | ED in university hospital | City of Ghent | Located in city with very large student population (63 000 students on a population of 263 000), very active party scene (week and weekends), a few large night clubs in the area. | 1000 | 200,000 | All poisonings are treated by the emergency physicians in the ED, if needed admitted to ITU and treated by intensivists. | No dedicated toxicology department, though two toxicologists in the ED team. |
| Bulgaria | Sofia | 42.7,23.3 | The University Multidisciplinary Hospital for Active Treatment and Emergency Medicine N. I. Pirogov | Specialist toxicology clinic and teaching facility. Referral clinic for toxicology pathology for the country. | Located in the centre of Sofia, the hospital is located near night life settings. | Mostly young people - heroin users, recreational stimulant users, party goers, but there are also older people with long-term drug addiction, included clients in methadone programs. | 38 (includes 10 paediatric) | 1,500,000 | The staff specialises in Internal Diseases, Clinical Toxicology and Emergency Medicine. The Toxicology Clinic is a teaching facility for Medical University of Sofia. | |
| Cyprus | Nicosia | 35.2,33.4 | Nicosia General Hospital | ER in the main public hospital of the capital city | City of Nicosia | The centre is located in the main public hospital of the capital city, however it is not located near an open drug scene or nightlife settings. The users more commonly presenting are recreational stimulant users (cocaine), cannabis users as well as people with high risk use (such as heroin and methamphetamine) | 419 | ~200,000 | Poisoned patients are initially managed within the ER and, if further treatment is needed, admitted to the general medicine wards or intensive care unit | |
| Czechia | Prague | 50.1,14.4 | Department of Occupational Medicine, Toxicological Information Centre, First Faculty of Medicine, Charles University and General University Hospital, Prague | Emergency Department in university hospital | Central part of Prague and part of Central Bohemian Region (surrounding Prague) | Use of marihuana, methamphetamine and alcohol most common | 1900 | About 250 000 people (25% of Prague) | Emergency Room physician and intensivist | |
| Denmark | Copenhagen | 55.7,12.6 | Bispebjerg Hospital | ED in teaching hospital | Copenhagen and Frederiksberg | 400000 | Emergency patients are seen by internists or anesthesiologists. The Danish Poison Information Centre (Giftlinjen, Bispebjerg Hospital) provides advice on complex or unusual cases. | The Danish Poison Information Centre has no day-to-day responsibility for patient care in the ED. | ||
| Denmark | Roskilde | 55.6,12.1 | Clinical Pharmacology Unit, Zealand University Hospital, Roskilde | Emergency Department in teaching hospital | ||||||
| Estonia | Pärnu | 58.4,24.5 | Pärnu Hospital | ED in general hospital | Western part of Estonia. Population served increases significantly in the summer with tourists from other parts of Estonia and abroad. | 100,000 | Poisoned patients are initially managed within the Emergency Room and, if further treatment is needed, may be admitted to the general medicine wards or intensive care unit. | |||
| Estonia | Tallinn | 59.4,24.7 | North Estonia Medical Centre | ED in general hospital | 1230 | Patients are initially treated by the emergency medicine doctors in ER and if further treatment is needed, the patients are transferred to intensive care or general medicine wards. | ||||
| Finland | Helsinki | 60.2,24.9 | Malmi Hospital | ER in general hospital | Eastern, south-eastern, north-eastern, and northern areas of Helsinki. | 3000 | 2.2 million | Treated by ER clinicians and referred to medical wards or ICU if required | For patient >16 years | |
| France | Paris | 48.9,2.3 | Emergency Department, Lariboisière Hospital, Assistance Publique – Hôpitaux de Paris | ED in teaching hospital | Central Paris | Next to ‘Gare du Nord’ (the largest and most crowded railway station in Europe), poor North-east area of Paris, located near a safe consumption room (next door). The area is a usual open drug scene with opioid users | 1200 | >3 million | Poisoned patients are seen by the Emergency Medicine Physicians on a 24/7 day-basis. | Specialists on-call from the Paris Poison Centre and the medical and toxicological intensive care unit are consulted for specific or severe cases, respectively. |
| Germany | Munich | 48.1,11.6 | Department of Clinical Toxicology, Klinikum rechts der Isar, School of Medicine,Technical University Munich. | Specialist department in a tertiary teaching hospital | City of Munichand the surrondings | Area of ~ 665 km2, the hospital is ~ 2 km from a party scene, an open consumption scene is near the main and eastern railway station, both ~<3 km. Users prefer sympathomimetics (NPS, cocaine, amphetamines, etc.). Among opioids, heroin does not play a dominant role, rather fentanyl and methadone. Cannabinoids and pregabalin are in the foreground. ChemSex, due to the proximity of a gay neighborhood). | 1161 (28 in department: 5 in a fully equipped ICU, 13 in a high dependency unit and 10 in a general ward | In the city and district of Munich: about 1.9 million | Poisoned patients are admitted directly and treated separately from the general medical ER at the department of Clinical Toxicology | Provides a toxicological laboratory service and the Munich´s Poison Control Center with about 44,000 inquiries per year |
| Italy | Monza | 45.6,9.3 | Emergency Department – Ospedale San Gerardo | Emergency Room in teaching hospital | North-eastern region of Milan | Monza is a quiet, wealthy medium-sized city with no special problems about drugs, although wealth may contribute to the use of recreational drugs. The type of users is very different: heroin users, recreational stimulant users, party goers with cannabis most used. | 600 | 500,000 | These patients are seen by ER medical staff and the consultant toxicologist is on-call by telephone from Poison Control Centre | Poison Control Centre : CAV/CNIT (Centro Antiveleni – Centro Nazionale di Informazione Tossicologica) of Pavia. |
| Italy | Rozzano | 45.4,9.2 | Humanitas Research Hospital, via Manzoni 56, 20089 | ER in teaching hospital | South Milan Lombardy | Outskirts south of Milan, near night clubs and discos. Several patients with psychiatric problems and substance abuse who do not usually belong to our ER because they do not have psychiatry | 780. (565 National Health Service,215 private healthcare) | 178 764 (Rozzano and neighboring municipalities) | Toxicology patients are seen by ER medical staff and the consultant toxicologist is on-call by telephone from Poison Control Centre CAV/CNIT | Poison Control Centre CAV/CNIT (Centro Antiveleni – Centro Nazionale di Informazione Tossicologica) of Pavia H24. |
| Latvia | Riga | 56.9,24.1 | Riga East Clinical University Hospital, Riga | |||||||
| Lithuania | Kaunas | NaN,NaN | Hospital of Lithuanian University of Health Sciences | ER in university hospital | Quiet area of the city with no safe consumption rooms nor night life settings | 2000 | NA - not only a regional hospital; in some areas of medicine, it is national. | Treated by ER clinicians and referred to medical wards or ICU if required | ||
| Lithuania | Vilnius | 54.7,25.3 | Toxicology Centre, Republic Vilnius University Hospital | ED in university hospital | City of Vilnius | No particular characteristic and the hospital is the main emergency hospital in Vilnius | 657 | 500000 | Patients are seen by the Clinical Toxicology doctor in the ER 24/7. 1000 patients per year are hospitalized in the toxicology centre. | This is a clinical department which consists of 6 ICU beds and 15 general ward beds. Alongside is a psychiatry ward with 17 beds. |
| Malta | Msida | 35.9,14.5 | Emergency Department, Mater Dei Hospital | The sole public, general, teaching hospital in Malta | Malta | A nearly whole country catchment area. Malta is the smallest national capital in the EU. A tourist destination with its warm climate with numerous recreational areas. Most common recreational overdoses are cocaine (crack on the rise), cannabis, synthetic cannabinoids, and heroin. Party goers presentations tend to be highest from April-Sept with another small peak in November | 1000 | 516000 | There is no formal toxicological service, with poisoned patients being treated in the Emergency Department, intensive care, paediatric wards or general medical wards. | |
| Norway | Oslo OAEOC | 59.9,10.7 | Oslo Accident and Emergency Outpatient Clinic (OAEOC) | Main casualty clinic in Oslo. Primary care emergency institution | City of Oslo | Located in the city centre, close to both main nightlife areas, safe consumption room, and open opioid addict scene. Main patient groups: ethanol (both binge drinking and chronic high alcohol consumption), injecting opioid and amphetamine users, and club scene drug users. | 15 beds for short time observation (max 6 hours) of recreational drug/ethanol toxicity patients. 18 beds in general 24-hour observation unit. | 700000 | Poisoned patients are treated at the Emergency General Practice Department, mostly by registrar/resident-level general practitioners. 15% of poisoned patients presenting are referred on to another hospital | In Norway patients cannot present directly to hospitals, but have to be assessed in primary care or by the ambulance service first. |
| Norway | Oslo OUH | 59.9,10.7 | Department of Acute Medicine, Oslo University Hospital (OUH) | Emergency hospital with local, regional and national responsibility of a variety of assignments | The most severe poisoned patients in the region. OUH is the region`s trauma hospital and consists of several acute specialities. All kind of people elder than 18 years are attending. People below 18y attend to a child-Hospital also located in the OUH-area. After stabilization, patients are sometimes continued to local hospitals. | The area around centre is a settlement area where people live and work and in connection to several travelling possibilities: bus, tram and subways. Type of people using drugs: young people attending to private parties and from the city night-life, and people in all ages using drugs in combining also because of addiction. Young and elder heroin users, GHB users, recreational stimulant users, party goers etc. | In the medical clinic:~ 200 beds. In our Department of Acute Medicine, the intensive care unit has 10 beds and the Observational unit has 17 beds for observational use for several medical needs. | Most severely poisoned patients from a catchment area of approximately 3 million people. | The Department consists of an observational unit of 17 beds with a medical intensive care unit of 12 beds and it hosts the Norwegian CBRNe Centre of Medicine. | All five Clinical consultants for the National Poisons Control Centre are also employed at the same department. |
| Poland | Gdansk | 54.4,18.6 | Pomeranian Centre of Clinical Toxicology (PCT) and Department of Clinical Toxicology Medical University of Gdansk | Specialist toxicology hospital | Centre of Gdansk but patients are from 25 hospitals in the Pomeranian province and~12 in Warmian-Masurian and Kuyavian-Pomeranian provinces of north Poland. | The cities of Gdansk, Gdynia and Sopot (Triplecity) form a large port with numerous night clubs and a large academic centre (about 100, 000 people). | 17 in PCT, including 7 intensive care beds | Combined population in 3 regions covered:~. 5,8 million | Staff specialises in internal diseases, clinical toxicology and emergency medicine. PCT serves as a Poison Control Centre and Toxicological Information Centre. | Toxicology reference hospital - operates 24/7. Only cases with serious toxicity are admitted. |
| Ireland | Drogheda | 53.7,-6.4 | Emergency Department, Our Lady of Lourdes Hospital | ED in general hospital | North East of the Republic of Ireland. Mixed urban and rural population | Large rural town population of 41,000 (2016). Large catchment area. Drugs ingested in context of parties and nightclubs primarily. Main drug groups are heroin, cocaine and stimulants. | 340 | 350,000 | Patients treated in the ED and admitted to hospital or discharged as appropriate | |
| Republic of Ireland | Dublin | 53.3,-6.3 | Emergency Department, The Mater Misericordiae University Hospital . Teaching hospital | ED in teaching hospital | North inner city serving a domiciled population | 600 | 185000 | Initial management of toxicological emergencies is in the ED with admission under general medicine or critical care if required. | ||
| Romania | Bucharest | 44.4,26.1 | Pediatric Poisoning Centre, Emergency Clinical Hospital for Children “Grigore Alexandrescu” | Reference toxicology unit for children in Romania within a teaching hospital | City of Bucharest and four counties around | Teenagers and young people using especially cannabis and recreational drugs, in clubs, private parties, street, school or universities | 440 | 5m | The patients are managed by the six paediatricians and 24 nurses working here. | Patients under 18 years old with acute overdoses are admitted to the centre. 25 beds in the unit |
| Slovakia | Bratislava | 48.2,17.1 | National Toxicological Information Centre, University Hospital (NTIC) | Teaching hospital. Largest medical facility in Slovakia | The common public area of the capital of Slovakia, city of Bratislava | 2500 | 500000 | NTIC, is a national clinical toxicology service providing advice and information to the health care providers, the general public, and other national organizations. | NTIC has about 6500 toxicological consultations per year. NTIC operates on a 24/7 - basis | |
| Slovenia | Ljubljana | 46.1,14.5 | Medical emergency unit and Centre for Clinical Toxicology, University Medical Centre | Emergency Department in teaching hospital | Central Ljubljana | Urban area with discos/dance clubs + a couple of squatter areas and an outpatient methadone clinic with a bustling drug using and trading community. Stimulant drugs more common than heroin and opioids.A high use of cannabis and GHB. | 2100 | 300 000 residents. Serves as a tertiary reference hospital for ~ 1.3 million people. | Patients in the ER are seen by internists, with consultant toxicologist on-call. Centre for Clinical Toxicology has 6 monitored beds and 15 beds in a general ward. | Excluding infectious disease, paediatric, surgical, neurological and psychiatric emergencies. Psychiatric evaluation and treatment is provided by a detached Psychiatric clinic. Toxicology Laboratory of the Institute of Forensic Medicine performs toxicological analyses. |
| Spain | Barcelona | 41.4,2.2 | Emergency Area, Clinical Toxicology Unit, Hospital Clinic | ED in teaching hospital | Central Barcelona | Centre of the city, with many nightlife venues around. Many of our patients are recreational drug users and also participants in chemsex sessions. | 600 | 550000 | Patients are treated in the emergency area, intensive care or general medical wards. | |
| Spain | Palma de Mallorca | 39.6,2.9 | Emergency Department and Clinical Toxicology Unit, Hospital Universitari Son Espases. | Teaching hospital | Leading tourist destination - large migrant population of tourists and seasonal workers especially during summer months, with over 8 million foreign tourists each year. | Near a) shelter for low/no income people where intravenous heroin and cocaine are used, along with other drugs. b) an area of pubs & clubs used all year round but especially in the summer and c) beach area with large influx of visitors in the summer and in both these areas MDMA, cocaine, cannabis and synthetic cannabinoids or other new drugs are used | 750 | Primary hospital for a resident population of about 400,000 and as a reference hospital for over a million people. | The ER treats poisoned patients on arrival; poisoned patients are reviewed by a member of the Clinical Toxicology Unit when on-duty or during office hours. | No formal reference consultant is on-call for toxicology. |
| Switzerland | Basel | 47.6,7.6 | Division of Clinical Pharmacology and Toxicology University Hospital | Primary care and referral centre | North-western Switzerland | Several safe consumption rooms in Basel, opioid abuse often, recreational stimulant users, no open drug scene in Basel. | 780 | 1000000 | Patients seen by the emergency physician with the clinical pharmacologist & toxicologist on-call when specialised advice is needed. | |
| Switzerland | Bern | 46.9,7.5 | Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital | Primary care facility (walk-in patients) and tertiary referral centre for hospitals in the greater Bern area | City of Bern and greater Bern area | A small city and there are some local night clubs and a drug treatment facility in the vicinity. | 1230 | 2 millions | Poisoned patients are seen by the emergency physicians with clinical pharmacologists and toxicologists on-call when specialised advice is needed. | Patients ≥16 years of age) |
| Switzerland | Lugano | 46.0,8.95 | Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale | Specialized clinical pharmacology and toxicology unit providing consultancy to and collecting data from EDs of a network of 4 public academic teaching hospitals in Southern Switzerland. | Urban and rural areas. | ER located near open drug scene and night life settings; commonly seen in ER are mostly recreational stimulant users. | 1000 | Almost 350 000 people. Serves as referral centre for Southern Switzerland. | Management of poisoned patients involves the emergency physician, supported by the consultant clinical pharmacologist and toxicologist when needed. | If required, management continues in medicine or critical care wards. |
| Switzerland | Geneva | 46.2,6.1 | University Hospitals, Rue Gabrielle-Perret-Gentil 4 | ED in university hospital | Canton of Geneva | 1920 | 499,480 | |||
| The Netherlands | Utrecht | 52.1,5.1 | University Medical Center (UMC) | ER in university hospital | Not located near open drug scene or safe consumptions rooms. Outside the city center of Utrecht though close (~10 km). However, the city center also has a hospital with an ED. | The hospital is located within Utrecht Science park. There are student housing facilities on the park and one restaurant, but other than that there is little to do and it is surrounded by grass-lands. The type of people are mostly recreational stimulant users and partygoers | 1100 | Unknown. We are an academic/ university hospital, so patients can come from the whole Netherlands to the UMCU (17.4 million inhabitants). | These patients are seen in the ED by specialists on call from acute internal medicine or intensive care. | The Dutch National Poisons Information Center is located within the UMC Utrecht |
| The Netherlands | Amsterdam | 52.4,4.9 | Emergency department, OLVG Hospital | ED in teaching hospital | Central Amsterdam | OLVG is a city centre hospital in Amsterdam. Many of the drug related patients are national or international tourists. Drug use is mostly related to social events, although people with chronic use are also seen. | 400 | 1 million | Toxicology patients are mostly seen (under supervision) by emergency physicians. | In case of severe toxicity, intensive care medicine, internal medicine, the hospital pharmacist and a clinical toxicologist will be involved. |
| Turkey | Izmir | 38.4,27.1 | İzmir Medical Sciences University, Tepecik Training and Research Hospital | ED in teaching hospital | City of Izmir | Deprived area with low income and education attainment households where whole families may use and deal drugs, usually synthetic cannabinoids | 600 | 350,000 | These patients are seen by the emergency medicine specialty program residents and their instructors. | Patients seen 24 hours/7 days in the ER, and consulted on in intensive care or general medical wards. |
| United Kingdom | London | 51.5,-0.1 | Clinical Toxicology Service, Guy’s & St Thomas’ (STH) NHS Foundation Trust | ED in teaching hospital | Central and south east London with a number of small and large night time economy venues nearby, particularly those catering for men who have sex with men (MSM, “gay”). | Recreational/NPS toxicity presentations are mostly commonly from those night-time economy venues, as well as privately held “chemsex parties” and private residences. Additionally, presentations are from street homeless and hostel dwellers. | 1100 | 1,6 million | Patients are seen by the Clinical Toxicology service during office hours in the ER, intensive care or general medical wards and out of hours a consultant toxicologist is on-call. | |
| United Kingdom | London | 51.4,-0.0 | Emergency Department, King’s College Hospital (KCH) NHS Foundation Trust | ED in teaching hospital. No formal toxicology service but strong links with the service at GSTT London. | South east London. It has a diverse socioeconomic resident population. | Recreational drug/NPS toxicity presentations are most commonly from local night-time economy venues, privately held “chemsex parties”, private residences, hostels and those who are street homeless. | 900 | 1 million | ||
| United Kingdom | York | 54.0,-1.1 | York Teaching Hospital NHS Foundation Trust | ED in teaching hospital | Semi-rural population, living in or near York and North Yorkshire | 700 | 800000 | Patients are managed initially within the Emergency Room and, if needed, may be admitted to the Acute Medical Unit or critical care areas under the care of a General Physician. | Support from a local liaison psychiatry team. | |
| United Kingdom | London STMW | 51.5,-0.2 | St Mary's Hospital, Imperial College Healthcare NHS Trust | ER in teaching hospital and inner-city major trauma centre. | Central west and northwest London | High numbers of stimulant recreational drug users, patients using drugs for chemsex and high rates of homelessness in the local area. | 495 | 2 million | Poisoned patients are initially managed within the ER and, if further treatment is needed, admitted to the general medicine wards or intensive care unit |
