New psychoactive substances – the current situation in Europe (European Drug Report 2023)
The market for new psychoactive substances is characterised by the large number of substances that have appeared in this area and that new compounds continue to be detected each year. On this page, you can find an overview of the drug situation for new psychoactive substances in Europe, supported by seizure data and information from the EU Early Warning System on substances detected for the first time in Europe. New substances mentioned include synthetic cannabinoids, hexahydrocannabinol, synthetic cathinones, new synthetic opioids, benzimidazole opioids.
This page is part of the European Drug Report 2023, the EMCDDA's annual overview of the drug situation in Europe.
Last update: 16 June 2023
Health concerns over highly potent substances, continued market adaptation and increasing seizures
The market for new psychoactive substances is characterised by the large number of substances that have appeared in this area and that new compounds continue to be detected each year. The term ‘new psychoactive substances’ covers a broad range of substance types that are not controlled by international drug control agreements, although some of them may be subject to national regulatory measures. In 2021, a record 8.5 tonnes of new psychoactive substances was seized by EU Member States (see the figure Seizures of new psychoactive substances in the European Union: number of seizures and quantity seized, 2005–2021). Drug producers continue to create new substances to avoid legal controls. The risks to health of these novel compounds are usually unknown, potentially exposing consumers to the risk of serious or even fatal poisonings or other health problems. Legislative controls in Europe and non-EU source countries appear to have contributed to a reduction in the number of new derivatives of some drugs, 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.
The 24 new cannabinoids detected accounted for over half of the new substances first reported to the EU Early Warning System in 2022 (see the figure Number of new psychoactive substances reported for the first time to the EU Early Warning System, by category, 2005–2022). The diversity seen in this area may reflect attempts by illicit drug producers to circumvent China’s 2021 class-wide ban on synthetic cannabinoids.
There is a growing concern that consumers of cannabis may be at risk of inadvertent exposure to synthetic cannabinoids. In 2021, there was an overall increase in reports of herbal material where THC or other natural cannabinoids were found alongside synthetic cannabinoids, with at least 13 European countries, mostly Germany and Sweden, reporting such cases. It is possible that such adulterated products are more widely available but go undetected. Adulterated cannabis appears similar in appearance to natural cannabis and can be mis-sold as cannabis to unsuspecting consumers. Synthetic cannabinoids are 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 apparent on the illicit European market since 2021. In addition to the risks that these products pose because of 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 may contain synthetic cannabinoids.
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, the appearance of new semi-synthetic cannabinoids reflected these concerns. Hexahydrocannabinol (HHC) was identified in May 2022 and had been reported by 20 EU Member States by March 2023. Three other semi-synthetic cannabinoids, HHC acetate, hexahydrocannabiphorol and tetrahydrocannabidiol, 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. Marketed online and in shops as ‘legal’ replacements for cannabis, they include hemp sprayed or mixed with HHC, which looks and smells like natural cannabis, as well as vapes and edibles. The effects of HHC in humans have not been studied, but anecdotal consumer reports suggest they may be subjectively similar to those of cannabis. However, some of the products are available in forms that may deliver high doses, raising concerns about the possible implications for public health of the availability of these substances.
Synthetic cathinones and new synthetic opioids are relatively well-established in some European drug markets. They are sold as replacements for stimulants such as amphetamine or opioids such as heroin, respectively. In 2022, large quantities of cathinones such as 3-MMC and 3-CMC continued to be seized. Although seizure numbers remain small, the very large quantities of cathinones found in some individual seizures, mostly trafficked from India, suggest that these substances have the potential to play a bigger role in Europe’s stimulant market. These concerns are further heightened by information suggesting that cathinones are increasingly being produced in Europe, with greater sophistication. Developments in this area include the detection of chemically masked non-controlled forms (N-acetyl-3-MMC) being trafficked into Europe for local conversion into the controlled cathinone 3-MMC. While information from indicators such as drug checking services suggests that MDMA products are less subject to adulteration than other illicit drugs they screened in 2021, the adulteration of MDMA products with synthetic cathinones may also increase the risk of unknown effects and potential harms. In 2022, signals of a possible increase in synthetic cathinones mis-sold as MDMA or used to adulterate MDMA were reported to the EU Early Warning System. While the overall scale of this issue is unknown, it has been reported by drug checking services in at least three EU Member States, including Spain, the Netherlands and Austria. The affected products included ecstasy tablets, crystals and powders, typically containing 4-CMC (clephedrone), 3-MMC, 4-MMC (mephedrone) and dipentylone.
Although only one new synthetic opioid was formally notified in 2022, recent signals, mostly from Baltic countries, suggest increased availability and harms (including drug-induced deaths) linked to these substances, particularly the fentanyl derivative carfentanil and the highly potent group of benzimidazole opioids, which includes drugs such as isotonitazene, protonitazene and metonitazene. The benzimidazole opioids emerged following control measures, introduced both in producer countries and elsewhere, to reduce the availability of fentanyl derivatives, including carfentanil. 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. Synthetic opioids have been linked to drug-induced deaths, with recent reports from Estonia and Lithuania indicating that these drugs now account for a significant share of overdose deaths in these countries. New preliminary data from 2023 suggest that mortality linked to benzimidazole opioids is being increasingly detected in Latvia and this represents a worrying development. In 2022, the Estonian police reported seizing mixtures containing the new synthetic opioid metonitazene and bromazolam, a new benzodiazepine, and mixtures containing the new opioids protonitazene and metonitazene and the animal sedative and analgesic xylazine. These mixtures, respectively known as ‘benzo-dope’ and ‘tranq-dope’ have been linked to increases in overdose deaths in Canada and the United States. There is a need to consider and further investigate what harm reduction and prevention measures are effective in reducing mortality risks associated with the use of synthetic opioids. For example, it has been suggested that approaches to providing the opioid antagonist naloxone need to be adapted to respond more effectively to the health risks posed by synthetic opioids.
Key data and trends
New psychoactive substances reported
- At the end of 2022, the EMCDDA was monitoring around 930 new psychoactive substances, 41 of which were first reported in Europe in 2022.
- Approximately 400 new psychoactive substances were detected in seizures in 2021 (see the figure Number of new psychoactive substances reported each year following their first detection in the European Union, by category, 2005–2021).
- In 2022, the EU Early Warning System received reports of 24 new cannabinoids, bringing the total number being monitored to 245.
- Since 2009, a total of 74 new opioids have been identified on the European drug market, with one new substance notified in 2022 (6 in 2021, 10 in 2020) (see the figure Number of opioids reported for the first time to the EU Early Warning System, 2009–2022).
Seizures of new psychoactive substances
- In 2021, seizures of low-THC herbal cannabis material containing synthetic cannabinoids amounted to 242 kilograms (37 kilograms in 2020; 200 grams in 2019). The samples were variously reported as ‘hemp’ or ‘cannabis’ or containing THC, CBD or CBG. In addition, seizures of 12 kilograms of cannabis resin were reported as ‘CBD hash’.
- In 2021, EU Member States accounted for almost 29 400 of the 59 620 seizures of new psychoactive substances reported in the European Union, Norway and Türkiye, amounting to 8.5 of the 10.8 tonnes seized. The increase was driven by a small number of large seizures of cathinones (3-CMC, 3-MMC,4-CMC), as well as ketamine and GBL (see the figure Seizures of new psychoactive substances in the European Union: number of seizures and quantity seized, 2005–2021). In addition, 23 634 litres of liquids containing new psychoactive substances were seized, mainly GBL (21 455 litres) and 4-CMC (1 228 litres).
- In 2021, just 5 substances accounted for over 80 % of the quantity of new psychoactive substances seized in EU countries: 3 cathinones (3-CMC, 3-MMC and 4-CMC, amounting to 4.0 tonnes), ketamine (0.9 tonnes) and GBL (2.0 tonnes) (see the figure Seizures of new psychoactive substances in the European Union: quantity seized, by substance, 2021).
- In 2021, 740 seizures of new opioids were reported to the EU Early Warning System, with 45 % containing carfentanil and 22 % containing isotonitazene. A total of 8.2 kilograms of material was seized, with 59 % (4.9 kilograms) containing carfentanil and 23 % (1.9 kilograms) containing isotonitazene. Most of the seizures occurred in northern Europe, with Estonia, Latvia, Lithuania and Poland reporting 97 % of the seizures and 86 % (7.1 kilograms) of the quantity seized.
Based on all physical forms expressed in kilograms.
Prevalence of new psychoactive substances use
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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 to 5.1 % in Romania. Among 15- to 16-year-old schoolchildren, the most recent European survey (see ESPAD 2019), from 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.
Hospital presentations related to new psychoactive substances
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In 2021, 3-MMC was reported in 68 acute drug toxicity presentations in 5 Euro-DEN Plus hospitals.
Source data
The data used to generate infographics and charts on this page may be found below.
About this page
Recommended citation: European Monitoring Centre for Drugs and Drug Addiction (2023), European Drug Report 2023: Trends and Developments, https://www.emcdda.europa.eu/publications/european-drug-report/2023_en
Identifiers:
HTML: TD-AT-23-001-EN-Q
ISBN: 978-92-9497-865-3
DOI: 10.2810/161905