From cannabis to ‘new’ opioids: how drugs affect health and safety

The drug phenomenon is becoming increasingly complex and fluid: the market, distribution and use of new substances (one every week) – whether pure, synthetic or high-potency – expose users to ever-greater health risks. The use of new cannabis-based products and the sale of various opioids and stimulants also place a strain on healthcare systems and have an impact on public safety and social vulnerability. This is the warning issued by the European Union’s European Monitoring Centre for Drugs and Drug Addiction in its annual report, which draws on data provided by 27 Member States, plus Turkey and Norway. The report reveals that Italia ranks first in terms of the number of people (105,652) who use drugs intravenously, ahead of France and Germany.

In 2025, 50 new psychoactive substances were reported for the first time in Europe. This brings the total number of substances being monitored to 1,050. These include new and potent synthetic opioids, which carry a higher risk of potentially fatal poisoning. Many e-cigarette vapes containing synthetic and semi-synthetic forms of cannabis have been seized; these act as a gateway for young people to other harmful substances. Sold in vapes and edibles, these adulterated products, based on cannabis and semi-synthetic cannabinoids, increase the risk of harm to new users.

“The European drugs market is dynamic and rapidly evolving. Substances are becoming more potent,” said Lorraine Nolan, Executive Director of the EU Drugs Agency, at the launch of the 2026 report. “Criminal groups are becoming more active and more violent. At the same time, Europe’s role in the global drug market is evolving. Europe is now a major producer of synthetic drugs for both the domestic and export markets.”

Cannabis is the most widely used illegal drug: over the past year, 24.9 million European adults (aged 15–64) have used it. In Italia, 18.1% of young people aged between 15 and 34 smoke it. Its use, including that of high-potency products, extracts and edibles, is increasingly linked to a rise in A&E admissions. 33% of users require treatment programmes. In 2024, there were 104,000 patients. Large quantities of cannabis arrive in European countries from Canada: in 2025, 21 tonnes of cannabis of Canadian origin were seized at the ports of Rotterdam and Antwerp. Among the risks is the presence of potentially dangerous pesticides, which requires targeted responses and ongoing international cooperation.

However, opioids are the leading cause of overdose deaths in Europe: in 2024, 7,600 deaths were caused by their combination with other substances. In 2025, seven new synthetic substances, including nitazeni and orphine, were reported to the EU Early Warning System. Counterfeit medicines containing nitazeni, which mimic approved medicines such as oxycodone or diazepam, are also being reported with increasing frequency. Between June 2024 and January 2026, there were 18 deaths linked to the use of orphine. Meanwhile, deaths caused by fentanyl, a powerful synthetic opioid, require greater vigilance: there have been 100 such deaths in Bulgaria.