In Germany, more than a quarter of the adult population have used illicit drugs during their lifetime, while less than 1 in 10 have done so in the last 12 months; of these, about half have used illicit drugs in the last 30 days.
Data on drug use among the adult population are available from the Epidemiological Survey of Substance Abuse (ESA). The Drug Affinity Study (DAS) provides data on the use of licit and illicit substances among adolescents and young people aged 12-25 years. The 2015 studies indicated that cannabis remains by far the most common illicit drug in Germany among both adults and adolescents. In general, consumption of illicit drugs is more common among males than females and remains higher among young adults, in particular 18- to 25-year-olds.
The most recent ESA results indicate a slight rise in cannabis use among young adults; in contrast, the DAS data from the most recent survey indicate a slight decline in cannabis use among adolescents and young people.
In 2015, amphetamine was for the first time reported to be the most popular stimulant used by German adults in the last 12 months, followed by cocaine and MDMA. About 2.8 % of adults in Germany had used any kind of NPS, while about 2.2 % of young adults (18-25 years) indicated use of these substances in the past.
German cities (Dortmund, Dresden, Dülmen and Munich) participate in the Europe-wide annual wastewater campaigns undertaken by the Sewage Analysis Core Group Europe (SCORE). This study provides data on drug use at a community level, based on the levels of illicit drugs and their metabolites in sources of wastewater.
Estimates of last-year cannabis use among young adults (15-34 years) in Germany
NBEstimated last-year prevalence of drug use in 2015.
The 2016 study reported increased MDMA levels in wastewater of all the cities, which may be related to increased purity of MDMA or increased availability and use of the drug; moreover, MDMA concentrations were higher at weekends. Methamphetamine metabolites were found in the wastewater of cities of eastern Germany. In contrast, cocaine use was concentrated in Dortmund.
In Germany, the patterns of drug use vary considerably by region. Recent data from the regional monitoring systems and local studies point to a possible stabilisation or even a decrease in cannabis use among adolescents in some parts of the country. Other specific regional characteristics include the significant burden of problems arising from the use of methamphetamine in the south-eastern Länder in Germany.
Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment centres, when considered alongside other indicators, can inform understanding on the nature and trends in high-risk drug use.
The population of high-risk opioid users in Germany is estimated by means of three multiplier methods using three data sources: police contacts (covering only heroin users), drug-induced deaths (the most recent estimates are based on 2015 data) and treatment admissions (the most recent estimate is based on 2014 data). These estimates range from 2.7 to 3.3 high-risk opioid users per 1 000 inhabitants aged 15-64 years. This corresponds to an absolute number of users ranging from 146 000 to 174 000. The estimate based on treatment admission increased slightly between 2013 and 2014, while the estimated values deriving from the police contacts have declined in the last decade. In contrast, the estimates from drug-induced deaths increased for the first time between 2014 and 2015.
At the same time, high-risk stimulant use has become more prevalent in Germany, mainly in regions that share a border with the Czech Republic. The latest estimate of high-risk use of amphetamines based on general population surveys data ranges from 51 000 to 255 000 users in 2015.
Data from specialised treatment centres indicate that the number of new treatment clients seeking help because of the use of stimulants other than cocaine (mainly methamphetamine) has increased recently and has surpassed new clients seeking treatment for opioid use. Injection is more popular among opioid users than among other high-risk drug users; however, a change in preferred administration routes in favour of smoking and snorting heroin has also been observed.
The 2015 ESA suggested that approximately 1 % of the population aged 18-64 years in Germany (around 612 000 people) showed indications of clinically relevant cannabis use in the 12-month period studied, according to the Severity of Dependence Scale. Moreover, cannabis users were found to constitute the largest proportion of clients of specialised treatment services, although this may be the result of the progressive development of special programmes for this target group.
National estimates of last year prevalence of high-risk opioid use
NBYear of data 2015, or latest available year.
Characteristics and trends of drug users entering specialised drug treatment centres in Germany
NBYear of data 2015. Data is for first-time entrants, except for gender which is for all treatment entrants.