Italy Country Drug Report 2017

Drug use

Prevalence and trends

In Italy, cannabis remains the illicit drug most commonly used by the general population, followed by cocaine. The use of most illicit drugs is concentrated among young adults aged 15-34 years; however, the highest prevalence of last-year cocaine use is reported by those aged 25-34 years.

The most recent study from 2014 indicated a possible increase in the prevalence of cannabis and synthetic stimulant use in Italy, whereas cocaine use seemed to be declining, in particular among those younger than 25 years.

Milan participates in the Europe-wide annual wastewater campaign 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 different illicit drugs and their metabolites in sources of wastewater. Concerning stimulants, the results show a sharp increase between 2015 and 2016 in cocaine metabolites detected in wastewater, while MDMA/ecstasy levels remained low and relatively stable over the period 2011-16. The levels of amphetamine and methamphetamine detected remained low during the whole study period, indicating limited use of these substances in Milan.


Estimates of last-year drug use among young adults (15-34 years) in Italy


NB Estimated last-year prevalence of drug use in 2014.


Substance use among 15- to 16- year-old school students in Italy

NB Source: ESPAD study 2015.

Drug use among 15- to 16 year-old students is reported in the European School Survey Project on Alcohol and Other Drugs (ESPAD).

In 2015, Italian students reported prevalence rates of lifetime use of cannabis above the ESPAD average (35 countries), whereas lifetime use of illicit drugs other than cannabis and of NPS was almost identical to the overall average.

High-risk drug use and trends

Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on the 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/

In Italy, high-risk drug use remains linked mainly to heroin use. The latest estimate based on a treatment multiplier suggests that there were approximately 205 200 high-risk heroin users in Italy in 2015.

Based on the 2014 general population survey, it is estimated that 0.9 % of 15- to 64-year-olds use cannabis daily or almost daily.

In Italy, high-risk drug use remains linked mainly to heroin use


Data from the specialised treatment centres in Italy indicate that in 2015 heroin was the most commonly reported primary substance for first-time clients entering treatment and that the decline in the numbers of new clients entering treatment because of heroin use that was observed in the last decade has now stopped. In general, injecting remains common among opioid users entering treatment, in particular among those who have been treated previously. Cocaine is the second most commonly used substance among first-time treatment clients, followed by cannabis.

The available data suggest an increase in cocaine-related new treatment demands in recent years.

In addition, an increasing proportion of clients enter treatment because of polydrug use. Approximately one in seven clients entering treatment is female, but the proportion of females in treatment varies by primary drug and by the treatment programme. The long-term trend indicates a steady increase in the age of heroin users seeking treatment, and the average age of new treatment clients in Italy is the highest in Europe. However, because of substantial changes in the national reporting system in the last years, the long-term trends for data from specialised treatment centres should be interpreted with a caution.

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 services in Italy


NBYear of data 2015. Data is for first-time entrants, except for gender which is for all treatment entrants.

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