Germany Country Drug Report 2018

Drug harms

Drug-related infectious diseases

In Germany, data on drug-related infectious diseases are available from the registers at the Robert Koch Institut and they are complemented by data from other, usually regional, sources.

The number of new human immunodeficiency virus (HIV) infections attributable to injecting drug use had shown a downward trend between 2000 and 2009, followed by stabilisation between 2010 and 2012. Since that time an increase has been reported. In general, around 5 % of new HIV cases are linked to injecting drug use in Germany.

Reliable information on the mode of transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) was available for only a minority of cases in the most recent data sets; nevertheless, the data suggest that injecting drug use remains a significant risk factor for HBV infection and this group accounts for a third of the notified cases in 2016. Around 8 out of 10 HCV cases with a known mode of transmission were linked to injecting drug use.

Prevalence of HIV and HCV antibodies among people who inject drugs in Germany (%)
region HCV HIV
Year of data: HCV: 2011/ HIV: 2014
National : :
Sub-national 36.9 - 73.0 0.0 -9.1

A study covering 2011-14 indicated large geographical variations in rates of HIV, HCV and HBV infection among PWID, which is attributed to different use patterns, age structures and local conditions.

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Drug-related emergencies

Information on drug-related emergencies in Germany originates from the hospital records of inpatients treated for intoxication and poisoning and from the Poison Information and Control Centres. The available data for 2015 indicate that almost 23 800 hospitalisations were linked to illicit drugs, an increase compared with 20 000 cases reported in 2014. In 2015, about half of the patients sought help because of intoxication with multiple psychoactive substances, followed by cannabinoids (including synthetic cannabinoids), stimulants other than cocaine, sedatives and opioids at a much lower level. The long-term trend indicates an increase in polydrug use-related intoxications as well as an increase in cannabinoid- and stimulant-related intoxications (excluding cocaine).

In 2015, five out of eight Poison Information and Control Centres reported around 3 300 enquiries related to the suspected consumption of illicit drugs and most of these were linked to stimulants.

A treatment centre from Munich participates in the European Drug Emergencies Network (Euro-DEN Plus) project, which was established in 2013 to monitor acute drug toxicity in sentinel centres across Europe.

Drug-induced deaths and mortality

Drug-induced deaths are deaths that can be directly attributed to the use of illicit drugs (i.e. poisonings and overdoses).

In Germany, there are two general, comprehensive systems for recording drug-related deaths. These are the police data from the ‘Drugs data file’ and the ‘Statistical report on the causes of death’ from the German Federal Statistical Office.

Both sources indicate a slight increase in the number of drug-induced deaths compared with the previous year. Data from the Police Register of the Federal Office of Criminal Investigation indicate a steady increase in the number of drug-induced deaths from 2013 to 2016. Opioids, alone or in combination with other substances, remained the most common cause of drug-induced deaths, followed by cocaine or crack and amphetamines. Data from the General Mortality Register, available up to 2015, also indicate an increase in drug-induced deaths for 2012-15, with levels now equalling those of 2008-09.

The Statistical Report on Substance Abuse Treatment in Germany indicated that around 2.3 % of clients receiving outpatient addiction counselling as a result of opioid use died in 2016.

The drug-induced mortality rate among adults (aged 15-64 years) was 23.6 deaths per million in Germany in 2016, compared with the most recent European average of 21.8 deaths per million.

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