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 remained 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 those aged 18-25 years.
The most recent ESA results indicate a slight rise in cannabis use among young adults. DAS data for the same time frame (2012 to 2015) also indicate a slight rise in cannabis use among adolescents and young people, although prevalence declined slightly between 2014 and 2015.
In 2015, amphetamine was for the first time reported to be the most common 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 (aged 18-25 years) indicated use of these substances in the past.
A number of German cities 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 municipal level, based on the levels of illicit drugs and their metabolites found in wastewater. In 2017, the study reported an increase in cocaine levels in wastewater in all the cities for which data for several years were available. Cocaine and MDMA/ecstasy concentrations were higher at weekends. Methamphetamine metabolites were found in the wastewater of cities in eastern Germany. In contrast, cocaine use was concentrated in Dortmund and Frankfurt.
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 an understanding of the nature of and trends in high-risk drug use.
The population of high-risk opioid users in Germany was estimated by means of two multiplier methods using two data sources in 2016: drug-induced deaths and treatment admissions. These estimates ranged from 1.1 to 3 high-risk opioid users per 1 000 inhabitants aged 15-64 years (138 000-164 000), which indicates a rather stable estimated population of opioid users in Germany. However, the data on drug-related deaths indicate that the cohorts of German heroin users may be ageing.
At the same time, high-risk stimulant use has become more common in Germany. The latest estimate of high-risk use of amphetamines and/or cocaine based on general population survey data was 1.91 per 1 000 inhabitants aged 15-64 years in 2015.
Data from specialised treatment centres indicate that the number of new treatment clients seeking help as a result of use of amphetamines has increased recently and is higher than the number of new clients seeking treatment for opioid use. Overall, the data suggest that injection is more popular among opioid users than among other high-risk drug users; however, heroin is increasingly being smoked or snorted. In addition, local data suggest that injecting is becoming less prevalent.
The 2015 ESA suggested that approximately 1.2 % of the population aged 18-64 years in Germany (around 612 000 people) reported 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 new treatment clients of specialised treatment services, although this may be the result of the progressive development of special programmes for this target group.