Italy Country Drug Report 2018

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 preliminary data from the most recent study, in 2017, indicate an increase in the prevalence of cannabis and a stabilisation in synthetic stimulant use in Italy, whereas cocaine use seems to be declining,

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 municipal level, based on the levels of illicit drugs and their metabolites found in wastewater. Concerning stimulants, the results show a considerable increase between 2015 and 2017 in cocaine metabolites detected in wastewater. The levels of MDMA/ecstasy and methamphetamine detected have remained low since 2012, indicating limited use of these substances in Milan. No amphetamine was found in wastewater in Milan in 2017. Use of all stimulants detected in wastewater in Milan was higher during weekends than during weekdays.




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 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.

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.

Data from the specialised treatment centres indicate that in 2016 powder cocaine was the most commonly reported primary substance among first-time clients entering treatment, followed by heroin and cannabis. The number of cocaine-using first-time entrants has been increasing since 2013 in Italy. Injecting remains common among opioid users entering treatment, in particular among those who have been treated previously. It is estimated that 4 out of 10 heroin users in Italy inject the substance.

Approximately 1 in 10 clients entering treatment is female, but the proportion varies by primary drug. The long-term trend indicates a steady increase in the age of heroin users seeking treatment. 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 caution.





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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.