EU Drug Market: Heroin and other opioids — Introduction

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Opioid use remains a major part of the drug problem in Europe and a major contributor to the associated harms. Heroin is the most frequently used illicit opioid, but other opioids such as methadone, buprenorphine, tramadol, fentanyl derivatives and benzimidazole opioids (nitazenes) are also available on the illicit market (for definitions, see Box Opiates, opioids and heroin). Due to data availability, this module of EU Drug Markets: In-depth analysis focuses on heroin. However, where information is available, analysis is also presented on other opioids commonly found on the illicit market in the EU.

The minimum estimated annual retail value of the heroin market is EUR 5.2 billion (with a likely range of EUR 4.1 billion to EUR 6.7 billion), based on data from 2021. Overall, it is estimated that there are about 1 million high-risk opioid users in the EU. Although the extent of illicit opioid use in many countries in Europe remains stable, it is responsible for a disproportionately large share of drug-related harms. These include high levels of dependence, other health problems and mortality. In 2021, opioid users represented 25 % of those entering specialised drug treatment in Europe, and opioids were found in three quarters (74 %) of drug-related deaths. Injecting drug use is commonly found among high-risk opioid users and is associated with an increased risk of acquiring blood-borne virus infections such as HIV and hepatitis. The wider social costs of illicit opioid use include the impact of open drug scenes on neighbourhoods, the costs associated with the acquisitive crimes that may be committed by people with opioid dependence, and expenditure on health and social support services and the criminal justice system. As in the case of other drugs, additional wider costs to society stem from the infiltration by criminal networks of certain sectors of the legitimate economy in order to facilitate heroin trafficking or to launder criminal proceeds.

The COVID-19 pandemic does not appear to have had a lasting impact on the European heroin market, which seems to be relatively stable. However, there is uncertainty due to the new political and security situation in Afghanistan, which is the main source of heroin consumed in Europe. At present, there are no signals of heroin shortages on the European market. However, information for 2023 shows that the area under poppy cultivation in Afghanistan has been substantially reduced. Experience with previous periods of reduced supply suggests that this can lead to changes in patterns of drug supply and use. These can include increased rates of polysubstance use among heroin users. Additional risks to existing users may be posed by heroin adulteration with substances other than paracetamol and caffeine, which are currently widely used, or the substitution of heroin with more harmful synthetic opioids, including potent fentanyl derivatives and nitazenes. A further possible outcome is the diversification of criminal markets and heroin sources for the EU.


Consult the list of references used in this module.