This report presents the latest findings on drug-related hospital emergencies from a network of sentinel hospitals across Europe. Almost 24 000 emergency presentations were recorded at 32 sentinel hospitals over the first 4 years of the project. The data reveal that the substances most commonly involved in acute drug toxicity presentations include heroin, cocaine and cannabis. Prescription medicines are frequently reported. The report also sheds light on other aspects of drug-related emergencies such as clinical features, geographical variation, outcomes, demographics and time patterns.