New figures from the European Union Drugs Agency (EUDA) show that overdose remains the leading preventable cause of death among people who use drugs in Europe, with growing concern over the role of highly potent synthetic opioids and cocaine.

The scale of the problem

At least 7,600 overdose deaths occurred in the European Union in 2024. That figure rises to an estimated 8,300 when Norway and Türkiye are included. Four in five victims were men, most in their late thirties or early forties. Opioids, including heroin, medications used in agonist treatment and a range of synthetic opioids, were involved in two thirds of Europe’s drug-induced deaths, though the pattern varies by country.

Fentanyl and nitazenes driving new outbreaks

Deaths linked to fentanyl and its derivatives rose across Europe in 2024. The increase was driven largely by an outbreak in Bulgaria, where forensic services linked the drug to more than 100 deaths in 2024 and 2025. EUDA points to limited treatment and prevention infrastructure in the country, including the absence of take-home naloxone programmes, as a factor in the spread of these highly potent substances.

Nitazene opioids have caused significant loss of life in Estonia and Latvia. Deaths linked to nitazenes peaked in both countries in 2023, when drug-induced mortality rates reached six times the EU average in Estonia and five times the average in Latvia. Although the worst of the outbreak has passed, nitazenes were still linked to around half of all reported drug-induced deaths in both countries in 2024.

Cocaine increasingly present in fatal cases

Cocaine was detected in over a quarter of drug-induced deaths across the 20 countries that reported comparable data for both 2023 and 2024, with cases rising from 1,053 to 1,133 over that period. Spain, Cyprus, Luxembourg, Malta and Portugal recorded the highest rates. Polysubstance use remains common, with opioids frequently found alongside cocaine in fatal cases.

Risk factors and the case for prevention

EUDA’s analysis points to several factors that shape overdose risk, including the substance involved, how it is used, and interruptions to treatment, such as reduced tolerance after release from prison. Suicidal intent is reported more often in female drug-induced deaths than in male cases, a pattern EUDA says calls for gender-sensitive prevention work.

Preventing overdose deaths is a stated priority of the current EU Drugs Strategy and the EU action plan against drug trafficking. EUDA’s own priorities include expanding access to evidence-based treatment, including opioid agonist treatment, and tailoring prevention efforts to the groups most at risk. The figures underline the same message prevention organisations have long made: sustained investment in prevention and early intervention saves lives, and the human cost of delay is measured in thousands of deaths a year..

Source: dbrecoveryresources