Overdose deaths in Europe: EUDA highlights growing concerns over highly potent opioids and cocaine

What do the latest data tell us about overdose deaths in Europe? An updated version of the EUDA's 'Frequently asked questions (FAQ): drug-induced deaths in Europe', published today, provides the most recent overview on the issue and responses underway across the region.

Drawing on the latest data from the 27 EU Member States, Norway and Türkiye, the FAQs highlight the continuing human toll of overdose, in particular pointing to growing concerns linked to highly potent synthetic opioids and cocaine.

Over 8 000 overdose deaths across Europe

Across the EU, overdose remains the main preventable cause of death among people who use drugs. It is estimated that at least 7 600 overdose deaths occurred in the European Union in 2024. This figure rises to an estimated 8 300 deaths, if Norway and Türkiye are included. Four in five victims were men, most in their late thirties or early forties. Opioids were involved in two-thirds of Europe's drug-induced deaths, although national patterns vary. Drugs linked to these cases included heroin, opioids prescribed in agonist treatment (e.g. methadone) and a variety of synthetic opioids.

Fentanyl drives outbreak of drug-related deaths in Bulgaria

Deaths involving fentanyl and its derivatives increased in Europe in 2024, underscoring the need for vigilance. The increase was largely driven by the outbreak of fentanyl-related deaths in Bulgaria, where forensic services reported the drug to be linked to over 100 cases in 2024-2025. In the context of limited treatment and harm reduction service provision in the country, including the absence of take-home naloxone programmes, the diffusion of highly potent synthetic opioids on the market in Bulgaria is particularly concerning.

Nitazenes linked to overdose deaths in some countries

The FAQs draw particular attention to nitazene opioids, which have been linked to poisoning outbreaks and significant loss of life across Europe, particularly in Estonia and Lavia. In these two countries, the outbreaks of nitazene-related deaths peaked in 2023, with the drug-induced mortality rate six times higher than the EU average in Estonia and five times higher in Latvia. While nitazene deaths in the two countries have passed their peak, in 2024 nitazenes were still linked to around half of the reported drug-induced deaths in Estonia and Latvia.

Cocaine frequently reported in overdose deaths

Cocaine was present in over a quarter (27%) of drug-induced deaths, in the 20 countries that provided data for both 2023 and 2024, with numbers rising from 1 053 in 2023 to 1 133 in 2024. The countries where cocaine was most frequently identified were Spain, Cyprus, Luxembourg, Malta and Portugal. Polysubstance use remains common, with opioids frequently detected alongside cocaine in fatal cases.

Wider risks and responses

The FAQs highlight how overdose deaths are shaped by multiple factors - from the type of drug and how it is used, to interruptions in treatment or reduced tolerance (e.g. after release from prison). Suicidal intent is reported more often in female drug-induced deaths compared to males, underlining the need for gender-sensitive prevention. On the response side, the FAQs review how overdose prevention services are currently implemented in Europe, both in communities and in prisons. They also highlight recent guidelines for first-aid in relation to opioid overdose and naloxone, and recommendations for the assessment and management of opioid toxicity in the hospital emergency departments.

Protecting public health and preventing overdose deaths are priorities under the latest EU Drugs Strategy and EU action plan against drug trafficking. This commitment is central to the work of the EUDA. Key measures include expanding the provision of evidence-based treatment, including the provision of opioid agonist treatment at scale; improving the availability of naloxone; and tailoring interventions for high-risk groups.

The FAQs include country-level data, maps, graphics and downloadable datasets, providing policymakers, practitioners and the public with an accessible overview of current trends and responses to drug-related deaths in Europe.

Further reading

Further information on these topics can be found in the drug-induced deaths chapter of the European Drug Report 2026. See also the EUDA threat assessment report examining how highly potent synthetic opioids could affect Europe over the next two years and what this could mean for public health and security preparedness.

An EUDA webinar held on 31 August focused on 'Preventing opioid-related deaths in Europe - continuity of care, peer naloxone and rapid overdose alerts'.

A recording is available here