Cocaine in Europe: Why cross-sectoral collaboration between security, justice, health, and social care is needed
Scientists warn that cocaine use in Europe has increased over the last decade. They point out that improved security measures are needed to combat drug trafficking in Europe, but that health and social aspects are not being sufficiently taken into account. The reason for this expansion lies in the transformation of the international supply chain. The consequences are visible in both hospitals and society.
The authors addressed this topic in a viewpoint entitled “Cocaine use in Europe: the need for cross-sectoral collaboration between security, justice, health, and social systems”, which was published in early January 2026. The authors are Marie Lhosmot-Marquet, Clotilde Champeyrache, Hélène Donnadieu, Emilie Jouanjus, Yasser Khazaal, Perrine Roux, Bénédicte Varignon, Laurent Fleury, and Etienne Coyaud.
In 2023 alone, it is estimated that 25 million people worldwide used cocaine
In 2023 alone, it is estimated that 25 million people worldwide used cocaine. However, the numbers do not stop there. For example, coca cultivation in the Andean region increased from 120,000 hectares in 2013 to 346,000 hectares in 2023. In Europe, cocaine seizures reached 419 tons in 2023. At the same time, hospitalizations, treatment requests, and deaths related to cocaine use have increased. “Cocaine-related hospitalisations (half of which are associated with co-consumption of alcohol), treatment requests, and deaths linked to cocaine use have also increased in Europe. Cocaine was mentioned in 25% of acute drug-toxicity cases in the European Drug Emergencies Network Plus sentinel hospitals network in 2023, and implicated in 26% of drug-induced deaths across 20 European countries,” they wrote in the paper.
New distribution methods emerged during the COVID-19 pandemic
According to the authors, traditional dealing locations are still in use, but new distribution methods emerged during the COVID-19 pandemic, such as ordering via encrypted messaging apps for delivery. “The highest rates of cocaine use are found in Spain (13.3%), the UK (11%), and Denmark (9%), and remain below 1% in several Eastern European countries (e.g., Hungary and Romania). According to the European Union Drugs Agency (EUDA), during 2024, an average of 2.3% of young adults (age 15–34 years) used cocaine,” they noted. Effects also extend to society through crime, violence, and money laundering, while health and social aspects are often neglected.
The rise in cocaine use combined with alcohol is alarming, further increasing health risks. Even occasional use can cause serious health consequences, including death due to vascular spasticity, and the risk rises when combined with alcohol. As noted in the paper, when use becomes problematic, individuals typically wait an average of 13 years before seeking help. In 2023, 70,000 people were treated for cocaine use in Europe, half of whom were first-time entrants.
A comprehensive response is essential
As the authors explained, halting cocaine use in the near future is unrealistic; however, a comprehensive response is essential, including prevention, harm reduction, health care, law enforcement, the justice system, and social support. They propose four gradual actions aimed at combining security, health, and social efforts to reduce cocaine-related harm without increasing societal and financial burdens. The overarching goal is to break the harmful cycle of health and social problems faced by this group and to mitigate broader societal impacts.
As noted, the initial focus should be on changing public perceptions of people who use cocaine, as stigma prevents many from seeking care. Developing facilities that combine healthcare and housing is also essential, given that this population often experiences homelessness. Special attention should be given to women, who are underrepresented among cocaine users seeking help, with reserved appointments and women-specific services. As explained, there is currently a lack of approved pharmacological treatments for cocaine use disorder. So, safe consumption facilities (SCFs) play a key role as they reduce overdose deaths, injection-related risks, and enable drug quality control (drug checking). In 2023, there were 151 SCFs across 16 European countries. SCFs should be flexible, offering mobile units for hard-to-reach users and keeping residents informed. Finally, securing financial resources is crucial to support education and harm reduction measures, which requires strong political will and enhanced international cooperation.
They conclude that the development of the European cocaine market has revealed key constraints in the upstream sector. They warn that a coordinated strategy across the continent is urgently needed and that meaningful progress will require substantial reorganisation.
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