European Drug Emergency Network Plus (Euro-DEN Plus)

The EMCDDA collects data on a number of key indicators related to drug and new psychoactive substance (NPS) use across Europe, which contribute to our understanding of the impact of the use of drugs in Europe. The data collated in these key indicators comes from a number of different sources, including the EMCDDA Early Warning System of national REITOX focal points and Europol. Systematic data is collected on the prevalence of drug used, border and local level seizure analysis, drug-related deaths and utilisation of drug treatment services for drug related dependency. However, national systems for capturing data on acute and chronic health conditions are largely based on international coding systems such as ICD-9, ICD-10, DSM-IV and DSM-V; these coding systems are not able to capture information on the acute harms related to the use of recreational drugs and NPS, and therefore there is limited robust data captured and available on the acute harms of these substances at a national or European level. This represents a significant public health gap in the understanding of the implications of recreational drug and NPS use and prescription medicine misuse in Europe. The European Drug Emergencies Network (Euro-DEN) was established in 2013 connecting sixteen sentinel centres and emergency departments in ten European countries to collect data on presentations with acute toxicity related to the use of recreational drugs, prescription medicines and new psychoactive substances (NPS) to try and address some of these issues. Initially it was a European Commission DG Justice DPIP funded project, and has continued since October 2014 as the expanded Euro-DEN Plus network. By the end of 2018 the network had 32 sentinel centres in 22 European and neighbouring countries. The Euro-DEN Plus Project has collected data on 23,947 presentations to the sentinel centres to the end of 2018.

The Euro-DEN Plus dataset provides a rich and unique insight into the acute harms associated with the use of recreational drugs/NPS and misuse of prescription medicines in Europe. Since 2015 the annual European Drug Report produced by the EMCDDA has included information on the acute harms from the use of recreational drugs and NPS provided by the Euro-DEN Plus network. This has highlighted the importance of the acute harm data that the network can provide. The network has contributed to a range of EMCDDA outputs including the Trendspotter reports on cocaine, MDMA and NPS use in high risk drug users, and Perspective on Drugs reports on synthetic cannabinoids, benzodiazepines and cocaine. Additionally, the network has published 10 papers in peer-reviewed scientific and medical journals. There are a number of active projects analysing data within the Euro-DEN Plus dataset; particular areas of interest related to trends in use and acute harms that been identified include: i) the increasing misuse of prescription and over the counter medicines and significant proportion of Euro-DEN presentations related to these drugs and ii) the increasing availability, use and healthcare utilisation related to the use of synthetic cannabinoids.