{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:00:18Z","timestamp":1792602018127,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>This paper addresses the question of whether Europe is facing an opioid epidemic and utilizes data from the European monitoring system on opioid use, harms and availability, to help assess the situation. Data sources covering the last decade on overdose deaths, drug treatment entrants and drug\u2010related emergencies suggest that the health burden associated with opioid use is mostly related to the consumption of heroin \u2013 and to a lesser extent diverted opioid substitution treatment medications \u2013 and that it is primarily affecting an ageing cohort of vulnerable users, with little evidence of an increase in initiation. While opioid\u2010related deaths are currently at much lower levels than in the United States, they still represent a large preventable health burden with differences across EU countries. There is also increasing concern related to the high availability of heroin, illicitly produced synthetic opioids and diverted opioid pain medications on the European drugs market. Trends in the latter categories are poorly monitored and we may miss signs of emerging problems. Moreover, the economic recession following the COVID\u201019 pandemic has a potential to lead to resurgence in opioid use and harms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This paper looks at data from the European monitoring system to address the question of whether Europe is facing an opioid epidemic. It reviews available health and supply side indicators, considering the limitations of each data source. A summary of the available evidence would suggest that while opioid\u2010related deaths in Europe represent a large preventable health burden with differences across EU countries, Europe as a whole is not facing an opioid crisis of the size and nature seen in the US.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1728","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T06:23:07Z","timestamp":1610691787000},"page":"1072-1080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Is Europe facing an opioid epidemic: What does European monitoring data tell us?"],"prefix":"10.1002","volume":"25","author":[{"given":"Thomas","family":"Seyler","sequence":"first","affiliation":[{"name":"European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Giraudon","sequence":"additional","affiliation":[{"name":"European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Noor","sequence":"additional","affiliation":[{"name":"European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Mounteney","sequence":"additional","affiliation":[{"name":"European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Griffiths","sequence":"additional","affiliation":[{"name":"European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Provisional drug overdose death counts","author":"Ahmad F.","year":"2020"},{"key":"e_1_2_9_3_1","volume-title":"Annual Surveillance Report of Drug\u2010Related Risks and Outcomes\u2014United States Surveillance Special Report","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"e_1_2_9_4_1","volume-title":"Internal statistics code of practice","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2015"},{"key":"e_1_2_9_5_1","volume-title":"Acryloylfentanyl: report on the risk assessment of N (1\u2010phenethylpiperidin 4 yl) N phenylacrylamide (acryloylfentanyl) in the framework of the Council Decision on new psychoactive substances","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2017"},{"key":"e_1_2_9_6_1","volume-title":"Carfentanil: Report on the risk assessment of methyl 1 (2 phenylethyl) 4 phenyl(propanoyl)aminopiperidine 4 carboxylate in the framework of the Council Decision on new psychoactive substances","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2018"},{"key":"e_1_2_9_7_1","volume-title":"Cyclopropylfentanyl: Report on the risk assessment of N phenyl N 1 (2 phenylethyl)piperidin 4 ylcyclopropanecarboxamide in the framework of the Council Decision on new psychoactive substances","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2018"},{"key":"e_1_2_9_8_1","volume-title":"Fentanils and synthetic cannabinoids: Driving greater complexity into the drug situation: An update from the EU early warning system","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2018"},{"key":"e_1_2_9_9_1","volume-title":"Drugs in syringes from six European cities: Results from the ESCAPE project 2017: May 2019","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2019"},{"key":"e_1_2_9_10_1","volume-title":"Drug\u2010related deaths and mortality in Europe\u202f:update from the EMCDDA expert network: July 2019. 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