"The prevalence of high-risk opioid use among adults (15-64) is estimated at 0.4 % of the EU population, equivalent to 1.3 million high-risk opioid users in 2018. At national level, prevalence estimates of high-risk opioid use range from less than 1 to more than 8 users per 1 000 population aged 15-64 (Figure 27). The five most populous countries in the European Union (Germany, Spain, France, Italy, United Kingdom), account for three quarters (75 %) of this estimate.

"In 2018 use of opioids was reported as the main reason for entering specialised drug treatment by 143 000 clients, or 34 % of all those entering drug treatment in Europe. Of these, more than 27 000 were first-time entrants. Primary heroin users accounted for 77 % (almost 20 000 clients) of first-time primary opioid users entering treatment, a drop of 2 200 clients or 10 % compared with the previous year.

"According to the available trend data, the number of firsttime heroin clients has fallen by more than half from a peak observed in 2007. Between 2017 and 2018 the number of first-time treatment entrants for primary heroin use decreased in 18 countries out of the 29 with available data."