Drug and Alcohol Abuse and Addiction in Germany

Much has been made of Germany’s level of opioid addiction which is much lower than the catastrophic levels of the United States. Additionally, Germany’s rate of opioid addiction has not changed much in the last few decades. While this is good news, not all the news coming from Germany is as positive.

In contrast, when it comes to stimulants like cocaine and methamphetamine, Germans have an increasing appetite. As either a cause or effect of this problem, the quantity of these drugs entering the country has been climbing.

Opioids

In 2019, a detailed study looked at the level of opioid addiction in Germany.¹ This report noted that heroin and opioid use had fallen in the last few years. It seemed that young people were more attracted to stimulants than opioids. Older clients had either gotten into treatment or had perhaps died from overdoses.

Aside from this gentle decline, the rate of opioid use has hardly changed over the last couple of decades. This report estimated that roughly 165,000 people were addicted to opioids, with three times as many men being addicted as women.

The report calculated that 95,000 patients were receiving substitution treatment. In most cases, the drug used was methadone, with about 23% of patients receiving buprenorphine.² About 1% of those in treatment were receiving pharmaceutical heroin, referred to as diacetylmorphine. This substitution drug is usually only used when a person has failed at every other type of opioid treatment.

Opioids were the most likely drugs to cause fatal drug overdoses, followed by amphetamine and cocaine.²

Statistics on people entering treatment for opioid addiction reveal a heartbreaking situation. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), more than 28,000 people entered treatment for opioid addiction but only one in 10 were there for the first time. That means that nine out of 10 people starting treatment had already failed at sobriety after rehab at least once.

Cannabis

Like many other EU countries, cannabis is the top drug sending people to rehab programs. According to the EMCDDA, more than 40,000 people enter treatment for cannabis addiction each year, with a little less than half of them entering for the first time.²

About 13% of young adults (aged 18 to 34 years) have used cannabis in the past year, but in the age group 19 to 24, it’s nearly one in five.

A 2019 report noted that cannabis use seemed to be increasing, possibly due to greater social acceptance.³

Cocaine

In 2019, German authorities seized nearly €1 billion worth of cocaine in the port city of Hamburg.⁴ The shipment had originated in Uruguay and was traveling to Antwerp via Hamburg.

While port cities Rotterdam and Antwerp have historically been used as major trafficking points for international criminal organizations, there are some signs that Hamburg is receiving more of this traffic at this time.^5-6 For example, in 2017, German police seized 3.8 tons of cocaine concealed in three separate shipments, two of coal and one of animal feed.

The EMCDDA reports that cocaine is the top drug seized in the country, followed by herbal cannabis and amphetamine.²

Cocaine trafficking is normally carried out via social media networks in Germany as well as many other EU countries. The purity of cocaine is normally very high which could indicate that German cities are very close to the points of cocaine’s arrival in the EU.⁶

Other Stimulants

Popular stimulants include amphetamine and methamphetamine. The EMCDDA reports that high-risk stimulant use has become more popular in recent years, estimating that 2 out of every 1000 people is using stimulants at this level, including cocaine as well as amphetamine.²

As fewer people use heroin, more are using stimulants and therefore are seeking rehabilitation for their addictions. In a recent year, more people entered rehab for stimulants for the first time than sought help for heroin addiction.

LSD

In 2018, police in southwest Germany reported a seizure of 646 kilos of drugs, including nearly 50,000 tabs of LSD. This is the country’s largest haul of this drug. Also seized were hashish, ecstasy and amphetamines.⁷

Alcohol

It might not be surprising that a country renowned for Octoberfest has problems with alcohol. According to the World Health Organization’s Global status report on alcohol and health, nearly 10% of men and 4% of women have alcohol use disorders, meaning that they are drinking at levels that cause harm.⁸ About half as many are dependent (addicted) on alcohol.

Still, consumption levels have declined slightly over the last few decades after peaking in 1975. Men drink 24 litres of pure alcohol each year, which is about three times as much as women do. Alcohol consumption accounts for nearly half of road traffic injuries for men and about one-third of the accidents for women.

What Can Wastewater Testing Tell Us?

For several years, wastewater in European countries has provided insight into the substances used in various cities, and an index of the volume of drugs being used. No one really assumes that face to face, phone or mail surveys on drug use are completely accurate. Many people are reluctant to be accurate about their drug or alcohol use.

Wastewater analyses that look for drug residues and compare it to the population served by that wastewater system provide independent corroboration of other types of data collection.

A report on this testing is published and updated regularly by the EMCDDA.⁹

Locations tested in Germany in 2019 include:

• Dortmund
• Dulmen
• Munich
• Dresden
• A rural area near Bad Wunnenburg

The calculations resulting from wastewater testing is reported as milligrams of drug used per 1000 population in the area, per day. For one city, residues equalling 375 milligrams of cocaine per 1000 people were reported. A weekend-only user might use 250 mg over a weekend.¹⁰ An addicted person whose tolerance is higher might use one or two grams a day.

Here are some of the results of this testing.

Cocaine

Significant levels of cocaine use were found in Dortmund (375 mg per 1000 people) and less in Munich, Dulmen and Bad Wunnerburg. Very low levels were found in Dresden. Not surprisingly, the levels in Dortmund and Munich increased on the weekends.

Amphetamine

High levels of amphetamine use were found in Dortmund (189 mg per 1000 people) and Dulmen (170 mg) and low levels in other cities.

Methamphetamine

Very low levels were found in all cities except Dresden (170 mg). This city is very close to the border of Czechia which is reported to be the methamphetamine production capital of Europe.¹¹

MDMA (Ecstasy)

Very low levels of ecstasy residues were found in all cities. Compare that result to Amsterdam, just 250 km from Dortmund, where the measurement of ecstasy residues comes to 287 mg per 1000 people, the highest in Europe.

Berlin’s wastewater was tested in 2018 and showed high results for amphetamine and ecstasy. In fact, both amphetamine and ecstasy results have increased steadily since 2014.

Reducing opioid addiction rates is a positive move but if other individuals simply begin using more stimulants, there is no improvement to society as a whole. What is needed above all is both prevention and rehabilitation that work. That is the only way that the condition of society can be improved.

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