Health
Cannabis and Cocaine Top Drug Use in the EU, but Other Substances Pose Rising Risks
Cannabis and cocaine remain the most commonly used drugs across the European Union, but other substances are emerging as significant public health threats, according to a joint report by the European Commission and the Organisation for Economic Co-operation and Development (OECD).
Nearly one in three Europeans have tried illegal drugs at some point in their lives. Regular drug use is linked to heightened risks of cardiovascular disease, mental health problems, accidents, and infectious diseases like HIV, particularly with injectable substances.
Cannabis and Cocaine Usage
Cannabis use is especially prevalent among young adults, with 15% reporting consumption in the past year. Among all age groups, the highest rates of cannabis use were found in the Czech Republic, Italy, France, and Spain. In contrast, Malta, Turkey, and Hungary reported the lowest rates.
Cocaine use is less common but remains significant, with 2.5% of young adults reporting use in the past year. The Netherlands, Spain, and Ireland report the highest rates of cocaine use, while Turkey, Portugal, Poland, and Hungary show the lowest prevalence.
Law Enforcement Impact
Strict drug penalties appear to have limited influence on drug availability for younger populations. “The major penalties impact only the people who use the substance once or fewer times in a year, so not the real [heavy] users,” explained Sabrina Molinaro, an epidemiologist and research director at Italy’s National Research Council.
Drug habits among youth often predict adult trends, Molinaro noted. Historically, boys were more likely than girls to use cannabis, but that gap has narrowed in recent years, with girls surpassing boys in some countries.
Growing Risks from Other Drugs
While cannabis and cocaine dominate drug use in the EU, substances like MDMA (ecstasy), heroin, opioids, psychedelics, and synthetic drugs are emerging as critical threats. Synthetic drugs, including lab-made cannabinoids and stimulants, pose unique challenges because they are difficult to identify and regulate quickly.
“They are so dangerous [because] you don’t know what you are taking,” said Molinaro, emphasizing the risks posed by low-quality manufacturing and potential contamination.
The EU dismantled hundreds of synthetic drug labs in 2022, and its early warning system identified seven new synthetic opioid substances in 2023, noted for their potency and health risks.
Public Health Concerns
Synthetic drugs, in particular, are a growing issue among adult populations, according to Molinaro. With the rise in new substances and increasing drug availability, experts are calling for more robust measures to address these evolving challenges.
The report underscores the need for comprehensive approaches to tackle drug use and its health implications across the EU, including better monitoring, education, and targeted interventions.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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