Drug use is one of the major causes of mortality among young people in Europe, both directly through overdose (drug-induced deaths) and indirectly through drug-related diseases, accidents, violence and suicide. Every year, over 6 000 drug users die of overdose in the EU, most of these deaths involving opioids and occurring among problem drug users. To gain a clearer picture of the overall number of lives lost due to drug use in Europe, a new EMCDDA Paper builds investigates ‘all-cause’ mortality among problem drug users via cohort studies linking data from death registries to drug treatment records. The study finds that the risk of death among problem drug users is typically 10 or more times that among their peers in the general population. The analysis shows that the deaths of problem drug users are overwhelmingly premature and preventable.