Between 2018 and 2021, 30 to 40 people died from overdoses each year in Estonia. But in the past couple of years, that number has jumped to around 100 annually. Just a month ago, Katri Abel Ollo, a researcher at the National Institute for Health Development, remained cautiously hopeful that this year's total might stay below 100 — but the situation has since changed.

As of the end of August, 57 people have died of drug overdoses in Estonia.

"New nitazenes are emerging, and alongside them we're also finding other highly potent opioids in used syringes — specifically cyclo-clorfine and spiroclorfine. These are synthetic opioids that are three to four times stronger than fentanyl," said Ollo.

These new substances have a shorter duration of effect. Where one dose used to last around seven hours, users now need to inject every few hours. What's more, naloxone — the overdose-reversal drug distributed to drug users and their families — is no longer effective in all cases.

"One of the major concerns prompting us to issue national-level warnings is that, according to forensic analysis, we're frequently seeing veterinary drugs mixed in, like xylazine and methadonine — sedatives and muscle relaxants used in animals. Naloxone works on synthetic opioids, but it doesn't counteract non-opioid additives. As a result, people often remain unconscious even after administration," Ollo explained.

Police say the presence of nitazenes is declining, but there's been a rise in alpha-PVP — commonly known as "zombie drug." Overdoses are often caused by the combined use of multiple substances, with nitazenes and alpha-PVP being two of the main contributors. A new variant of nitazene discovered this week prompted police to issue a public safety alert.

"Fentanyl originally appeared as a heroin substitute in the early 2000s, when heroin became scarce. A similar pattern played out a few years ago when an even stronger substance emerged. Nobody knew how to dose it properly and people relied on trial and error. There were no instructions," said Artur Kamnerov, head of the narcotics and organized crime division at the North Prefecture.

While fentanyl can be 10 to 100 times stronger than heroin, nitazenes can be several or even dozens of times stronger than fentanyl.

According to the researcher, the European drug market is currently shifting. As of July 1, China banned nitazenes and their precursors — a move that may help explain why some of the nitazenes previously widespread in Estonia have all but disappeared.

"Unfortunately, when one drug fades out, another takes its place. And we can only hope the next one isn't worse — but so far, they've only gotten worse," said Ollo.

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