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The nitazene epidemic in Estonia: a first report
Katri Abel-Ollo1, Mailis Tõnisson2,3, Peep Rausberg4
1Drugs and Addictions Department, National Institute for Health Development, Tallinn, Estonia.
European Journal of Public Health
|September 24, 2025
Summary
Estonia has seen a surge in nitazene synthetic opioid use since 2022, doubling drug deaths. This public health crisis requires more data on nitazene effects and consequences.
Area of Science:
- Public Health
- Epidemiology
- Toxicology
Background:
- Estonia faces a growing public health challenge due to novel synthetic opioids known as nitazenes.
- Since 2022, nitazene emergence has significantly impacted the nation's drug landscape.
Purpose of the Study:
- To document the timeline and scope of the nitazene epidemic in Estonia.
- To examine the prevalence, health consequences, and user experiences associated with nitazene use.
Main Methods:
- A multifaceted approach combining administrative statistics, surveillance data, and government documentation (2015-2024).
- Focus on health consequences (2019-2024), supplemented by qualitative interviews with nitazene users.
- Analysis of syringe residue and drug seizure data to confirm prevalence.
Main Results:
- Drug-related deaths in Estonia more than doubled since 2022, exceeding 100 cases in 2023.
- Nitazene prevalence increased significantly from 2022, confirmed by residue and seizure data.
- Users report nitazenes as stronger and shorter-acting than fentanyl, with harm reduction services seeing increased demand.
Conclusions:
- The nitazene epidemic in Estonia presents a critical public health threat.
- There is an urgent need for evidence-based information on nitazene use and consequences to inform effective interventions.
- Enhanced harm reduction strategies and user education are crucial to address this emerging crisis.
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