Report on good practices of synthetic opioid preparedness, and needs and challenges in EU Member States

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Executive summary Highly potent synthetic opioids like fentanyl and its derivatives are a growing concern in Europe. Since 2009, 57 new synthetic opioids have been detected on Europe’s drug market — including eight reported for the first time in 2019.

In 2019 only two of these opioids were fentanyl derivatives. This is the first time that more novel non-fentanyl synthetic opioids than fentanyl-derivatives were identified (EMCDDA, 2020a). New synthetic opioids pose a high risk of overdose to consumers, because they are often much more potent than ‘traditional’ opioids like heroin. In the United States, the opioid epidemic has been called the “most consequential preventable public health problem.”

Drug overdoses are the leading cause of death among Americans under the age of fiftyfive, and synthetic opioids (mainly fentanyl and its analogues) are responsible for most of these deaths. Also in Canada the numbers of synthetic opioid-related deaths are very high. There is a growing concern that similar developments might occur in Europe. Fentanyl-related deaths have been increasing in some European countries in recent years (EMCDDA, 2019a).

With Europe being a mosaic of different countries, cultures, and health systems, European countries can try to learn from each other’s experiences.

The project SO-PREP aims to strengthen European countries’ preparedness and response to the threat and potential harm from potent synthetic opioids. The aim of this report is to explore existing strategies and good practices of preparedness for dealing with a potential synthetic opioid crisis in Europe, and to identify needs and challenges and propose recommendations to strengthen EU Members States’ synthetic opioid preparedness. The first part of the report provides a brief overview of the synthetic opioid situation in the US and in Europe, followed by a description of various tools for monitoring synthetic opioids on the European level. This is based on review of available literature, research reports, and publications of the EMCDDA. The second part of the report is based on a survey among the EMCDDA Reitox network of national focal points, which was carried out in 2020 as part of the SO-PREP project.

The survey aimed at mapping existing strategies of synthetic opioid preparedness in different EU countries. The main finding from the survey is that most EU countries do not seem to have concrete plans for preparing for or responding to possible increases in synthetic opioids and related harms. However it should be noted that the responses were somewhat limited and not necessarily comprehensive. The third part of the report presents examples of good practices on synthetic opioids preparedness as well as conclusions drawn from this report. With the rapidly changing drug markets and ever-growing number of new synthetic opioids, countries need to be vigilant and would benefit from developing multi-faceted and multi-disciplinary preparedness plans.

The review of the literature shows that plenty of effective tools are available to enhance national SO preparedness.

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