In the last decade, Estonia has witnessed one of the biggest problems with opioid use in Europe and the highest overdose death mortality rate. Estonia is one of the few countries in the world where the drug market has been dominated by illicitly produced fentanyl – a synthetical opioid more potent than heroin. At the beginning of the 2000s, country was hit by several waves of deaths related to fentanyl overdoses. Upon examining the history of the availability and use of fentanyl, it can be claimed, that the substance appeared unexpectedly on the Estonian drug market in 2002 due to a temporary shortage of heroin caused by the war in Afghanistan. Experts thought that the situation is temporary, and that the fentanyl will disappear, and overdose deaths decrease once the heroin supply is restored. However, after a few years it was clear that fentanyl came to stay.
Estonian overdose crisis was caused by highly potent synthetic opioids and country’s unpreparedness to address the new threat, also by failure to provide timely care and safety net for people who use drugs. Presentation will explore the emergence of the problem and lessons learned and introduce European Commission co-funded project SO-PREP aimed to strengthen health systems’ preparedness to respond to the potential increases in prevalence and use of synthetic opioids.
Aljona Kurbatova, Head of the Center for Drug and Infectious Disease Prevention, National Institute for Health Development, Estonia
As the head of the Center for Drug and Infectious Disease Prevention, she is responsible for development, coordination and financing of health and social services in the field of drug use, HIV and tuberculosis prevention, as well as implementation of national and international cooperation projects. Her work includes designing services for people who use drugs and / or are living with HIV. A sociologist by education, Aljona started working in the field of public health in 1998, conducting research among young people who use drugs. She has participated in elaboration of different public health strategies including the most recent National drug policy 2030 that was adopted in June 2021.