A wave of synthetic opioids more potent than anything previously seen is sweeping across Europe, leaving hundreds dead and prompting urgent warnings from health authorities and law enforcement alike.
At the heart of the crisis is a class of drugs known as nitazenes—laboratory-synthesised compounds that were first developed in the 1950s as potential painkillers but never released for medical use. Now, decades later, they are fuelling a new public health emergency as criminal networks manufacture and distribute them under the radar, often disguising them as heroin or counterfeit prescription pills.
With potencies reportedly up to 250 times greater than heroin, nitazenes pose an extreme overdose risk, even in minute quantities. Their rise across the UK, Estonia, and Latvia in particular has led to a dramatic surge in drug-related deaths, overwhelming morgues, emergency rooms and addiction services already stretched thin.
“Far deadlier than fentanyl”
Though fentanyl remains a byword for the opioid epidemic in North America, experts now warn that nitazenes may represent an even greater threat on the European continent.
Dr Paul Ingram, a toxicologist at St Thomas’ Hospital in London, described the trend as “nothing short of terrifying.”
“These compounds are pharmacologically unstable, incredibly strong, and often consumed unknowingly,” he said, “We’ve had patients who thought they were taking oxycodone or Valium but were in fact ingesting nitazenes—sometimes with fatal consequences. The dose required to kill can be as small as a grain of salt.”
Unlike heroin, nitazenes are fully synthetic and can be made without access to poppies or other plant-based materials, making them attractive to illicit chemists operating in clandestine labs across Eastern Europe and Asia. Their production is cheap, their smuggling footprint minimal, and their effects devastating.
Deaths spike in Eastern Europe
In Estonia and Latvia, where heroin supplies have become less consistent due to enhanced border enforcement, nitazenes have rapidly filled the void. According to figures released last month by the Latvian Centre for Disease Prevention and Control, the country recorded a 300 per cent increase in opioid-related deaths in the past year alone. Of those, nearly half were traced to nitazene analogues such as isotonitazene and metonitazene.
A similar pattern has emerged in Estonia, where morgue officials in Tallinn have resorted to using refrigerated trucks to store bodies during peak periods.
“The scale is unlike anything we’ve seen before,” said Inspector Jaak Lillemäe of Estonia’s Narcotics Division. “Young people are dying after taking just one pill. Often, the packaging is identical to legitimate pharmaceuticals. You’d have no way of knowing unless you tested it.”
Britain’s silent killer
In the UK, the alarm has been sounded repeatedly by drug treatment charities and coroners who have identified nitazenes in a growing number of overdose victims. While official figures are still being collated, the National Programme on Substance Abuse Deaths (NPSAD) at King’s College London estimates that at least 140 deaths in the past 18 months are directly linked to nitazenes.
Particularly troubling is the emergence of these opioids in counterfeit benzodiazepine pills—such as fake Xanax—sold on social media and through encrypted messaging platforms. Many users, often young and inexperienced, are unaware they are ingesting powerful synthetic opioids until it is too late.
“The typical heroin user knows what they’re getting into,” said Fraser McLeod, a frontline worker at a Glasgow harm reduction centre. “But when a 17-year-old takes a pill at a party thinking it’s a downer and ends up dead, it’s a different story altogether. This isn’t a moral panic—it’s a lethal game of Russian roulette.”
Law enforcement struggles to keep pace
The clandestine nature of nitazene production and the continual modification of their molecular structure has rendered many of them “legal by omission,” as existing laws struggle to keep up with the pace of chemical innovation. Dealers and chemists often tweak the compound slightly to evade regulation, creating new analogues faster than they can be banned.
Europol, in coordination with Interpol and national police forces, has launched Operation Krait to identify and dismantle the trafficking networks behind the surge. Initial raids have uncovered sophisticated laboratory setups in Lithuania and the Czech Republic, with precursor chemicals traced back to China and India.
But as one official noted anonymously, “We’re always one step behind. By the time we ban one compound, two new ones are already on the market.”
An urgent call for reform
Experts and campaigners are calling for pan-European regulatory reform to address the crisis. They argue for broader “generic” bans that would prohibit entire families of chemical compounds rather than individual molecules.
Others point to the need for public education, improved drug checking services, and expanded access to naloxone—the overdose-reversal drug now increasingly being carried by police and paramedics across Europe.
As funerals multiply and hospital admissions rise, Europe may be on the cusp of a synthetic opioid epidemic of unprecedented scale. The question is whether policymakers act before the death toll climbs further.
