Baltic States Grapple With Deadly Nitazene Opioid Surge

Estonia Sees Threefold Rise in Overdose Fatalities as Potent Drug Spreads Unchecked

A potent synthetic opioid, nitazene, is fueling a severe drug crisis across Estonia, Latvia, and Lithuania. This little-known substance, far less responsive to standard overdose treatments, is now linked to a significant portion of fatal overdoses in the region.

Nitazene’s Unchecked Spread

Nitazenes, which mimic fentanyl’s intense effects, are proving particularly dangerous due to their poor interaction with naloxone, the widely used emergency opioid reversal medication. The drug’s prevalence in the Baltic states is an anomaly, with experts struggling to pinpoint the exact reasons for its deep entrenchment.

“What’s peculiar with nitazenes is that they spread mainly in the Baltic states – Estonia, Latvia, Lithuania. This is an anomaly that is hard to explain – no one can give a good reason why it’s so.”

—Raigo Aas, Estonian State Prosecutor

Estonia Faces Peak of Crisis

Estonia has been the hardest-hit, reporting 332 drug overdose deaths between 2021 and 2024, predominantly among men. Prosecutor **Raigo Aas** estimates nitazenes are responsible for about half of these fatalities. The drug’s lethality is extreme, with even minute dose variations proving fatal. A single dose typically costs €20 to €30, making it accessible.

Trafficking Routes and Origins

The drug primarily enters Estonia from Latvia, often arriving as a fine powder. Once in Estonia, it is mixed with other substances by dealers before being sold on the streets. Authorities indicate that the raw material for nitazenes largely originates from China or India.

Regional Opioid Epicenter

While much of Europe remains focused on heroin or prescription opioid misuse, the Baltic region has emerged as a rare European hub for nitazene abuse. Speculation among experts points to established trafficking networks, cost advantages, or early experimental supply chains as potential drivers for this concentrated market.

The United States continues to battle the opioid crisis, with synthetic opioids like fentanyl driving an alarming number of overdose deaths. In 2022, over 107,000 drug overdose deaths occurred in the U.S., with synthetic opioids accounting for the majority (DEA 2023 Report).