Appendix 2: Case Study: Fentanils: A Serious Threat to Public Health in Europe

The fentanils are a family of highly potent opioid analgesic drugs. A small number are widely used as medicines in anaesthesia, for pain relief and for the immobilisation of large animals. Due to their psychoactive effects, such as causing euphoria, they are also sold on the illicit drug market as replacements for heroin and other opioids. Exposure to small amounts of fentanils can rapidly cause life-threatening respiratory depression. Left untreated, this can be fatal. Timely administration of the antidote naloxone can reverse such poisoning. While playing a small role in the overall drug market in Europe, there has been a large increase in the availability of fentanils in the past few years. This has been driven by globalization, which has allowed bulk production in China and online sales. There has also been a substantial increase in the number of reported fatalities linked to their use. In this case study we discuss these developments and the risks posed by these highly potent substances and highlight the role of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)'s early warning and risk assessment activities in supporting national and European Union preparedness and responses to this serious public health threat.