Estonia stems fentanyl crisis but has few answers for US

Tallinn (AFP) - Sitting in the back of a mobile clinic, in front of racks of anti-overdose treatments and clean needles, Jaan Vaart recalls when fentanyl first appeared in Estonia in 2001.

"I overdosed four times in a month. A lot of people died," Vaart tells AFP. "That was June or July, I remember."

The yellowish powder is 50 times stronger than heroin, meaning just a few grains can be enough to kill.

"You go unconscious, you stop breathing, you're going blue," Vaart says. "People are using and then pass away, boom."

Against the odds, Vaart survived.

The opioid that is behind the deadly overdose crisis in the United States has also taken a heavy toll in tiny Estonia.

Of the more than 1,600 overdose deaths in Estonia since 2001, the vast majority were caused by fentanyl, according to the European Monitoring Centre for Drugs and Drug Addiction.

The highly addictive drug took a particular hold during a shortage of heroin in the country.

The Baltic nation of just 1.3 million people had until recently the highest proportion of fatal overdoses in the European Union.

But official statistics show that opioid-related deaths plunged to 39 in 2018, the lowest in 15 years and less than a quarter of the peak of 170 in 2012.

It is one of the world's rare good-news stories in the desperate fight against fentanyl.

The success has begun attracting attention, especially in the US, where the government said fentanyl and other synthetic opioids killed 32,000 people in 2018.

However, experts warn that Estonia's small size may make replicating its turnaround elsewhere impossible.

- Life-saving antidote -

Having survived six years of close calls as an addict, Vaart began rehab in 2004 after the realisation that his luck was running out.

"It was prison, death or homelessness. Then I decided to make a change," he recalls.

But overcoming dependency was only the first step.

"I was 26 when I stopped and it was, 'What next? Go back to mother? My classmates were businessmen, doctors, and where am I? I'm nothing.'"