Estonia won its war on fentanyl, then things got worse

TALLINN, Estonia (AP) — Igor Smirnov was introduced to opiates the day his first son was born, when he got celebratory drunk and a neighbor injected him with an intoxicating extract of opium poppies.

“I’ve never tried anything better in my life,” he said. “It’s natural, it’s a clean high.”

Smirnov graduated to heroin during a stint in prison for robbery in the mid-‘90s, as the Estonian economy was reeling from the 1991 collapse of the Soviet Union and drug abuse rates shot up. After the Taliban banned poppy production in Afghanistan, decimating the 2001 harvest, a new drug appeared to take the place of heroin on the quaint, cobbled streets of Estonia’s capital, Tallinn: Fentanyl. People called it “China White.”

Smirnov didn’t like the drug at first, but soon learned to live with it.

“Fentanyl costs too much,” he said. “If you use fentanyl, the dealers are simply collecting money because the high lasts a short time.”

Smirnov has lived the arc of illicit drug abuse in Estonia, a tiny Baltic state that for nearly two decades has battled a fentanyl epidemic so severe its overdose death rate was almost six times the European average.

Once fentanyl landed in Estonia, heroin disappeared. Even after poppies started growing again in Afghanistan and Estonian police choked off fentanyl supply in 2017, heroin didn’t come back. Instead, users turned to cocktails of other kinds of synthetic drugs, including amphetamines, alpha-PVP, a dangerous stimulant also known as flakka, and prescription drugs, harm reduction workers, users, public health officials and police told The Associated Press.

There are signs that the U.S. is on a similar path, tipping from plant-based drugs like heroin to synthetic ones like fentanyl and methamphetamine. That could...