The recent wastewater study revealed several new psychoactive substances, including a very strong synthetic opioid called nitazene (benzimidazole-opioid). Katri-Abel-Ollo, head of the narcotics department at TAI, told ERR that the nitazene finding is cause for great concern.

"Nitazene is responsible for a spike in overdose deaths since 2022. We've been told by ambulance crews that it takes a lot of naloxone to bring back patients who have overdosed on the substance," Abel-Ollo said.

In the fall, nitazene was only found in Tallinn waste water.

But Steven Ilves, head of the organized and severe crime unit of the Southern Police Prefecture, said that the substance has reached Tartu by now – two people have died likely as a result of a nitazene overdose in the Southern Estonian city.

"Its main effect is hypoxia, followed by loss of consciousness, heart and other organ failure. It is the last three months' trend, we have not seen this substance in Tartu or the southern region before. Nitazenes fall somewhere between fentanyl and carfentanyl in terms of their severity, and we can say the substance is one hundred times more potent than heroin," Ilves said.

Abel-Ollo said that nitazenes usually come in the form of powder, while their use in counterfeit drugs is also becoming an issue.

"It could also come in the form of a pill, where you buy a new so-called designer benzodiazepine and it contains nitazene. People should be very careful with those," she remarked.

Steven Ilves said that the risk of overdose is further increased by the fact nitazenes are often taken with alcohol or GHB.

Staple drugs haven't gone anywhere either, with cannabis and cocaine still the most prevalent finds of the waste water study.

For example, the average cocaine residue in waste water per 1,000 residents grew by 40 percent in Tallinn in 2023 compared to 2022. The concentration of cocaine in waste water was up 2.6 times in Tartu.

Abel-Ollo said that the prevalence of cocaine comes down to availability and purity. "Forensic tests have found 90 percent pure cocaine, whereas prices have been going down. Data from the European Monitoring Center for Drugs and Drug Addiction also suggests that Europe has been flooded with very pure and affordable cocaine," Abel-Ollo said.

Cannabis use is tied to stress and mental problems people are struggling with and where help is difficult to come by.

"According to studies, 46 percent of respondents say they use cannabis to manage stress and depression, so it is definitely an aspect," Katri Abel-Ollo admitted.

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