Everyone is used to seeing a patrol officer carrying a gun and a set of handcuffs, but now a prescription drug called naloxone is being added to help keep a person alive in the event of an overdose from synthetic opioids such as nitazines.

Prior to the introduction of the naloxone nasal spray, police officers were asked if they would be willing to administer a drug to an addict.

"Most of them had a positive attitude and were willing to undergo the training. In the first phase, there was a voluntary distribution of naloxone, and most colleagues were willing to take it and were able to use it," Rait Pikaro, the head of the Northern Prefecture's drug unit, said.

Ideally, naloxone should be part of every patrol's kit, but for now, it is being distributed in areas where people are more likely to overdose, he went on.

There is a real need for the drug because police are failing to curb the spread of nitazene, he explained.

"The number of drug-related deaths in Estonia has been increasing for five years. In the past, we achieved a very positive trend, reaching 27 drug-related deaths per year; last year, the number was again 117. Drug-related deaths have quadrupled, reflecting the fact that substances have become more potent. Synthetic opioids are on the market, which is easy to overdose on," Minister of Health Riina Sikkut (SDE) said.

Since 2013, naloxone syringes have been distributed in Estonia to people with substance use disorders and their families, as well as to people who work with them. Experience so far shows that the most frequent users of this life-saving drug are people with a synthetic opioid addiction themselves, but also their parents. 

"It helps, but of course, the amounts have to be right because when the fentanyl (an earlier version of a less potent synthetic opioid, - ed.) came in, we realized that we had to hike naloxone doses; that a single dose was not enough. With the latest synthetic opioids it's even worse than with the fentanyls; the doses of naloxone have to be much higher," Katri Abel-Ollo, the head of the center for addiction prevention of Estonia's National Institute for Health Development.

Just as persons with opioid addiction have to use several syringes of naloxone to reverse an overdose, the researcher said, one syringe is not enough for the nasal spray that police are about to administer.

Two or three doses of fentanyl are helpful, but we've heard that five or six doses of nitazenes are necessary. This information was also given to us by the Tallinn Ambulance Service when nitazenes first appeared.

Initially, naloxone will be a prescription medicine, but Sikkut says it should become a non-prescription medicine.

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