Drugs Worse Than Fentanyl Have Emerged in 150 Countries

Estonia beat fentanyl. Then something worse arrived.

Estonia nearly eradicated fentanyl from within its borders. But before anyone could cheer, synthetic drugs far more potent and deadly moved in to take its place. “We wish we still had a fentanyl problem,” said Raigo Aas, chief prosecutor for organized crime in Estonia, to the New York Times. For one thing, overdose reversal drugs work primarily for opioids like fentanyl or heroin, but generally not for new drugs called novel psychoactive substances, or NPS.

The small country developed a fentanyl problem around 2002 for much the same reason it is experiencing one with the new class of drugs, called nitazenes, now: There was a shortage of another drug in an active narcotics market. Fentanyl took over after heroin became scarce. Seeing the amount of overdose deaths skyrocket as a result of the highly potent synthetic opioid, Estonia’s government and law enforcement partnered to enact policy that pushed the drug out — reducing overdose deaths more than 70 percent by 2018. But while the government was slaying one monster, yet another was being baked in a lab — cooked and sold with such speed, there was no time to process the onslaught of new victims it left behind.

It’s not an issue contained to small countries in Northern Europe. Over the last decade, more than 1,460 new psychoactive substances have been identified in more than 150 countries and territories across the world, including the United States — a vast majority in the last decade, according to the United Nations. There are only 193 member states in the UN.

The first waking nightmares to arrive in Estonia are known as nitazenes. With varieties 40 times stronger than fentanyl, they are even more addictive and harder to treat or quit. This year, a new synthetic opioid called cychlorphine has begun killing even more people than nitazenes.. “It’s changing too quickly,” said Katri Abel-Ollo, a researcher at Estonia’s National Institute for Health Development. “Just as we are trying to investigate and collect data on one drug, suddenly there’s a new phenomenon.”

Despite the high risk of death, people still choose to use these drugs. After a friend’s death, one young man visited his friend’s mother and told her that she would never understand how wonderful the drugs made them feel. The drugs were the only thing that cleared his confusion and anxiety, he said. The satisfaction they offered was worth risking death.

“We can do our job perfectly, but sooner or later this problem is going to return,” said Ago Leis, head of Estonia’s organized crime bureau. “You can’t end this fight if you don’t go after addiction.”

Research suggests exercise, other lifestyle changes could prevent almost half of dementia cases

A study from researchers at Curtin University and published in The Lancet Healthy Longevity last week found that nearly half of all dementia cases could be prevented with consistency in certain behaviors, including maintaining an exercise regimen, not smoking, access to education, not drinking in excess, getting adequate sleep and building strong relationships with other people. Current public health strategies aren’t translating that awareness into actual behavior change. Study co-author and Curtin University Professor Mario Siervo told Newsweek that the findings show a disconnect between what people know and what they do. Up to 45% of dementia cases are linked to factors that can be changed such as our lifestyle, health status and environment. 

Another related Curtin-led study, published in Clinical Nutrition this March, shows that muscle strength and body composition are significant and previously underappreciated factors in dementia risk. Following nearly 500,000 adults over more than a decade, researchers found that people with sarcopenic obesity, which indicates both low muscle strength and excess body fat, face a higher risk of developing dementia. But obesity alone wasn’t linked to increased risk when muscle strength was preserved.

Laura Bojarskaite, a neuroscientist at the University of Oslo, added that in this case, “preventable dementia” comes with caveats. “Preventable is a population estimate, not a personal guarantee,” she said. “It means that if these risk factors were removed across an entire population, up to this share of cases might be avoided or delayed. It doesn’t mean an individual can guarantee they’ll never develop dementia by ticking boxes, and it shouldn’t become a new source of blame for people who do.”

For the Lancet study, researchers examined prevention campaigns across eight countries and found that large-scale awareness campaigns reach wide audiences but produce limited behavior shifts and small gains in knowledge. Interactive approaches were more effective, including online programs walking people through practical brain-health steps, personalized risk assessments and community-based programs led by trusted local figures like peer educators and health workers. Programs combining culturally-relevant content in familiar settings with realistic goal-setting, unsurprisingly, drove the most lasting change.