The opioid epidemic has been going on for years in the United States and Canada. The misuse of prescription pain relievers, heroin, and synthetic opioids is a serious national crisis that affects public health and social and economic welfare. More than 70 000 Americans died from a drug overdose in 2017, and synthetic opioids, mainly fentanyl and its analogues, were responsible for the majority of these deaths. In Canada, the number of drug-related deaths is similarly high. Synthetic opioids are also becoming a significant public health threat in Europe, and there is a growing concern that similar development might occur in Europe. The use of synthetic opioids and the number of drug-related deaths have been increasing in many European countries. In 2015, fentanyl and its analogues became the deadliest drug in Sweden. In addition to Sweden, the most recent data shows an increase in synthetic opioid (SO) prevalence and incidents in a number of countries across Europe.

This report aims to provide an overview of generic national health emergency responses to public health threats and identify mechanisms that may be applicable to enhance national SO preparedness. The underlying question is: what can we learn from the range of approaches and models of preparedness from other fields, and the measures that have been developed to reduce the effects of pandemics and other public health threats? How could these methods be adopted and tailored to prevent or address a possible SO crisis in European countries? The report is based on a review of available literature research reports, and various publications related to preparedness, as well as discussions with staff from the project SHARP (Joint Action Strengthened International HeAlth Regulations and Preparedness in the EU).