The report highlights the rapid emergence and high-risk profile of these substances, including their potential to cause severe harm at very low doses and to appear in misrepresented products, exposing both established high-risk opioid users and wider populations.  It identifies key uncertainties shaping future developments and presents two plausible scenarios, supported by a set of priority actions to strengthen early detection, coordination and response capacity.

Designed as a forward-looking preparedness tool rather than a predictive model, the assessment supports policymakers and practitioners in anticipating risks, reducing delays in response and enhancing Europe’s readiness to respond to emerging opioid threats.