NPS have been a prevalent topic of concern in Estonia since 2002, when there were first reports of fentanyl appearing on the Estonian drug market. Ever since, synthetic opioids have had a large impact on Estonian drug users, causing numerous overdoses and deaths over the years.

This report provides a general overview of drug use (including NPS) in Estonia, as well as of the risks and consequences related to NPS use. It also reviews responses to the consumption of NPS and the needs of NPS users (regarding services that should be developed) in the area of harm reduction and treatment for NPS users. Finally, the document provides recommendations for decision makers and specialists in the field on how to improve responses to emerging NPS challenges.