A growing share of overdose deaths is associated with (prescribed and illicit) fentanyl, its analogues or other synthetic opioids – in Canada from 5% in 2012 to nearly 80% in 2017. Between 2009 and 2016, 25 new opioids were detected in 10 EU countries; nine of those were reported first in 2016. Among these were 18 fentalogues and eight were reported for the first time in 2016.
The present response to acute opioid overdose, if existent, is designed around the availability of the antidote naloxone. The burden of effectiveness for the actual response relies largely on professional first responders, and is characterized by 20th century communication infrastructures and tools, which do not facilitate rapid and accurately coordinated responses to overdoses. The enormous potential for volunteer action associated with the high level of awareness and concern over the opioid crisis among the public is not utilized.