Tallinn (AFP)
Sitting in the back of a van transformed into a mobile clinic, in front of a shelf loaded with overdose treatment products and sterile needles, Jaan Väärt recalls the arrival of fentanyl in Estonia in 2001.
"I overdosed four times in one month. Many died," said AFP, in his forties with piercing blue eyes, his face surrounded by a beard with four winds. "It was June or July, I remember."
The yellowish powder is 50 times stronger than heroin. A few grains are enough to kill.
"You lose consciousness, you stop breathing, you turn blue," says Jaan Väärt.
He survived, a chance. But since 2001, according to the European Monitoring Center for Drugs and Drug Addiction, overdoses have caused more than 1,600 deaths in Estonia, mostly due to fentanyl and other synthetic opioids.
The small Baltic country of 1.3 million inhabitants thus takes first place in the EU, in per capita rate, several times higher than the European average.
Last year the death toll fell to 39, the lowest number in 15 years, four times less than the peak of 170 deaths in 2012. This is one of the few good news in the history of the fighting the deadly opioid.
The success caught the attention of other fentanyl-ravaged countries, including the United States, where the drug killed 32,000 people last year.
- Healthy antidote -
After six years of high-risk drug addiction, Jaan Väärt got out of it in 2004, thanks to a rehabilitation program.
"It was either prison, death, or a life of the homeless. It was then that I decided to turn around."
But rejecting the drug was only the first step. "I was 26 years old when I stopped. I asked myself: what should I do now? Go back to my mom? My comrades had become businessmen or doctors, and me? I am nothing."
Today, he plays a key role in the fight against fentanyl, by coordinating a network of rehabilitation centers and needle exchange, funded by the Ministry of Health.
The mobile clinic is parked in a dilapidated housing estate in the Mustamäe district of Tallinn, where Väärt and his colleagues regularly meet drug addicts, offering them clean needles, advice ... or simply listening to them.
Crucially, the team also distributes naloxone, a drug in the form of a nasal spray that can save life in the event of an overdose with fentanyl.
A take-out naloxone distribution program was launched in 2013. One year after the peak of 170 deaths in 2012, when the death toll became intolerable and prompted the government to tackle the problem, however identified. as a national priority from 2005.
- Network dismantling -
Since then, 2,000 people, drug users, family members, police officers, have received training to administer the treatment, said Katri Abel-Ollo, an expert in fentanyl at the Estonian Institute for Development, to AFP. of health.
The greatest successes came in 2017, when the police closed a large laboratory, a year after pinning a network of traffickers who brought drugs from behind the Russian border.
"The main intermediaries and those who introduced fentanyl to the Estonian market have been arrested and brought to justice," said Rait Pikaro, head of the organized crime division at the regional prefecture in northeast Estonia.
"Since then, we have seen a significant change in the market, and overdose deaths are four to five times less than before."
According to Ms. Abel-Ollo, fentanyl has not completely disappeared from the Estonian market, since new derivatives from China continue to appear and internet sales are increasing. But international traffic to Estonia has significantly weakened.
The reputation of the Estonian recipe having crossed borders, foreign experts are flocking, looking for answers to their own opioid problems.
"The American and Canadian delegations came here and tried to learn from us, but Estonia is so small," smiles Katri Abel-Ollo. "It is quite difficult to teach them how to tackle this problem."
According to the prosecutor Vahur Verte, the small size of Estonia and the efficiency of its databases in the exchange of information on criminals have been decisive.
- "Law of nature" -
"Everyone knows each other. It is easy for different authorities to meet around a table and speak frankly," he told AFP.
In addition, in Estonia, fentanyl has spread among users of illegal drugs, while the opioid crisis in the United States comes from dependence on fentanyl pain relievers prescribed by doctors.
Estonia has managed to bring down the number of deaths from fentanyl at a time when economic growth has brought unemployment down to 5%, down from 20% in 2010, the year when the financial crisis drove its inhabitants to despair.
But the social problems, poverty and unemployment that fueled the scourge of drugs persist and affect the Russian-speaking minority in particular.
"It is a law of nature that wants something to replace fentanyl," said Abel-Ollo. "So far, these have been prescription drugs and cathinones," cheap and psychotropic amphetamines that are said to be bad for the mental health of addicts. "But at least they are not as deadly as fentanyl."
In her mobile clinic, Jaan Väärt believes that the key to helping people quit drugs is confusingly simple.
"Sometimes the memory of where I was, my experience, helps to look beyond the addiction, to see that there is a little boy or girl who just needs security."
© 2020 AFP