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Opioids: Fentanyl and Co. have arrived in Germany

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Opioids: Fentanyl and Co. have arrived in Germany

Thursday, February 15, 2024, 10:11 a.m

Federal model project RaFT of the German Aids Aid organization detects synthetic opioids as dangerous admixtures in heroin. Federal states and municipalities must now take precautions and strengthen drug support.

In Germany too, heroin is already being mixed with life-threatening synthetic opioids. In the German Aids Aid (DAH) federal model project RaFT, 3.6 percent of 1,401 heroin samples tested positive for the admixture last year. The federal model project, funded by the Federal Ministry of Health, is publishing key results today.

Rapid tests for fentanyl were offered in 17 drug consumption rooms nationwide for over six months. RaFT (“Rapid Fentanyl Tests in Drug Consumption Rooms”) was intended to determine how widely the dangerous mixture is already widespread in Germany in order to be able to react accordingly.

The concern is urgent: Illegally produced synthetic opioids as additives in other substances are on the rise because they are cheap and easy to produce. Fentanyl, Nitazene and other such substances have a much stronger effect than heroin. While 200 milligrams of heroin are lethal, fentanyl is just 2 milligrams. If consumers do not know about the additive, their lives are in danger.

Dangerous global trend

Last year there were 54 drug emergencies in Dublin due to nitazene, and in Birmingham last summer 30 people died from using heroin containing synthetic opioids.

In North America, substances from chemical laboratories have almost completely replaced heroin. There, consumers generally know what they are consuming.

The risks remain either way: Due to their extremely strong effects, synthetic opioids can hardly be dosed safely. Interpol also recently warned about the new substances.

Fentanyl in Germany

In Germany, 83 people were proven to have died under the influence of synthetic opioids in 2022 (previous year: 102). The real number is probably higher because toxicological reports are usually not prepared for drug-related deaths.


The data from the RaFT project now provides an initial indication of the spread of fentanyl as an admixture in Germany. In December, as has just been reported, carfentanyl was found during a police check in Munich, which has a much stronger effect.

RaFT documented cases primarily in Hamburg as well as in Düsseldorf and Münster, but there were also a few positive tests in Berlin, Frankfurt, Hanover and Wuppertal. However, these do not allow any statement to be made about the amount of the substance in the samples examined. The smallest amount of contamination is enough for the test to work.

Winfried Holz from the board of the German Aids Aid says:

“Synthetic opioids have arrived in Germany. Extreme vigilance is now required. International experience shows that many people could lose their lives this way. The federal states and municipalities must now ensure that drug support facilities and users are prepared!”

Implement measures against drug-related deaths

The following well-tested measures are shown:

The prescription and easy-to-use emergency medication naloxone also reverses the effects of synthetic opioids. It must be disseminated among potential first responders (emergency services, drug support workers, police, users themselves). The federal model project NALtrain has laid the foundations; the states must now ensure implementation. Naloxone is already standard equipment in drug consumption rooms. In emergencies, the life-saving nasal spray can be administered immediately. This is also why more drug consumption rooms are needed – especially in the missing federal states such as Bavaria, which have so far refused the necessary legal regulations – and longer opening times. People who use heroin must be informed about the risk and possible precautions. For example, you can initially only consume a small amount of your substance (dose splitting) to test its effectiveness and thus avoid overdoses. Rapid tests for fentanyl admixtures must be part of the standard offering in drug consumption rooms and other drug help facilities. After on-site advice, the tests could also be taken home in the future. The legal situation already allows these tests. We also need drug-checking services for people who use drugs in nightlife. The federal states must create the legal requirements for this. Only Berlin and Thuringia have already taken decisive steps here.

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The drug consumption rooms involved now continue to offer the tests upon request.

“The federal model project speaks in favor of expanding the range of rapid tests and implementing them across the board: Last but not least, testing offers for admixtures open up the opportunity for drug helpers to offer advice on the topic so that users can make a decision based on facts. Risks can be reduced in this way,” says RaFT project manager Maria Kuban.

Kuban continues: “With the experience from the project, a well-tested and successful approach is now available: the tests are highly accepted, deliver reliable results and protect the health and lives of consumers.”

Apply proven testing procedures across the board

In the federal model project, 70 percent of users accepted the offer to have their substances tested. Tiny amounts of the substance are sufficient for rapid tests; they can be detected by swabbing the packaging material. Consumers do not have to give up any of the substance. You receive the result before consumption, so you can avoid risks immediately.

“RaFT has provided important insights into how we can better protect the lives and health of people who use drugs. The situation for this marginalized group is becoming increasingly worse, also due to an increased incidence of crack cocaine. Drug policy must urgently create the conditions for adapted offers of help,” says DAH board member Winfried Holz.

Additional Information:

Results of the federal model project RaFT

More information about RaFT

Information about drug consumption rooms

Information about naloxone

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