In the battle against synthetic opioids, the spotlight is often on the United States, where fentanyl devastates communities, driving record-breaking overdose deaths and overwhelming police and public health teams. Yet, across the Atlantic Ocean, Estonia, a small but mighty nation known for its digital innovation and medieval cities, has fought —and decisively triumphed—over fentanyl. This is not a tale of luck, but of strategy, precision, and relentless action.

Estonia, a Northern European nation of just 1.3 million people, once had the highest per capita overdose death rate in the European Union. At the peak of the crisis, Estonia’s capital city, Tallinn, became known as the fentanyl capital of Europe. Overdoses occurred nearly every day. Narcan (naloxone) became a first responder necessity. A generation of people with substance use disorders were caught in a cycle of addiction with few options for recovery. The drug was pervasive—until, quite suddenly, it was not.

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