Fentanyl & Nitazenes and emerging risks in the Dutch Drug Market

Synthetic opioids like fentanyl and nitazenes are increasingly linked to overdose incidents in Europe, including the Netherlands. While originally developed for medical use, these ultra-potent substances—up to 200 times stronger than heroin—have found their way into the illegal drug market, often without the user’s knowledge.

In March 2025, the first death from an overdose of illegally obtained oxycodone pills containing nitazenes was reported in Amsterdam.  This has raised concerns about the growing presence of these substances in counterfeit medications and heroin.

Lethal

Fentanyl and nitazenes act on opioid receptors, offering pain relief but also suppressing breathing—a key cause of fatal overdoses. We emphasize that fentanyl can never be used cautiously, as a microgram alone can be lethal, making the substances incredibly dangerous.

While overdose rates in the Netherlands remain relatively low, people who use drugs in marginalized settings—such as homeless people—face elevated risks. This group often seeks stronger substances for little money and has little access to drug testing, which increases the risk of purchasing a counterfeit substance substituted with nitazenes.

call 112

Mainline provides educational materials and flyers to alarm people about the risks. Additionally, we inform people how to recognize an overdose. Naloxone, the opioid overdose antidote, is not legally accessible to the general public in the Netherlands. So, calling an ambulance (call 112) as soon as possible is the only option.

Would you like to read more about fentanyl and nitazenes? Read more on our page or read the leaflet on it from the GGD Amsterdam (in Dutch).

(Written by: Sophia Selinger)