The same fundamental drivers but differently expressed: what can we learn from comparing the recent experiences with synthetic opioids in the US and Europe?

Pardo et al.’s analysis makes a powerful argument for why synthetic opioids have become a major health problem in the United States that also represents a threat to other regions [1]. They highlight the market advantages that highly potent synthetic opioids deliver to suppliers with respect to profits and risk mitigation and argue persuasively for the need for innovative responses. Reflecting from a European perspective, we would endorse the central tenets of this argument, but also point out that there are more general lessons to be learnt from comparing how these same drivers have also impacted on European countries, drawing upon our experience of implementing some of the innovative measures they call for.