Is recreational use of fentanyl becoming a growing problem in Poland?

Dear Editor,
In this letter we would like to highlight the potential problem of fentanyl use as a recreational drug in Poland. Fentanyl is an opioid commonly used as an analgesic and in the management of chronic pain; it is 100 times more potent than morphine. Its danger as recreational-use opioid is related to its rapid action and relatively small dose, which is often unpredictable and can even lead to fatal outcomes. Overdose symptoms include respiratory depression, delirium, coma, skeletal muscle flaccidity, cold and clammy skin, miosis, pulmonary edema, bradycardia, hypotension, cyanosis and discoloured lips. Sources of recreationally consumed fentanyl, apart from prescription medications, include illegal distribution of the drug, often adulterated with other substances, thereby increasing its toxic potential.
Fentanyl abuse has been a significant issue in the United States and Canada, leading to continuously increasing overdose fatalities since 2013 [1]. Additionally, there was a notable rise in fentanyl-related deaths during the early COVID-19 pandemic [2]. While Poland had remained relatively resistant to the global opioid crisis, recent data indicate a growing number of fentanyl-overdose fatalities [3]. In 2023, there were 28 reported deaths from psychoactive substance use in Poland [4], and as of 2024, the Polish Chief Sanitary Inspectorate has recorded 48 cases of fentanyl poisoning according to a Polish press article [5].
The rising popularity of fentanyl in Poland may be linked to its illicitly produced availability and the increasing use of online prescription services, where patients can obtain prescriptions for fentanyl without in-person consultations, indications, physical examinations or identity verification. Fentanyl poisoning from transdermal patches has already been documented in Poland [6] and the growth of online prescription services might increase their frequency due to the lack of proper opioid-use discussion.
The published data is concerning and underscores the need for monitoring opioid abuse, including fentanyl, in Poland and implementing strategies to combat this issue. It is crucial to raise awareness among healthcare professionals, particularly in smaller communities, about the growing problem of opioid abuse, its symptoms and treatment methods. Furthermore, patients with certain indications should not use pharmaceutical fentanyl without medical supervision.

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