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Plenary Session at the 5th European Harm Reduction Conference Speakers: -Introduction, John Peter Kools, Trimbos Institute 0:10 -Background of the global opioid situation, Lisa Strada, Trimbos Institute, recorded 3:14 -Current epidemiological situation in Europe, Andre Noor, EMCDDA 14:09 -Key lessons to be learned from the opioid epidemic in North America, recorded interview with Mrs Jennifer Carroll 35:45 -Experiences and lessons learned from the synthetic opioid crisis in Estonia, Mart Kalvet, community member 47:04 -Tools and strategies for SO preparedness in Europe: a case study of 5 countries, Inari Viskari, THL 57:30 Illustration of the SO Toolbox: Naloxone (TAI) 1:10:58 Panel discussion 1:18:22 Lessons and boarder implications for current/future drug trends on policies and services André Noor, Mart Kalvert, Tuukka Tammi Abstract: The session provided an interactive setting where experts discussed recent developments in synthetic opioids (SO) in Europe and the recommended tools and strategies that make countries better prepared and equipped to deal with emerging threats from synthetic opioids. While North America has been experiencing an opioid epidemic for nearly a decade, highly potent SO are also a steady concern in Europe. Some European countries report an increasing availability and use of SO and related incidents. We will present some of the latest findings of the research that has been conducted in the EU funded SO-PREP project. The session also discusses the implications of other current changing drug markets in Europe. The session includes a panel discussion on the lessons that can be learned: how European countries can be better prepared for other current and future drug market developments?