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Everyone knows someone who has died. In the circles of Estonian friends who use 'china white', death is a constant possibility. In Estonia, the drug - whose proper name is fentanyl - is taking a heavy toll of young people. Nationally, drug overdoses now kill more people than road accidents. Marko believes his only hope is to leave Estonia for good. Fentanyl , external is a synthetic form of heroin, produced in clandestine laboratories across the border in Russia. It has almost completely replaced heroin on the Estonian market, and is much more deadly. Marko desperately wants to break his addiction. He started injecting seven years ago, aged I tried it with my friends when I was drunk and began to like it, and soon I was doing it every day,' he says. He has managed to cut down, and is currently shooting up three or four times a month. But he needs a daily dose of methadone to cope with the withdrawal symptoms. And the mental dependence is much harder to deal with. But when I came back, within the first hour, I felt the temptation again - it's in my head somewhere and I can't get it out. But there's no such thing as one more time. Back among his drug-taking peers, he dreams of escape. That's the only solution. Fentanyl first appeared in Estonia about 10 years ago, during a heroin shortage. At an addiction treatment centre in the capital, Tallinn, another addict, Ragnar, explains why it has got such a grip. It can be hundreds of times more potent than heroin and, once sampled, there is no going back. I found it meaningless,' Ragnar says. Every time I overdosed I am dead. But the emergency services came and saved my life. According to the most recent data , external , Estonia's overdose mortality rate is the highest in the European Union - seven times the average. At the Estonian Forensic Science Institute, it becomes clear why fentanyl can be so deadly. In a small dish is less than half a teaspoon of the caramel-coloured powder. It's actually 37 doses of fentanyl,' says police Major Risto Kasemae. In fact, the strength of a batch can vary significantly. And when dealers cut the drug with other substances to reduce its strength, mistakes can have fatal consequences. Besides the rising body count, fentanyl has many other social costs. It is linked to theft and petty crime, family breakdown, and Estonia's extremely high rates of HIV and hepatitis. She runs a needle exchange in Tallinn, where users can get clean equipment to cut down the risk of passing on infectious diseases. Now it's fentanyl, two generations ago it was alcohol,' she says. Experts in Tallinn cannot explain why fentanyl is largely restricted to Estonia. Katri Abel-Ollo, an analyst for the Estonian Drug Monitoring Centre, says the Estonian government still has 'no specific strategy' for dealing with the overdose issue. She advocates training drug users in how to recognise and respond to an overdose. And allowing them to keep the overdose antidote, naloxone, at home. The big question - that none of the experts in Tallinn can really answer - is why fentanyl has taken such a hold in Estonia, but not elsewhere. And whether it is only a matter of time before it does. But why, 10 years on, the vast majority of Estonia's users are still from its ethnic Russian community, is harder to explain. Most of the theories are anecdotal. Despite attempts to smuggle fentanyl to Finland and Latvia, and unrelated outbreaks in Slovakia and the Czech Republic, it remains, for now, mainly an Estonian problem. But there is a warning from Katri Abel-Ollo, who has closely observed fentanyl's rise. She says the rest of Europe cannot afford to be unprepared. Estonian Drug Monitoring Centre. Estonian Forensic Science Institute. By Sam Wilson. They know that. But that does not mean they can stop. Feeling trapped. Survival 'miracle'. He has good reason to want to break his habit. Family dependence. Europe 'should prepare'. Related internet links.