Strategies The synthetic opioid crisis, once limited to North America, is now reaching Europe and Switzerland. The spread of fentanyl, nitazenes, and xylazine in the illicit drug market significantly increases the risk of fatal overdoses. These substances are highly potent, often undetectable, and partially resistant to standard treatments such as naloxone. To avoid a crisis similar to that in the United States, a coordinated response is essential: expanding access to naloxone, supporting drug checking services, strengthening supervised consumption sites, and adapting opioid-assisted treatments. Switzerland has a strong harm reduction legacy, but it now needs to update its strategies and ensure national coordination to address this emerging threat.