It could be pure coincidence, but the fact that the addiction care center in the western German city of Essen, population 600,000, is located on Hoffnungsstraße ("Hope Street" ) could also be a sign. It represents hope for the people struggling with addiction, who can find somewhere they can get a free meal and a place to sleep. Hope Street is also the place where they can snort, smoke or inject heroin in sterile drug consumption rooms, under supervision. "The scene is changing," said Caspar Stolz from the harm reduction team in Essen. "Even people who have been consuming intravenous heroin for 15 years are now smoking crack," he said. "The people deteriorate quicker because they can sometimes no longer escape the spiral of '15-minute kick, get money, buy crack.'" Medical staff providing syringes to drug consumers.Medical staff providing syringes to drug consumers. Sterile syringes are provided under medical supervision at the drug consumption room Image: Oliver Pieper/DW Since the drug consumption room opened in 2001, there hasn't been a single death there, Stolz reported with satisfaction. But the latest, even more dangerous drugs are already on the doorstep. In large German cities such as Frankfurt or Berlin, synthetic opioids like fentanyl or nitazenes, which are mixed with heroin, have long been on the streets. Even a small amount, the size of a grain of salt, can kill. Latest trend: Taking drugs live on TikTok Ruben Planert, an addiction care spokesperson in Essen, has observed a worrying new trend which began during the COVID-19 pandemic: an increasing number of young people consuming anxiety-reducing benzodiazepine and opioids live on social platforms like TikTok, as the dealers wait in the comments. "Recently we had a young man in our youth facility who spent five days in a coma after smoking fentanyl. He suffered an overdose with respiratory paralysis, which with pure heroin is possible but very unlikely," said Planert. What makes fentanyl even more dangerous: "The people consuming it often have no idea, because the heroin is laced with fentanyl; just enough that it does not lead to an overdose. Only experts and chemists can very precisely dose that, not any old street dealer." Essen, Hanover, Berlin: Model cities for prevention Essen, along with Hanover and Berlin, is one of three model cities conscientiously preparing for a further increase in fentanyl. The project is called "Synthetic Opioids — Prepare and Response," or "so–par" for short, and is set to serve as a blueprint for the whole country. Cities are preparing emergency plans, training emergency services and hospital staff and, above all, expanding drug tests to be able to more precisely detect opioids. Ruben Planert and Caspar Stolz from an addiction treatment center in Essen.Ruben Planert and Caspar Stolz from an addiction treatment center in Essen. Ruben Planert (left) and Caspar Stolz said the internet has made drugs significantly more accessibleImage: Oliver Pieper/DW "The goal of this 24-month project is for our municipality to get ahead of the situation," said Rebecca Lehmann from Essen's addiction services department. "Also to prevent our health system from being overwhelmed. It makes sense to develop an early warning system."