[2][3] 3-methylfentanyl was first discovered in 1974[4] and subsequently appeared on the street as an alternative to the clandestinely produced fentanyl analog α-methylfentanyl.

[6] The only country in the world with significant (200+ deaths a year, more than 10,000 addicts) abuse of this chemical is Estonia, where a dose of 3-MF costs 10 €, and other opiates are not generally available since the end of the 2000s.

[11] 3-methylfentanyl has similar effects to fentanyl, but is far more potent due to increased binding affinity to its target site.

Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.

The opiate antidote naloxone was on-hand to treat the victims of the crisis, but, whether due to their incarceration, lack of food, or water, or sleep, or due to the novel nature of the still-unconfirmed compound used, acute symptoms continued to develop, resulting in many fatalities despite the administration of naloxone.