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Since fall 2013, fentanyl has contributed to more than 5,000 overdose deaths in the US.
Since fall 2013, fentanyl has contributed to more than 5,000 overdose deaths in the US. Photograph: Spencer Platt/Getty Images
Since fall 2013, fentanyl has contributed to more than 5,000 overdose deaths in the US. Photograph: Spencer Platt/Getty Images

Synthetic opioid crisis in US serves as warning for the world, says UN

This article is more than 6 years old

Fentanyl, which is 50-100 times more potent than morphine, was recently tied to the deaths of 60 people in the UK – and a growing number of deaths in Australia

Efforts to combat the opioid addiction crisis in the US have been weakened by the synthetic opioid fentanyl, which a top UN drug official has warned could infiltrate Europe and Australia in a similar way.

“Other countries with opiate problems should be concerned because fentanyl could quickly be pushed into their supply,” Jeremy Douglas, regional representative of the UN office on Drugs and Crime (UNODC) to Southeast Asia and the Pacific, told the Guardian.

Fentanyl, which is 50 to 100 times more potent than morphine, was recently tied to the deaths of 60 people in the UK and there have been a growing number of deaths from the drug in Australia, Douglas said.

Fentanyl presents a lucrative business opportunity for drug traffickers because it is incredibly powerful in small amounts and is easy to produce. Since fall 2013, fentanyl has contributed to more than 5,000 overdose deaths in the US – including the musician Prince, whose death in 2016 was caused by “self-administered fentanyl”. From 2009 to 2014, it contributed to at least 655 deaths in Canada.

Fentanyl drove a 73% increase in synthetic opioid deaths in the US from 2014 to 2015, according to the Centers for Disease Control and Prevention.

The rates of death from synthetic opioids has increased across all demographic groups and regions. And there is currently a higher availability of fentanyl, increased seizures of fentanyl and more known overdose deaths from fentanyl than at any time since the drug was synthesized in 1959, according to US government data.

“What’s occurring in the US and Canada is because of the overprescription of opioids originally, and then the clampdown on the legal supply,” Douglas said. “But there are a lot of markets out there with a significant heroin consumption issue and fentanyl is easy to smuggle and you can mix it into that market.

“If you’re an unscrupulous organized crime guy looking at the benefits of fentanyl for your business, it would make sense that they’re going to start pushing it [in other markets].”

Police in the UK’s Yorkshire and Humber region said earlier this month that they expected the drug “to be here to stay” after it was found that at least 60 drug deaths in the UK have been linked to fentanyl and carfentanil since December 2016.

“Whilst we will do everything we can to stem the flow of this supply into communities, because of its availability on the dark web, it’s something that is very difficult to control and it is freely available,” said detective superintendent Patrick Twiggs of West Yorkshire police.

There is a similar concern in Australia, where the US Drug Enforcement Agency warned its counterparts that the country could face a similar threat from fentanyl, according to News.com.au. There has recently been an uptick in fentanyl overdoses in Australia, where the use of opioid-based painkillers has quadrupled in the past decade.

The scale of fentanyl use in the UK and Australia is small compared to the US or Canada, but Douglas said that could change because fentanyl is so attractive to traffickers.

“It’s easy to hide production, you don’t need very much to ship, so it’s going to be movable,” said Douglas. “Basically, it’s great if you’re an organized crime guy.”

One kilogram of fentanyl can result in a batch of more than 666,600 1.5mg pills. Sold at $10 a piece, that’s $6.6m in revenue. Cut the dosage down to 1mg, and the manufacturer could have $10m.

Fentanyl is also cut into heroin to strengthen weak supply – often without the consumer’s knowledge. With heroin and other plant-derived opioids, the manufacturing process begins in an opium field where plants must be harvested. Because fentanyl is a synthetic, all that is needed to produce it is a lab.

Fentanyl is typically sent from China to consumers in the US and Canada. Though there have been efforts to clampdown on China’s manufacturing of fentanyl, the country has an enormous pharmaceutical industry and officials say it is impossible to completely root out the source for such a lucrative product.

This is why it could land in Australia and Europe in a similar way as it has arrived the US, where it has been smuggled in by traffickers or ordered on the internet and sent through the postal service, which does not have the resources needed to detect every block of fentanyl in the mail.

Fentanyl sales have been traced to dark web sites like AlphaBay, which was closed in July, but Douglas’s team has also seen sales of fentanyl and carfentanil, which is about 10,000 times more potent than morphine and intended only for very large animals, on normal websites.

“I don’t think the shutdown of AlphaBay had much of an impact on this,” Douglas said. “There will be another one there. It comes back to the fact that if the demand is big enough, they will find a way to get it there”.

To address demand, Douglas said countries with opioid addiction problems should emphasize a public health approach instead of policing, which is how the US has long managed drug crises.

Douglas said countries such as Australia should be watching how the US responds to the fentanyl problem. “I hope they are watching what they should and should not do, if say, it does become a problem there,” he said.

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