Taliban poppy ban puts Europe on fentanyl alert

Taliban poppy ban puts Europe on fentanyl alert
Опубликовано: Friday, 31 March 2023 05:09

Drug users could switch to more dangerous synthetic opioids as heroin supply dries up.

Europe’s heroin market could soon be in for a supply shock, and experts fear the gap could be filled by something much worse.

Almost all heroin consumed in Europe comes from Afghanistan, where the Taliban have imposed a ban on poppy cultivation that will take effect in the coming weeks.

The likely poppy shortage could make it more profitable for criminals to manufacture synthetic opioids such as fentanyl, to be sold to desperate addicts denied their hit of heroin.

That in turn presents a serious public health risk, as synthetic opioids tend to be much stronger than natural heroin — 50 times stronger in the case of fentanyl. That means it’s much easier to overdose: fentanyl claims tens of thousands of lives in America each year.

The Taliban banned poppy cultivation in April 2022, after wresting back control of Afghanistan from the US-backed government in 2021. The 2022 crop was exempted, meaning the results will start to be seen with this year’s April harvest. It takes between a year and 18 months for the harvest to reach the European market as heroin, giving governments until next year before the impact starts to be felt.

“If the Taliban ban does result in a dramatic reduction in heroin produced from opium poppy, that could create a possibility of us seeing more synthetic opioids," said Paul Griffiths, scientific director of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

“It seems strange to say this, but almost in terms of synthetics, the high availability of heroin at the moment is … arguably a protective factor,” said Griffiths.

History backs up his fears. The Taliban previously banned opium in 2000, causing a heroin shortage in Europe. Not long after, fentanyl surfaced for the first time on the continent.

“From the early 2000s onwards, we had a problem with fentanyl in the Baltics, Estonia particularly, where it was responsible for quite high levels of drug-related deaths, and was quite a long-term intractable problem there,” Griffiths said.

By 2017, Estonia’s fentanyl crisis was over, as intense law enforcement initiatives shut down many of the producers located in the country. But Estonia still has the highest proportion of fatal overdoses involving fentanyl in the EU, according to figures provided to POLITICO by the EMCDDA.

A lesson from America

For an idea of just how dangerous synthetic opioids can be, look to America. More than 58,000 people died from fentanyl overdoses there in 2020, compared to 97 in the EU. By 2022, the U.S. figure for synthetic opioid deaths, mostly attributed to fentanyl, had increased to 68,000.

There are some important differences, however. America’s opioid epidemic stems from large number of prescriptions doled out for pain management in the 1990s. This led to overdoses on pain medication itself, as well as an increase in addiction leading to illicit heroin use.

A drug user shoots-up a mix of heroin and fentanyl | Spencer Platt/Getty Images

Since then, fentanyl has penetrated the broader U.S. illicit drug market, according to the Centers for Disease Control and Prevention (CDC). It can be found blended into many illicit substances, from counterfeit Xanax, an anxiety medication, to recreational drugs including MDMA, cocaine and even cannabis. The fastest-growing group for overdose deaths is teenagers.

By contrast, far fewer Europeans have become addicted via prescription medication, meaning the main risk group is likely to be the far smaller number of heroin addicts. There’s also much less of an established illegal manufacturing base for synthetic opioids.

“In Europe, in many countries, prescribing rates are not necessarily less than in the U.S., but it doesn’t spill over to the illicit opioid use or illegally manufactured opiates,” said Arnt Schellekens, professor at Radboud University Medical School in the Netherlands.

In a letter published in medical journal The Lancet in October, Schellekens and colleagues pointed to the widespread availability of health care in Europe as a protective factor. This is both because it gives patients access to affordable interventions, such as hip or knee replacements, rather than them needing to rely on opioids to alleviate chronic pain, and because it provides addiction care including opioid substitution treatment.

Others agree. “The health care system is an important infrastructure to prevent and treat people that become addicted,” said Nora Volkow, director of the U.S.-based National Institute on Drug Abuse. “It is key to actually avert a crisis like the one that we’re living in the United States with fentanyl.”

Fentanyl appearing on the European market is declining — but there’s a growing number of new opioids | Patrick T. Fallon/AFP via Getty Images

Despite this, Volkow believes that as markets for fentanyl become saturated in North America, Europe could be the next target for trafficking the drug. “There is nothing that says Europe is immune to these drugs entering their borders,” she said.

Mixing it up

It’s a worry echoed by Europe’s drugs agency which, together with Europol, runs an early warning system to keep track of illicit substances making their way into the EU.

Recent analysis from the EMCDDA shows that the amount of fentanyl appearing on the European market is declining — but there’s a growing number of new opioids.

“The market is adapting to the U.S. pressure and Chinese action to reduce fentanyl. And what we’re seeing is other new synthetic opioids appearing. These are initially uncontrolled, they’re difficult to detect, people aren’t aware of them and they’re again, still highly potent,” said Griffiths.

Europol spokesperson Jan Op Gen Oorth believes the danger for Europe lies in fentanyl mixes.

“It’s probably unlikely that a drug called fentanyl or China White, China Doll or Sudden Death or whatever it’s called … will just pop up on the European market,” Op Gen Oorth said. “What we might see here and there in the next year is groups trying to cut another drug with fentanyl mix. It creates new markets knowing that fentanyl is cheap and highly addictive.”

Nevertheless, Op Gen Oorth believes that international cooperation and continued monitoring will be effective in keeping fentanyl contained, and that Europol or local agencies could quickly respond.

More than 58,000 people died from fentanyl overdoses in the U.S. in 2020 | Alex Wong/Getty Images

Ultimately, one factor may serve in Europe’s favor — time.

“Here we had a 10-year time lag or something,” Schellekens said. “In the beginning, the idea in the U.S. was these opiates, if you prescribe them, are not addictive. By the time that it came to Europe, we had these very important lessons from them that these are not harmless.”

“It’s just the advantage of having somebody else go first,” he said.

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