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douglas todd: why has europe been spared canada's fentanyl disaster?
opinion: the death toll from fentanyl is small in europe. what is happening on the other side of the atlantic that has avoided this poisonous scourge?
dec 11 2023
5 minute read
canada and the u.s. suffer about 77,000 deaths a year from fentanyl. europe doesn't come close. it's enforcement agencies are desperate to stop fentanyl crossing the atlantic. (photo: an example of the amount of fentanyl that can be deadly.)
jacquelyn martin
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the associated press
hardly a week goes by that we don’t hear new horrifying numbers about opioid deaths in north america, four of five of which are linked to fentanyl.
last year, 70,000 americans died of overdoses from fentanyl, a synthetic opioid that is 50 times more powerful than heroin. the toll in canada is comparable, at about 7,000 a year. in b.c., fentanyl-related deaths run at about 2,000, which is among the worst rates per capita on the continent.
what is the death count due to fentanyl in europe?
no more than 200 a year.
police and addiction experts are trying to figure out the huge disparity. and they’re desperate to stop fentanyl from crossing the atlantic ocean.
in some ways, it’s astonishing fentanyl hasn’t overwhelmed europe. almost one million europeans inject heroin, a semi-synthetic opioid derived from poppies, most of which are grown in afghanistan. the misery of addiction penetrates the streets and apartments of paris, berlin and rome.
the availability of cheap heroin in europe could be affected next year now that the taliban, who took power two years ago in afghanistan, has cut back poppy production by 95 per cent. the threat looming over europe is drug gangs may already be looking to fentanyl to keep their ruthless trade thriving.
vancouver’s dr. bill macewan , who has for decades worked with people who are addicted and police officers, says fentanyl basically came to b.c. in 2015.
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“fentanyl got into the local drug supply via the china/hong-kong triad gangs,” said macewan. “they told dealers that if they wanted to keep their cocaine supply they had to add fentanyl to it. they severely punished those who did not comply.”
the hells angels gang soon joined the vicious fentanyl trade, he said.
“dealers just care about moving product. they don’t care about deaths. and they generally do not test their dope because they can’t return it to the seller.”
fentanyl roared into b.c.’s illicit drug supply network less than 10 years ago “via the china/hong-kong triad gangs,” says dr. bill macewan.
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while opioid-production patterns vary by region, police now believe a great deal of north america’s fentanyl supply streams in from a combination of mexican drug cartels mostly using chemicals from china.
still, why hasn’t fentanyl really made it to europe yet?
the economist magazine recently suggested that one reason could be that reckless u.s. pharmaceutical companies a couple of decades ago created the demand for powerful painkillers. by 2015 american physicians were handing out 227 million prescriptions a year for opioids.
“a cohort of patients hooked on pills soon discovered they were available illicitly when prescriptions ran out. europe, by contrast, largely resisted, in part thanks to universal medical care. unlike americans, those with ailments could get the procedures they needed to alleviate pain, instead of turning to painkillers for a quick fix,” says the economist article.
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however, the article concedes the universal-health-care theory doesn’t necessarily stand up to a full test — because “canada has state-funded health-care systems to rival any in europe, yet it too has fallen prey to fentanyl.”
how big a factor is law enforcement for combating super-potent, inexpensive-to-make fentanyl?
antony blinken, the u.s. secretary of state, has warned his european counterparts they could soon have problems with fentanyl. and europe now has the strategic advantage of seeing how fentanyl has ravaged north americans, especially men .
a novel study led by timothy moore of purdue university found that port cities like vancouver are most vulnerable to fentanyl simply because they do more trade. regions that bring in more goods from abroad have higher rates of fentanyl deaths, moore found, with the probable explanation being that gangs take advantage of existing trade routes for smuggling.
regardless of the exact cause, macewan is among those raising the alarm that once fentanyl takes hold in any region it can be impossible to stop.
“people who try fentanyl do not, cannot, go back to weaker opioids. even if a fentanyl user retried heroin, their body would still crave the stronger fentanyl.”
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julian somers, a leading researcher in addiction and a simon fraser university clinical psychology professor, says enforcement is definitely necessary, but it’s not sufficient to curtail deadly drug overdoses.
it’s crucial that police around the world co-operate on investigating and seizing drugs, says somers. “those are vitally important activities that canada must support.” like others, he stresses the importance of canada re-establishing the harbour police force .
the main key, he said, is to minimize both supply and demand.
“specifically, we have enabled an increase in the drug supply through decriminalization and public supply of addictive drugs. and we have no focus on demand reduction. we are literally concentrating people with drug problems together in sros (single-room-occupancy buildings) with a drug supply and an overdose-prevention service.”
all in all, somers believes drug deaths “are powerfully explained by human despair and inequities.”
the authors of deaths of despair and the future of capitalism , economists anne case and angus deaton, detail how people experiencing socio-economic downturns, such as unemployment, are prone to suicide, alcoholism and addiction to several drugs, including fentanyl.
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society has a large role to play in addressing such despair, somers says. “the most powerful means of reducing (drug) poisonings involves promoting social integration. european countries have rich social and cultural traditions compared to western north america. and that may contribute to current and previous european successes.”
the psychologist admires, for instance, how portugal and switzerland emphasize “social reintegration” in helping people overcome opioid addiction.
europe may have suffered less from fentanyl deaths because of the benefits of the so-called welfare state and shared values about citizenship, suggests sfu clinical psychologist julian somers.
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despite the focus on ultra-potent fentanyl, somers is among those who don’t believe it’s the novel drug itself that is the cause of the latest devastation in north america. other drugs are also causing torment, somers says, including alcohol and a new injectable drug, xylazine, which is even more destructive than fentanyl.
that’s one of the reasons he leans to the idea that europe has suffered less from fentanyl deaths in part because of the benefits of the so-called welfare state.
“european social-welfare provisions are themselves an extension of more fundamental traditions involving citizenship, social harmony and reciprocal obligations between individuals and society,” somers says.
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“practices related to those values — education, employment, life in families and communities, social integration, et cetera — are the most powerful avenues for preventing harmful drug use.”
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