{"id":6001,"date":"2024-12-19T17:56:12","date_gmt":"2024-12-19T16:56:12","guid":{"rendered":"https:\/\/www.rivistaeco.com\/?p=6001"},"modified":"2024-12-23T11:19:52","modified_gmt":"2024-12-23T10:19:52","slug":"if-fentanyl-reaches-europe","status":"publish","type":"post","link":"https:\/\/www.rivistaeco.com\/en\/2024\/12\/19\/if-fentanyl-reaches-europe\/","title":{"rendered":"If Fentanyl Reaches Europe"},"content":{"rendered":"

In America, Fentanyl causes 100,000 deaths annually. Now, there are warning signs of its arrival in Europe. Preventing the spread of this particularly dangerous drug is still possible, but it requires learning from the mistakes made in the United States and identifying the most promising initiatives, including those focused on law enforcement. For once, Italy is at the forefront.<\/span><\/i><\/p>\n

The opioid epidemic continues to ravage the United States, killing around 100,000 people each year. Now Fentanyl, the primary driver of skyrocketing overdose mortality in America, is beginning to emerge in Europe. Between 2012 and 2020, the EU Early Warning System identified 37 new Fentanyl analogs circulating on the European illegal drug market. The risk is already high. According to the European Monitoring Centre for Drugs and Drug Addiction, 74% of overdoses in the EU in 2021 were attributed to opioids, and it is estimated that one million people in the Union are at high risk of opioid abuse. Without adequate preventive measures, that population could face grave danger if Fentanyl manages to replace heroin as the dominant opioid.<\/span><\/p>\n

Fortunately, Europe appears to lag behind the United States in terms of the scale and intensity of its emerging opioid crisis. For now, heroin remains the dominant opioid of abuse in Europe, whereas in the U.S., Fentanyl overtook it nearly a decade ago in 2015, ushering in the so-called \u201cthird wave\u201d following the epidemics of prescription opioids and heroin. This delay offers Europe a chance to avoid the mistakes and policy failures that worsened the situation in America.<\/span><\/p>\n

The Most Common Mistake in Drug Policies<\/b><\/h3>\n

When policies aimed at mitigating the harms caused by drug epidemics fail, it is often due to a fundamental misunderstanding by policymakers: the belief that drug users are rational consumers\u2014like those in any other market\u2014and therefore respond to economic incentives. In reality, they differ from consumers of other goods because their demand does not change with price fluctuations. Addicts inherently require a certain quantity of drugs, regardless of actual price changes. This seemingly simple principle underlies the failure of many drug-related policies.<\/span><\/p>\n

Take, for instance, harm reduction policies. A 2022 study by Jennifer L. Doleac and Anita Mukherjee showed that broader availability of a potentially life-saving drug capable of reversing overdoses did not lead to a reduction in overdose mortality. Instead, it resulted in an increase in opioid-related hospital admissions. Similarly, another 2022 study by Analisa Packham found that syringe exchange programs effectively reduced HIV transmission rates but also led to an increase in overdose mortality.<\/span><\/p>\n

Both initiatives, despite their good intentions, unfortunately lowered the effective cost of drug use. Rationally, the reduced costs allowed users to increase consumption. Ultimately, harm reduction approaches succeeded in reducing certain negative effects, but those benefits came with increased drug use, making the trade-off between advantages and disadvantages difficult to calculate.<\/span><\/p>\n

On the supply side, completely removing illicit drugs from a market is practically impossible. Consequently, various enforcement initiatives aim to reduce the available quantity of drugs or increase economic costs for sellers. If the demand for narcotics were similar to that for other goods, this would reduce demand and, in turn, mitigate the negative consequences of drug consumption.<\/span><\/p>\n

Unfortunately, the demand for drugs differs from that for other goods. When the availability of a substance decreases, consumers begin searching for substitutes, which can be dangerous due to the inherent risks of experimenting with new narcotics. In other words, drug users do not respond to price increases in the way policymakers and law enforcement would like: they do not reduce consumption, as apple buyers might when apple prices rise. Instead, they shift to cheaper drugs or seek alternative supply sources.<\/span><\/p>\n

Perhaps the best example of this dynamic is the U.S. attempt in the early 2000s to crack down on the burgeoning market for diverted pharmaceutical opioids. Under pressure from bad publicity and lawmakers, Purdue Pharma\u2014the company behind the most commonly abused prescription painkiller at the time, OxyContin\u2014replaced the drug with a new \u201cabuse-deterrent\u201d formulation. Predictably, OxyContin abuse decreased. However, dependent users could not simply leave the market. As documented in a 2018 study, widespread substitution with heroin\u2014much more dangerous than OxyContin\u2014followed, causing a massive increase in heroin overdoses in America.<\/span><\/p>\n

The same type of effect is evident in law enforcement attempts to suppress the use of illicit drugs. A recent study in Indianapolis found that arrests of drug dealers led to an immediate increase in overdose mortality. The disappearance of known dealers initiated a risky search for new supply sources, often fatal for addicts. Arresting drug suppliers does not eliminate the demand for opioids among addicts. Instead, searching for new suppliers often creates more dangerous situations.<\/span><\/p>\n

When Policies Work<\/b><\/h3>\n

Better results were achieved through a heroin supply prevention action implemented in Australia in the early 2000s, as documented in a recent study by Timothy J. Moore and Kevin T. Schnepel. Significant seizures at entry ports prevented heroin from entering the country. Of course, Australia is an island with no viable overland routes, and at the time, there was no true substitute for heroin\u2014Fentanyl was still largely unknown, and prescription opioids were much more expensive. In this context, heroin users found no replacement product. Through administrative data, the study\u2019s authors tracked known drug users and discovered a substantial reduction in overall mortality within this group.<\/span><\/p>\n

Is this an example to follow? Europe is not an island and has porous land borders, making it unlikely to prevent Fentanyl\u2019s arrival via this route. More reliable guidance on actions to take once drugs enter a local market seems to come from a recent law enforcement initiative in a part of Philadelphia, United States. In Kensington, America\u2019s largest open-air drug market, police targeted only the largest dealers using intelligence-led operations. This initiative, covering just a three-square-kilometer area, reduced drug trafficking to other regional markets up to 50 kilometers away. It also altered overdose mortality trends across the metropolitan area, with a significant reduction in deaths compared to other U.S. cities.<\/span><\/p>\n

The initiative worked because it disrupted a large regional supply chain at its epicenter. As in the Australian example, local addicts had few options to replace the substance they used. The supply shock in a small neighborhood reverberated regionally, effectively forcing a large group of users out of the market.<\/span><\/p>\n

The Italian Plan<\/b><\/h3>\n

Where does Italy stand? The country was one of the first in the EU to adopt a national plan directly addressing Fentanyl. The plan, drafted by the Department for Anti-Drug Policies, focuses on two objectives: prevention and management. Prevention efforts target both intercepting illegal Fentanyl to prevent its entry into the market and preventing abuse of legally prescribed Fentanyl. An emergency plan is also in place for synthetic opioids\u2019 proliferation, including training healthcare workers to better recognize and treat overdoses, expanding access to the drug naloxone, and educational initiatives for youth and high-risk populations.<\/span><\/p>\n

In presenting the plan, Prime Minister Giorgia Meloni made direct reference to the American epidemic, calling Fentanyl a \u201czombie drug.\u201d It is promising that Italy prioritized combating Fentanyl before this drug and other synthetic opioids have gained a foothold in the country. The plan appears well-designed for success. Notably, although details of its implementation remain scarce, the plan\u2019s explicit reference to coordination with the Anti-Mafia Commission suggests that law enforcement efforts will focus on higher levels of the supply chain\u2014a level that research has shown produces the best results by effectively reducing the amount of drugs available on the market and preventing substitution with other substances. Combining this approach with public health initiatives and harm reduction measures offers a real chance of preventing the worst effects of a potential Fentanyl spread.<\/span><\/p>\n

Europe is now beginning to confront Fentanyl. As it defines its response, it is crucial to consider lessons from America and Australia. Blind crackdowns on street-level dealers achieve little. Instead, an approach based on accurate intelligence to identify and disrupt regional epicenters is more effective.<\/span><\/p>\n

Strategic policy accounting for the behavior of drug consumers is Europe\u2019s best chance to prevent the devastation caused by Fentanyl if this dangerous drug takes hold on the continent. We can only hope European policymakers heed lessons learned elsewhere.<\/span><\/p>\n

Zachary Porreca is a researcher at the CLEAN Center at Bocconi University and a fellow of the SSRC-Arnold Ventures Criminal Justice Innovation. He earned a Ph.D. in Economics from West Virginia University in the United States in 2023.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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