Fentanyl’s spread likely linked to heroin shortage: report
A new report says the spread of fentanyl, the powerful synthetic drug that causes thousands of deaths across North America each year, is most likely the result of shortages of prescription pills and heroin, and its lower cost for drug wholesalers.
The report from the University of California, San Francisco includes work by Daniel Rosenblum from Dalhousie University’s school of economics.
The authors said that fentanyl is often sold as heroin or prescription drugs like Oxycontin or Xanax, and that users and street-level dealers often don’t know what they are taking because the synthetic is added higher up in the distribution network. Because of that, they said, it’s unlikely user demand is causing the spread of the drug.
The report — which looks at use in the United States — says fentanyl was implicated in 29,000 overdose deaths in the United States alone in 2017.
Because it’s made in labs, fentanyl is more powerful and cheaper to produce than heroin, which is derived from poppy opium and can’t be made until the crop comes in.
“(Fentanyl) is substantially cheaper than heroin, and is more concentrated, so if you’re trafficking something that is a hundredth the size but with the same potency as heroin, the economics of it are pretty stark,” Rosenblum said. “It’s hard to imagine that synthetics are going to go away given that they’re so cheap.”
The cost difference is good for some in the illicit drug trade, but not others, Rosenblum said.
“It’s definitely not good for the user because so many people are dying, but it’s not clear that it’s good for the street-level dealers, or that they’re making any more money from this,” he said. “But definitely the higher-ups in the supply chain are profiting from it.”
The report’s authors say having a better understanding of whether the spread of the drug is driven by the economics of suppliers or the preferences of drug users will help policymakers find ways to curb it.
The problem is that fentanyl isn’t usually sold as fentanyl, the study says. Sarah Mars, a researcher in the department of family and community medicine at UCSF, said in a news release that the dealers selling fentanyl directly to the users often don’t know what’s in it.
“Not only is this particularly dangerous, but it also means penalizing low-level dealers isn’t going to make any difference in the fentanyl poisoning epidemic.”
Rosenblum said the dealers don’t necessarily want to be selling fentanyl-laced drugs because they will lose customers, and while some users want the synthetic drug blended in for the stronger high, others don’t.
“The thing is, no one knows what’s in their drugs anymore,” he said.
While the study looked at U.S. statistics and information, the situation is similar in Canada, Rosenblum said.
“B.C. has been the worse hit, and it’s heading east,” he said. “There have been a few fentanyl-related deaths in Nova Scotia, but not that many.”
Dr. Daniel Ciccarone, a professor of family and community medicine at UCSF, said in the release that fluctuations in the potency of drugs containing fentanyl is what makes them dangerous.
The researchers said the data collected for the study shows that heroin shortages or “supply shocks” occurred before the current and prior fentanyl waves struck in both Europe and the United States, at a time when prescription opioids were also becoming harder to obtain.