Opioids: Counterfeit Fentanyl on Europe’s doorstep

An injectable drug is loaded into a syringe

Widespread abuse of a therapeutic product

What precisely are we dealing with? A synthetic opioid with a hundred times more analgesic strength than morphine, which is used for therapeutic purposes by individuals suffering from chronic pain, especially due to cancer. In theory, this drug is administered at a very low dose given its powerful analgesic and sedating properties. But over the last few years, Fentanyl has also been used as a recreational drug, particularly on the other side of the Atlantic in Canada and the United States. This ultra-powerful opioid is used as a hard drug by addicts and overdosing has caused tens of thousands of deaths due to total respiratory failure.

By law, products derived from Fentanyl have been classified as narcotic drugs in France by a decree of 5 September 2017 due to their highly addictive properties. 11 other EU Member States have followed suit (Belgium, Cyprus, Ireland, the United Kingdom, Latvia, Lithuania, Sweden, Germany, Denmark, the Czech Republic and Estonia), as have Norway, Canada and China.


Fears of an influx of counterfeit Fentanyl onto the European black market

Illegal Fentanyl derivatives are increasingly entering onto the black market, as it’s becoming more and more difficult to obtain these painkillers on prescription. This was what led to a massive influx of counterfeit Fentanyl into the United States at the end of the 2000s. Dealers bought them at a low cost in China before cutting them with heroin and importing them onto the parallel market1.

These derivative opioids are clearly far more concentrated than other products, since they are cut with far more harmful substances. This opioid mix has been causing untold health damage, resulting in countless fatal overdoses in North America2. Although it’s currently scarce on the ground on the European parallel market, public health experts are worried about the possibility of synthetic Fentanyl derivatives also flooding into Europe, where opiate consumption is constantly on the rise.


The danger of a European health crisis due to an influx of counterfeit medicines

American President Donald Trump has called opioid addiction in the United States a “public health crisis”. Europe must take heed that today’s global counterfeit medicine crisis, and especially Fentanyl derivatives, pose a serious threat on the continent. The former Europol Director Rob Wainwright has said that the product ‘is on its way’ to France, in interview with the French newspaper Journal du Dimanche.

The counterfeit Fentanyl epidemic across the Atlantic is affecting over 43 American States, according to a study by The Partnership for Safe Medicines (PSM). It’s become a public health crisis given the health damage. As well as fatal overdoses (the United States recorded 63,600 deaths from overdoses in 2016), there has been a drop in life expectancy from birth in the US (falling from 78.9 in 2014 to 78.6 in 20163).

A massive influx of counterfeit Fentanyl onto the European black market in the years to come is a potential serious threat. European Member States, and especially the public health authorities, should tackle it in a coordinated initiative, facing up appropriately to the considerable health stakes.

This is the scale of the challenge that it will be to regulate the production, export and smuggling onto the market anticipated for the future. The UN’s Anti-Drug Commission’s March 2017 initiative to add the most commonly-used ingredients for making illegal Fentanyl to the list of controlled – and as such forbidden – substances is a welcome step. This decision will help to make it much harder to obtain these substances and for them to push into the European black market.

As such, while Fentanyl-based opioids are still relatively scarce in France, the French National Drug Safety Agency (ANSM), and every pharmacovigilance organization in France as whole, are remaining vigilant as to the potential onset of an epidemic.


1 Corky Siemaszko, ‘Fentanyk figures in most fatal drugs overdoses in U.S., researchers say’, NBC News, 05/2018.

2 Corine Lesnes, ‘Overdoses d’opiacés : une ‘urgence de santé publique’ nationale aux Etats-Unis’, Le Monde, 10/2017.

3 Florian Delorme, Pauline Chanu and Léa Mormin-Chauvac, Crise des opioïdes aux Etats-Unis: la France est-elle concernée?, France Culture, 12/2017.

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