Just two milligrams of fentanyl is enough to cause a fatal overdose. For comparison: 200 milligrams are needed for a fatal overdose of heroin. The synthetic opioid, actually a painkiller, is quickly addictive and has plunged the USA into a drug crisis. In 2022, more than 70,000 people died from synthetic opioid overdoses in the United States.
The German Aid Aid (DAH) warned this week that fentanyl and other synthetic opioids have already arrived in Germany. This emerges from a federal model project in which rapid tests for fentanyl were carried out in 17 drug consumption rooms from March to August 2023. It should be determined to what extent the synthetic opioid is already added to other drugs.
According to the DAH, 3.56 percent of 1,401 heroin samples tested positive for fentanyl. In percentage terms, the opioid was most frequently detected in samples in Hamburg. There, eleven percent were positive, in Berlin it was only 0.4 percent. Around 70 percent of consumers accepted the DAH test offer. However, the tests did not reveal how much fentanyl was contained in the samples. “The smallest impurities are enough for the test to work,” said the DAH.
“There are currently no signs of a situation like that in North America”
However, the project does not allow any firm conclusions to be drawn about the general distribution of fentanyl in Germany, the DAH explained. It is not apparent that the retail and scene structures have already changed. “From our point of view, there are currently no signs of a situation like that in North America,” it said.
A vial containing two milligrams of fentanyl is presented at the Drug Enforcement Administration’s (DEA) special testing and research laboratory. : Image: dpa
Nevertheless, vigilance is required in view of international experiences. The DAH called on federal states and municipalities to take precautions now and strengthen drug support. It is important to expand the existing rapid test range; the tests can also be given home. Drug users need to be informed about the dangers of fentanyl. In addition, the drug naloxone must be distributed among potential first responders such as police and emergency services. The emergency medication is administered as a nasal spray and is effective against opioid overdose. According to the DAH, it is already standard equipment in drug consumption rooms.
The DAH demanded that we also keep an eye on the changes in Afghanistan. It is not yet apparent that heroin is becoming scarce on the German black market. However, the Taliban ruling Afghanistan banned the cultivation of opium poppies in April 2022. If there is a heroin shortage, drug addicts could turn to fentanyl. The opioid is not only much stronger, but also significantly cheaper than other drugs.
Blienert: More low-threshold offers for consumers are needed
The federal government’s drug commissioner, Burkhard Blienert (SPD), told “Welt am Sonntag”: “An opioid crisis like in the USA and Canada will not repeat itself here, we fundamentally have different, better conditions.” In the USA An excessive prescription of strong painkillers was the starting point; in Germany people are more careful.
“Nevertheless, it would also be possible for us that heroin users would increasingly switch to cheaper and much more dangerous fentanyl,” said Blienert. More low-threshold offers for consumers are needed. “These include drug checking, rapid tests in drug consumption rooms and also the use of the emergency medication naloxone, which even medical laypeople can administer,” said the drug commissioner.
In Germany, 83 people were proven to have died from synthetic opioids in 2022. However, according to the DAH, the number of unreported cases is likely to be higher because toxicological reports are rarely prepared for drug-related deaths. Fentanyl is actually an extremely strong painkiller that is prescribed, among other things, to cancer patients. In medical use it is most commonly used in the form of a plaster.
Interpol also worried
Interpol also warned this week of increasing drug use of the dangerous opioid fentanyl in Europe. “The fact is that fentanyl is already in Europe, is extremely potent and must be treated as an imminent threat,” Interpol Secretary General Jürgen Stock also told “Welt am Sonntag”. “Even small amounts of this drug can be fatal for users. but at the same time very profitable for the criminal networks behind the distribution,” he warned.
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Interpol recently conducted the first global law enforcement survey on fentanyl. Initial findings showed that the drug and similar substances “are distributed or manufactured in all regions of the world, including Europe.” These included illicit and medicinal fentanyl in the form of powder, patches, tablets and liquids.
Although the current seizures in Europe are “nowhere near” the amounts in North America, they should “cause concern among law enforcement and health authorities due to the high addictive potential,” Stock said.