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Fentanyl is flooding into Britain

Scotland has become the drug death capital of Europe. Credit: Getty

March 19, 2024 - 10:00am

Great Britain is getting ready for fentanyl. The country will soon have an early warning system, the Times reported on Friday, which will allow the Government to track the presence of synthetic drugs using wastewater surveillance and other epidemiological indicators.

Chris Philp, Minister for Crime and Policing, told the Times in advance of the system’s announcement that it was a strategy to help avoid a synthetic drug crisis like the one now taking over 100,000 lives a year in the United States, and another 8,000 in much smaller Canada.

The Government will also expand the availability of the overdose-reversing drug naloxone, alongside bolstering enforcement efforts. Philp has also endorsed “drug-checking services” which can measure whether other drugs are tainted with fentanyl.

Such measures are an admirable, valuable effort to stave off the inevitable. In an increasingly global illicit drug market, the United Kingdom and Europe will eventually follow North America in the synthetic drugs transition. But policymakers can and should delay that shift as long as possible.

In some senses, the best time to worry is now, before things get bad. UK overdose death rates are still below those in the United States. There were about 8.4 drug overdose deaths per 100,000 people in England and Wales in 2022, and 19.8 per 100,000 in Scotland, for a total rate of about 9.4 per 100,000 in Great Britain. The equivalent rate in the United States was 33.8 per 100,000.

But rates have been rising steadily across the United Kingdom since 2012. This is in part because the UK has one of the world’s highest rates of opioid consumption, thanks especially to high rates in Scotland. That hasn’t translated into US levels of overdose death principally because fentanyl remains rare. But the number of fentanyl-related deaths, while still small, is rising. And increasing the risk is the rising prevalence in the British drug supply of nitazenes, a class of highly potent synthetic opioids that is also starting to spread in the US.

The North American context, then, provides a grim glimpse of the UK’s future. In both America and Canada, drug overdose death rates have risen dramatically because of the spread of deadly synthetic opioids. In Canada, the opioid overdose death rate rose 150% between 2016 and 2022; in the US, the increase was “only” 63%.

What determines whether any country — including the UK — makes the transition to fentanyl? In some regards, it’s contingent. The US and Canada have largely unrestricted trade with Mexico, a nation large swathes of which are controlled by sophisticated cartels that have invested in the technology to produce fentanyl. The restriction of the synthetic drugs crisis to North America thus far is probably explained by the fact that those markets source their drugs from Mexico, while European drugs come mostly from Southeast Asia.

That said, the fentanyl transition is also a necessary consequence of drug markets working rationally. From a producer’s perspective, synthetic drugs are superior to organics on basically all dimensions: not subject to growing seasons, cheap to manufacture, easy to hide from law enforcement, and arbitrarily potent.

In short, fentanyl has replaced heroin in most US markets because it’s a much better product. At some point, the same pressures will push European markets to transition.

That point could be a very long time off, though. Fentanyl was first synthesised in 1959, and small drug operations have tried to take it mainstream in the US since at least the 1980s. But it wasn’t until the 2010s that it began really to spread in America. This represents a failure to innovate on the part of illicit market actors — and, consequently, a success of prohibition and enforcement in keeping the drug market less innovative.

How far off the UK is from the transition, too, is a function of how aggressively the Government targets the problem while it remains small. Steps such as the early warning system are an important part of that strategy, as are crackdowns on any fentanyl sales. The control over trade with the continent restored by Brexit could also prove important.

None of these measures will keep fentanyl out forever. But they will keep it out for a while, and time saved is lives saved.


Charles Fain Lehman is a fellow at the Manhattan Institute and contributing editor of City Journal.

CharlesFLehman

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edmond van ammers
edmond van ammers
8 months ago

Could we ask some advice from Singapore, Malaysia, and Indonesia how to deal with this problem?

Matt M
Matt M
8 months ago

I was just about to write that. A few scaffolds and some rope is a cheap and effective solution.

John Riordan
John Riordan
8 months ago
Reply to  Matt M

Ineffective, I think. What happens is that drugs dealers who aren’t scared of the risk of jail will be replaced by drug dealers who aren’t scared of the risk of death. This is not what I’d call an improvement.

Stephen Walsh
Stephen Walsh
8 months ago
Reply to  John Riordan

It could be if there are a lot fewer of the latter. At present in the UK and Europe even the risk of a long jail stretch is pretty low.

Dennis Roberts
Dennis Roberts
8 months ago
Reply to  Stephen Walsh

Yes, you can maximise the deterrent aspect as much as you like, if you’re not catching and then convicting them it has little value.

Lizzie J
Lizzie J
8 months ago
Reply to  Dennis Roberts

In my local town in Dorset a supplier was let off with a caution because she pleaded ‘mental health problems’, which didn’t seem to stop her from driving a new, high spec BMW, or from claiming benefits.
The big boys from Birmingham moved in about a year ago – I’m hoping that a raid this week will put them away, but I’m not holding my breath. You can literally get away with murder here if you’re a dealer.

Martin M
Martin M
8 months ago
Reply to  Lizzie J

It is a very lucrative business. Still, even the police should be able to spot lads with a Brummie accent, eh?

Mike Rees
Mike Rees
8 months ago
Reply to  John Riordan

Singapore simply doesn’t have a drug problem. A supplier caught in possession with more than 15g of heroin will hang.

Dumetrius
Dumetrius
8 months ago
Reply to  Mike Rees

They do drink a lot tho, and get very drunk.

Alcohol in Singapore is (or was) taxed by volume, not by alc/vol.

So it makes sense to drink Martinis rather than beer.

Martin M
Martin M
8 months ago
Reply to  Dumetrius

I imagine any Singaporean who wants to take drugs goes to Indonesia to do so. Lord knows plenty of Australians do. Well, there or Thailand.

Albireo Double
Albireo Double
8 months ago
Reply to  John Riordan

Except that (at least in Singapore) it actually works. So, not ineffective.
And incidentally, regardless of their fear thresholds, I regard every single dead drug dealer as an improvement.

Roddy Campbell
Roddy Campbell
8 months ago
Reply to  John Riordan

Or, perhaps drug dealers who are a bit scared of death (all of them) might pack up and go elsewhere. If you’re being chased by a lion, you don’t need to be the fastest runner in the group. Just not the slowest.

Dumetrius
Dumetrius
8 months ago

Well, I don’t know, as they mainly hang dealers.

But dealers are there because there is a market there, that is worth the risk of supplying.

Hang a few users, and make sure the story is in the media (sure that won’t be a problem) and there may not be any market at all.

Martin M
Martin M
8 months ago
Reply to  Dumetrius

Yeah, rape or murder someone – jail time. Have a bit of a toot – hang. Doesn’t seem that logical, does it?

Roddy Campbell
Roddy Campbell
8 months ago
Reply to  Martin M

Surely ‘murder 100 people you don’t know who die because you smuggled a kilo of powder to make a fast buck” = hang.

Dave Smith
Dave Smith
8 months ago

Fentanyl will come here. It will kill up to 20,000 a year if it reaches the same level as in the US. Then no doubt we will wring our hands ,wail and say something must be done. It is so dangerous a drug that we cannot take it lightly and argue in typical liberal ways about drug taking.
I would make a life sentence mandatory for those who sell it . Whatever the amount with a minimum sentence of many years and no parole. Harsh it is but the alternative is harsher.
Dave S

Martin M
Martin M
8 months ago

I take your point on Singapore, and I’ve never investigated Malaysia in this regard, but I can’t say I’ve noticed any shortage of drugs in Indonesia (well, Bali anyway).

UnHerd Reader
UnHerd Reader
8 months ago
Reply to  Martin M

It’s definitely easy to find drugs in Bali nowadays. Nothing to do with the influx of young Russians I’m sure. I guess the odds look better than fighting in the Ukraine.

Mike Downing
Mike Downing
8 months ago

Luckily, we don’t have to worry; we can just move the goalposts and legalise everything and let ‘the government ‘ or ‘the health service’ deal with the fallout while we self-medicate into oblivion.

Maybe the government could ‘get ahead of the curve ‘ and produce ‘safe’ tester strips of fentanyl for pre-teens and then they can at least take it safely. I mean they’re going to anyway, right ?

They could package it using cartoon characters and out-cool the other producers. Maybe prime-time advertising on TV to really make an impact; Gary Lineker would be a good fit.

What’s not to like ?

John Riordan
John Riordan
8 months ago
Reply to  Mike Downing

Well, testing kits ARE being made available, as the article says.

The value of these isn’t necessarily to provide safe dose information people knowingly taking fentanyl, it’s to detect it where it shouldn’t exist at all, ie in other illicit street drugs such as cocaine and ecstasy. The last thing people taking those drugs want is an opioid overdose: they’re not trying to take opioids at all.

Kirk Susong
Kirk Susong
8 months ago
Reply to  John Riordan

‘The last thing people taking cocaine and ecstasy] want is an opioid overdose; they’re not trying to take opioids at all’
I am sure the drug users come in a wide range of sophistication… but your comment I believe wildly overestimates their average sophistication. This ain’t like ordering a pinot grigio with dinner, swishing it around, enjoying the aroma, sampling it, then wistfully thinking maybe you should’ve gotten the chablis instead, “it goes better with skate.”
These folks are looking to get high, and what they consume is largely contingent on the social networks they move in, the parties and houses where they consume it, etc. If something else comes along and gets them high, they’ll take it.
Of course they don’t want to die – but a lot of them are so depressed and hopeless that the risk of death posed by street drugs isn’t much of a disincentive.

Dumetrius
Dumetrius
8 months ago
Reply to  Kirk Susong

I think drug users are not particularly sophisticated, as you say. A lot of it is wish-fulfilment and actively choosing not to acknowledge or admit what it is they are taking.

They will go on for years chasing and hoping to get the same fantastic high as they did, the first few times when they started using a substance.

Even tho that substance, in the present day, is more than 50% cut with something else inferior.

To admit that tho, would be to admit to themselves that they will not get the high they used to, and which they wish to recreate.
So they’ll take it . . . whatever is in it. So to my mind, the chances of fentanyl getting into other drugs, is very high.

Billy Bob
Billy Bob
8 months ago
Reply to  Kirk Susong

Most users of cocaine and ecstasy aren’t the depressed and hopeless addicts you see on the street. Most are just weekend warriors who do it for a buzz on a Saturday night and wouldn’t touch knowingly touch fentanyl or other opioids

Martin M
Martin M
8 months ago
Reply to  Kirk Susong

I’m not sure your wine analogy is on point. Still, I suppose some people wouldn’t know a claret from a bordeaux…

David McKee
David McKee
8 months ago
Reply to  Mike Downing

Excellent idea, Mike! Gary Lineker would leap at the chance to have yet another platform to ‘inform’ the (no doubt, grateful) world of his considered views on how evil the Tories are.
Seriously though, you do have a point. We do need to have a re-think about what should be illegal, and why. Our current policy on illegal drugs is an unenforceable mess.

Martin M
Martin M
8 months ago
Reply to  Mike Downing

Excellent strategy! Oh, wait…..were you being ironic?

Kirk Susong
Kirk Susong
8 months ago

What baffles me about this discussion is how it is conducted in terms that sound like a natural disaster. “There’s a tidal wave coming, we must prepare!” But this tidal wave isn’t an Act of God but the Acts of Men, many little acts, many little men, all making choices.
The first step to stopping people from ruining their lives and the lives of their friends and families, is to stop telling people that drug use is OK. It’s not OK. It ruins everything. Yes, there is some percentage of people that can use heroin at will, but most people will face serious medical, economic, interpersonal, etc. effects from using powerful drugs like these.
Why do we continue to let the choices and desires of the elite few control policy that ruins things for everyone else?

Billy Bob
Billy Bob
8 months ago
Reply to  Kirk Susong

You’ve always had the drunks, addicts and generally hopeless, unfortunately all the lecturing in the world isn’t going to stop them doing what they’re doing. The biggest danger is going to come from a group of young lads who dabble in some coke or ecstasy on a Saturday night getting a massive dose of opioids instead because it’s been cut into what they thought they were buying

Martin M
Martin M
8 months ago
Reply to  Kirk Susong

I think you need to differentiate things that are habit forming, and whose dosage cannot be guaranteed, like fentanyl, and things that are essentially harmless, like cannabis. It is “ok” to do the second sort, which is why they are being legalised around the world.

Kirk Susong
Kirk Susong
8 months ago
Reply to  Martin M

I agree that there is a line to be drawn somewhere, depending upon just how destructive the substance is. I do not know if marijuana is on this or that side of the line – but I do know that many regimes which legalized marijuana have not seen the positive outcomes they hoped for. The medical effects are worse than predicted, the economic effects less than hoped for, and the social problems just keep getting worse – part and parcel of the young men who have dropped out problem. There are potentially many explanations for all this (everything from bad tax systems to unexpectedly potent grass), but suffice it to say that I think the jury is still out.

Anna
Anna
8 months ago
Reply to  Kirk Susong

Exactly. People have been incredibly naive about how legalization would play out.

Here in California, crime associated with marijuana has increased as criminals routinely rob legal dispensaries. Cartels still import illegal marijuana to avoid taxes, and ship marijuana from here to states where it is still illegal. Legal dispensaries are having to hire armed security which further increases their costs. Everything has gotten worse, not better.

Ardath Blauvelt
Ardath Blauvelt
8 months ago

Transition? An extraordinary characterization of a move to more efficient death dealing. As you do, take a closer look at America. If you truly believe that a 20 year old trajectory will apply to today, maybe you need to check out your hallucinogens. It will happen over night.

In truth, drug use is our modern scourge, plague, or better, pandemic. We could always use those draconian tactics. Maybe with better reasons and to better effect, this time.

Good luck.

Alex Lekas
Alex Lekas
8 months ago

“Well, the kids are going to have sex anyway; best we figure out how to minimize the potential harm.” That’s the mentality on display here with the hand-wringing over how to stop something that other countries somehow managed to stop. The kids part is less of an issue today because so many are more interested in video games or their smartphones to notice the opposite sex. Or the same sex, for that matter.
If you want to stop something, then you have to make the consequences of that activity extremely unpleasant. Disproportionately unpleasant. Because incentives work. They can be used for good reasons along with perverse ones, such as rewarding those who violate immigration laws or pretending that no-bail policies will reduce crime.
Human nature is not that radically changed from what it was thousands of years ago. People tend to act in their self-interest. With drugs, there will be no perfect solution. Our “war on” in the US has worked no better than Prohibition did with booze, but all-in legalization comes with trade-offs, too. People want feel-good solutions but those don’t exist.

Martin M
Martin M
8 months ago
Reply to  Alex Lekas

If you want to stop something, then you have to make the consequences of that activity extremely unpleasant.
You are up against the fact that the initial experience of taking drugs is extremely pleasant, which is why people do it. That is true even with highly addictive things like fentanyl, although in that case, the “pleasantness” does diminish.

Roddy Campbell
Roddy Campbell
8 months ago
Reply to  Martin M

So, treat addicts with leniency. But hang dealers.

Winston Schwarz
Winston Schwarz
8 months ago

As someone who is in constant pain and at the same time in a continuous struggle with the NHS to provide me with pain relief I personally welcome the increased availability of strong synthetic pain killers. The deaths are directly attributable to the bogus drug war fought by hypocrites and the judgemental.
Germany has just legalized Cannabis. Can we ever see that happening in the UK? This is how far we are behind the rest of the world.

Albireo Double
Albireo Double
8 months ago

It is a sign of the completely skewed priorities that “our” vaunted NHS is unable to allow you to effectively manage your pain, while the same sector fids it absolutely simple to ease someone’s financial pain, by shoving them onto a PIP and associated benefits for a decade, because they say they suffer from anxiety.
Difficult to work that one out, I reckon.

Aphrodite Rises
Aphrodite Rises
8 months ago

‘Between 1928 and 2004 and since 2009, cannabis has been classified as a class B drug. From 2004 to 2009, it was a class C drug. At present, it is a class B, with very limited exceptions. Drug policy (including Cannabis classification) has been a contentious subject in UK politics.’
There were good reasons for the reclassification. The anticipated effect of reclassifying did not manifest rather like the legalisation of drugs in many places which seems to have aggravated the problem and associated problems.

Anna
Anna
8 months ago

You don’t ever want to rely on illegal fentanyl for pain management. It’s nothing like pharmaceutical fentanyl used in hospitals and very dangerous. I don’t know why the health system in the UK has trouble providing legal support for pain relief. Here in the US doctors are generally patient-focused and responsive to their needs in this regard although that comes with its own set of problems.

Sophy T
Sophy T
8 months ago
Reply to  Anna

As a consequence of Dr Shipman murdering a large number of his patients with opioids, doctors are now either forbidden to or frightened to prescribe large amounts of painkillers.
This means many people in the UK who are in serious and constant pain aren’t given enough pain relief.

Roddy Campbell
Roddy Campbell
8 months ago
Reply to  Sophy T

A doctor writes: they’re not forbidden. Most err on the cautious side because nobody likes killing their patients and the bell curve means that if doctors prescribed effective doses of painkillers to all patients, a few would end up dying from them. This is NOTHING to do with Shipman, who apparently sought his patients’ deaths.

Sorry you’re in pain. Maybe you might benefit from finding another doctor. We’re all different.

Albireo Double
Albireo Double
8 months ago

We need look no further than Singapore.
Drugs dealers – hanged.
Illegal gun dealers (they find you with 2 illegal guns) – hanged.
Bad street behaviour – Large fines, and / or a rattan caning.
Prisons – very, very, very unpleasant places to be.

Aphrodite Rises
Aphrodite Rises
8 months ago
Reply to  Albireo Double

And the most desirable passport in the world.

Martin M
Martin M
8 months ago

Yes, and the same party keeps winning elections and forming government. A veritable utopia….

Aphrodite Rises
Aphrodite Rises
8 months ago
Reply to  Martin M

Singapore may not be your idea of the closest thing to heaven on earth but to a large number of realists it is. A young man from Hong Kong of Chinese descent once told me the Chinese believe all governments are corrupt so as long as life is ok for them and they can do business, they do not care what type of government they have.

Martin Layfield
Martin Layfield
8 months ago

Generally I’m against the death penalty, however, if in Britain fentanyl problems get even just a fraction as bad as North America, I may have to alter my view.

Gerard A
Gerard A
8 months ago

The article seems to have ignored one of the most relevant factors. That the Taliban after encouraging opium cultivation when not in power have now clamped down on it again. This means there is a void in the supply chain in Europe which fentanyl is set to fill.

Michael
Michael
8 months ago

Unfortunately instead of trying different solutions, they just theorise about different solutions.

UnHerd Reader
UnHerd Reader
8 months ago

Terrifying, its destroyed much of the youth in the U.S and crushed communities.

Carmel Shortall
Carmel Shortall
8 months ago

‘Problem.’ Reaction. ‘Solution.’ And the answer is… MORE SURVEILLANCE!

Now they’re going to surveil our pee and poo?? And that’s a good thing? Off to research the Manhattan Institute…

Roddy Campbell
Roddy Campbell
8 months ago

No fentanyl in Singapore. So, it boils down to a single choice:
Do we want fentanyl – or do we want to virtue-signal?

UnHerd Reader
UnHerd Reader
8 months ago

Would be great to address the root causes of opioid (and substance abuse in general) . These rapidly rising numbers are driven by poverty, the increasing atomisation of humans, the decline of community, inequality in incomes , declining social protections etc. all of which are leading to people to lean on crutches. If it’s not opioids it’ll be alcohol, porn, Netflix, social media, suicide.
problems that can’t just be solved by putting people in prison or whatever clever punitive measures we come up with (and conveniently blaming the individual as if they have control over these socioeconomic factors. Let’s not forget the tripling of mortgages and utility bills that just happened)

Singapore was strict AND addressed those root causes to an large extent. As it stands the U.K. institutions that could help address some of these issues have been stripped of the funding to do so. we’re in deep shit and bandaids alone will not work.