It is near impossible to discuss the drug landscape today without the mention of one word: fentanyl.
The drug is responsible for the deaths of hundreds of thousands of people, and experts warn that it is increasingly being found in - or en route to - Australia.
Is Australia facing a fentanyl crisis in our future? And are we prepared for if or when it arrives on our shores?
What is fentanyl?
Fentanyl was created in 1959 as a form of powerful new pain relief, and is 100 times stronger than morphine. For decades it was used by medical professionals for pain management, with high rates of success. However, by the early 2000s, illegally manufactured versions began to widely circulate in the illicit drug market, and between 2005 and 2007, the drug was linked to over 1000 overdose-related deaths in America.
Almost 20 years later, fentanyl has saturated the illicit drug markets in America and Canada. It is killing hundreds of people per day, and is the leading cause of death for Americans ages 18 to 49.
The potency of the drug not only makes it incredibly dangerous, but also very appealing to drug smugglers.
The Iron Law of Prohibition
The Iron Law of Prohibition theorises that the criminalisation of drugs fuels the production, distribution, and consumption of increasingly potent and dangerous forms of drugs. As police crack down on drug production and shipments, drug smugglers move toward more potent drugs that are easier to hide and transport - maximising profits whilst minimising risk.
We have seen this occur in America during alcohol prohibition and the market dominance of 75% alcohol moonshine; the rise of crack cocaine in the 1980s; and, closer to home, the explosion of methamphetamine use. Fentanyl is yet another example of this phenomenon taking place in North America, where it has replaced heroin as the opiate of choice for dealers and users alike. And there are many warning signs that Australia is not far behind.
Warning signs for Australia
Fentanyl is already becoming increasingly prominent in Australia. Last year, the Australian Federal Police seized the largest shipment of fentanyl in the country: enough for 5 million doses. Usage rates are also increasing, and recent wastewater analysis reports show high levels of fentanyl use (illicit and licit) in Queensland, South Australia, and the ACT.
Patterns of drug production are also shifting worldwide, and will continue to impact Australia’s illicit drug market.
Fentanyl is cheaper and easier to produce and can be made in makeshift laboratories because it does not rely on organic production.
The Taliban have recently banned opium production in Afghanistan – the producer of 80% of the world’s heroin supply. Experts warn that once heroin supplies begin to dry up, fentanyl will take its place.
Of greater concern is the shift in drug production in Laos, Thailand, and Myanmar, where most of Australia’s heroin is made. The countries’ close proximity to China – the world’s largest producers of fentanyl and its precursors – has made fentanyl an attractive alternative for drug syndicates.
Huge fentanyl hauls have been seized in recent years, and it likely won’t be long until the drugs begin to reach Australian shores.
Is Australia prepared?
Harm reduction experts and law enforcement usually disagree, but they can agree on one thing: Australia must brace itself for the inevitable arrival of the drug.
So how prepared are we?
Although we like to boast about our healthcare system, the reality is that many Australians with problematic drug use already struggle to access harm reduction services.
People with opioid use disorder face barriers when trying to access opioid replacement therapy such as methadone treatment or a bed in a rehab facility.
A sudden surge in fentanyl-related cases could easily overwhelm Australia's existing support programs.
Despite the success of the first safe injection facility in Melbourne, the promise of a second facility has yet to be fulfilled and new location suggestions continue to face public resistance.
When fentanyl does arrive, drug users are unequipped to keep themselves safe. Drug testing programs remain a controversial topic, and governments continue to refuse widespread implementation.
Fentanyl test strips: A necessary tool
Being able to detect the presence of fentanyl in other drugs will become a vital tool in the fight against the drug. Fentanyl test strips are a quick and easy way to detect fentanyl at home, but they are still not easily available to purchase within Australia.
Without access to these harm reduction resources, it will be impossible to detect fentanyl in other substances such as MDMA, heroin, and cocaine.
And it won’t be uncommon to hear horror stories like those happening in the U.S., where three young New Yorkers lost their lives to a fentanyl overdose on the same day after ordering what they thought was cocaine from the same drug dealer.
At Drug Policy Australia, we understand the need for these resources, and have fentanyl test strips available to purchase on our website with free shipping Australia wide.
It's time to act
As the threat of a fentanyl crisis looms large over Australia, it is time to confront the harsh reality – we are not adequately prepared.
Although we are moving in the right direction, we are not moving fast enough.
The time to act is now, for the consequences of inaction could be catastrophic.
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