The EU should prepare for the consequences of a future heroin shortage, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has warned, following the Taliban crackdown on opium in Afghanistan.
In 2022, the Taliban announced a ban on the cultivation of opium, previously a mainstay of the Afghan economy. The UN Office on Drugs and Crime (UNODC) estimates there has been a 95% decline in production since the ban was introduced.
“The analysis of satellite images shows that this ban is being implemented,” said Alexis Goosdeel, director of the EMCDDA.
“What we know is that there are still stocks available, either in Afghanistan or along the heroin route, so we can expect that it will take some time before we can observe a decrease on the market.”
However, Goosdeel says that there are already signs in some EU member states, or in the UK, that there is a shortage in supply.
Presenting the most recent annual report of the EMCDDA, he said: “The question is what will happen next? The risk is that those who are using heroin will switch to drugs that are cheaper, easily produced and much more dangerous than heroin. Some of them can be 700 times more potent than morphine.”
The United States has seen a dramatic increase in deaths due to opioid overdoses linked to fentanyl derivatives, but Goosdeel said it was difficult to predict what substances people will turn to in the EU,
“Twenty years ago when there was a similar shortage, we saw that the behaviour of drug users was very different from one country to another.”
In 2023, six new ‘nitazene’ synthetic opioids were reported to the EU’s Early Warning System for the first time. They have been linked to sharp rises in deaths in Estonia and Latvia. However, their presence may not be detected in post-mortem toxicology tests in some countries, so deaths linked to this opioid may be underestimated.
Goosdeel said the agency will present advice in July to encourage states to prepare.
A key element is to expand access to opioid agonist and related support treatments. It is also important to have sufficient access to Naxalone, a medicine that rapidly reverses an opioid overdose, to prevent overdoses and adjust guidance to its use to take account of the greater strength of synthetic opioids.
Heroin is the most commonly used illicit opioid in Europe and is responsible for a significant share of the health problems associated with illegal drug use. Unlike cocaine use, which is booming, heroin is used by older groups and there are fewer new users.
Polysubstance drug abuse on the rise
A key message that the report highlights is the growing complexity of drug use.
Like for opioids, there are complex drug cocktails that are increasingly in use, with benzodiazepines mixed with opioids, cocaine mixed with alcohol and semi-synthetic cannabinoids mixed with natural cannabis, to name but a few.
According to the report, “one of the challenges facing drug surveillance in 2024 is to gain a deeper understanding of what drugs are actually being consumed and in what combinations”.
The EU’s Home Affairs Commissioner Ylva Johansson described the report as a vital resource for policymakers, “We need to be vigilant; we need to be prepared,” she said.
[Edited by Zoran Radosavljevic]