By Jenny Noyes
After years of having dodged the devastation caused by synthetic opioid abuse in North America, the revelation last week Australia has received its first-ever bulk shipment of fentanyl has sparked fears the nation’s luck is about to run out.
The discovery of 11.2 kilograms of pure fentanyl in a shipment of machinery that arrived in Melbourne from Canada has raised alarm among drug experts and police, who have long feared the entry of the lethal opiate onto Australia’s illicit drugs market.
John Ryan, chief executive officer of drug research and public health advocacy group Penington Institute, sees the discovery as “a canary in the coalmine alert that we’re going to see fentanyl imported illicitly in Australia”. And when that happens, he says, “we’ll be like lambs to the slaughter”.
The first-ever large shipment of fentanyl discovered in Australia has been called an “anomaly”. Credit: Australian Federal Police
Fentanyl, a powerful synthetic opioid, is so lethal that its discovery in February inside an industrial wood lathe shipped into the Port of Melbourne prompted Border Force to set up an exclusion zone, with paramedics on standby while AFP forensic officers in protective biohazard suits undertook the delicate task of removing the powder from the machine, careful to avoid skin contact.
While it’s impossible to know whether other shipments of the drug have made their way past the border, it’s common sense that authorities don’t intercept all illicit drugs that arrive. If criminal groups haven’t already, Ryan says it’s “inevitable” they will attempt it again, due to the profit opportunity of fentanyl, which is much stronger than heroin and easier to produce and traffic.
Yet to date, Australia has remained almost entirely untouched by fentanyl outside its proper medical use as a powerful painkiller administered during and after surgery, or to manage the chronic pain of cancer patients. Normally administered via patches or lozenges, there have been exceedingly rare accidental overdoses among patients, and slightly less rare examples from deliberate misuse.
Forensic officers in bio-hazard suits removing the illicit substances from the shipment.Credit: AFP
The 11 kilogram shipment is the first seizure of fentanyl in Australia larger than 30 grams, which makes it an “anomaly”, according to AFP forensics commander Paula Hudson.
“Australia’s illicit fentanyl market is small, and mostly served by pharmaceutical diversion and gram quantity dark web imports. At this stage, no other broad warning systems, including wastewater or overdose rates, indicate a substantial increase in the fentanyl threat.”
It’s a sharp contrast to the crisis besetting the United States, where opioid overdoses have caused half a million deaths in the two decades since 1999, according to the Centers for Disease Control and Prevention. It began with the rise in prescription opioid use and subsequent overdoses in the 1990s, followed by a rise in heroin use around 2010, as prescription drug users sought their fix on the illicit market amid a regulatory crackdown.
A third wave, which sent overdose deaths skyrocketing, came in 2013 with the introduction of synthetic opioids, and in particular the rise of illicitly manufactured fentanyl.
Centers for Disease Control and Prevention.Credit: https://www.cdc.gov/
Drug overdose deaths in the US have quadrupled since 1999 – and the crisis hasn’t slowed. From 2018 to 2019 alone, overdose deaths increased by 5 per cent, and those involving synthetic opioids rose by 15 per cent. Drug overdoses are now the leading cause of accidental death in the US, largely driven by opioids. In 2020, opioids were behind three quarters of 92,000 overdose deaths.
In the US and Canada, Ryan says, fentanyl has now overtaken heroin as the preferred drug of opioid addicts. But it’s also often consumed accidentally, and with fatal consequences: combined not only with heroin, but methamphetamine and cocaine, when dealers cut those drugs with fentanyl.
It’s not entirely clear why fentanyl is yet to make its mark on Australia, but Ryan suspects it’s because “we’re particularly a stimulant nation”, and organised criminals have “made an absolute fortune” by focussing their energy over the last 15 years on methamphetamine, or “ice”, and cocaine.
He’s now deeply concerned that it’s only a matter of time before fentanyl finds its way into Australian supplies of heroin, cocaine, ice and MDMA.
Ryan tells of speaking with a “shattered mother” in California only recently, whose 17-year-old son died at a party. “He thought he was having a line of coke, and it turned out it included fentanyl, and he died from a fentanyl overdose not intending to have any fentanyl whatsoever.
“There is a huge population of people who use drugs very infrequently, very occasionally, who don’t take significant quantities of drugs, but one dose of fentanyl laced cocaine is enough to kill.”
Hudson says the intended purpose of the bulk fentanyl imported to Melbourne remains “the subject of ongoing enquiries” and investigators “are unable to make an educated guess” as to what the criminal group behind it planned.
But it seems likely the drug would have been mixed with others for which there is an existing market. Nick Lintzeris, professor of addiction medicine at University of Sydney, says small business principles apply: If there’s a demand for heroin but not enough can be imported, “you then start to put other drugs into it like synthetics”.
Lintzeris doesn’t see a fentanyl crisis in Australia as a fait accompli, but says heroin use has been growing and “we would be foolish to not be prepared”.
But with “massive waiting lists for drug treatment services” that cost addicts money, and GPs groaning under pressure, Ryan says Australia is not at all prepared.
“There’s a huge population of Australians who are not currently having their opioid dependency adequately addressed,” he says, which means there is already a market for fentanyl.
Along with improving treatment access, both Ryan and Lintzeris want to see wider use of the overdose antidote naloxone. In July, the federal government launched its $19.6 million Take Home Naloxone program, which makes the drug available to people at risk of opioid overdose and their loved ones. Lintzeris says the program is a “ray of hope” but “still not as widely available as we want it to be”.
In Western Australia, police began a 12-month trial in July for carrying naloxone – something Ryan wants to see in all jurisdictions. But he’s frustrated that the government still appears to be “putting all our eggs in the law enforcement basket” and wants to see an overhaul of addiction treatment services as a priority.
A spokeswoman for federal health minister Mark Butler said questions about how the government plans to address the threat of fentanyl should be directed to Home Affairs.
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