Why Europe Doesn't Have a Fentanyl Crisis — and Why We Credit the Wrong Reason

The numbers are stark. In 2025, fentanyl and related synthetic opioids were involved in roughly 38,000 American overdose deaths. Across 16 reporting European countries in 2024, the total was in the low hundreds. Italy counted a handful.

A tidy explanation circulates to close that gap: Italy's mafias, protective of their customers and wary of police attention, have chosen to keep fentanyl off the market. It's a great story. It's almost certainly wrong — and understanding why it's wrong teaches you a mental habit you can use far beyond drugs.

The model: we attribute absence to a decision, not to missing pressure

When something doesn't happen, people instinctively look for someone who decided it wouldn't. We imagine a gatekeeper who surveyed the situation and said no. This is a close cousin of what psychologists since Lee Ross (1977) call the fundamental attribution error — the tendency to explain outcomes by the intentions of an actor and to underweight the situation they're in. Applied to non-events, it becomes an agency bias: a thin market, a quiet border, an untaken opportunity all get read as "someone held the line," when the truer explanation is that the underlying pressure was never there.

The corrective is economic and just as old: a market is two blades of one scissors — supply and demand. No amount of available product creates a market by itself; there has to be a population ready to buy. Before crediting a supplier's restraint, ask which blade is actually cutting.

Here, it isn't supply.

The mechanism: demand was manufactured in America, and never in Europe

America's opioid demand was, in effect, built. From the late 1990s, aggressively marketed prescription painkillers such as OxyContin created millions of dependent people through entirely legal channels. When prescribing tightened in the 2010s, the dependence remained. Those people moved to the illicit market — heroin first, then fentanyl, which is cheap, easy to smuggle, and so potent that a tiny quantity goes a long way. Suppliers who already ran heroin simply added a product to serve demand that already existed.

Europe never had that prescription wave. Opioids are prescribed far more cautiously, so no large population was cut off from legal supply and pushed to substitute. Heroin, meanwhile, never left — it remains Europe's most common illicit opioid, with settled supply routes, established users, and treatment services built around it. There is no mass of newly dependent people to funnel toward something new, and little reason for existing users to switch to an unfamiliar, far more lethal drug.

So the market for fentanyl in Europe is small because the demand is small. Supply decisions are nearly beside the point.

Why the mafia-veto story fails on its own terms

The veto theory needs two assumptions, and neither survives contact with evidence.

First, it treats organised crime as a single strategic actor that can assess a product, judge it too risky, and ban it nationwide. Italian mafias don't work that way. Groups like the 'Ndrangheta are loose federations of families acting on local opportunity. No one inside can impose a market-wide ban, let alone coordinate one across rival mafias and the many other criminal networks in Europe's drug trade.

Second, it credits these groups with restraint they've never shown. They are central to Europe's cocaine trade; their defining trait is adaptation to whatever sells, not squeamishness about harm. Two recent Calabrian cases make the point: police found ten hidden cannabis plantations with drip irrigation and automatic timers, and a clandestine cocaine refinery run by a transnational network with its own chemist. The lesson of both is that Italy's drug economy is not a closed shop. Independent operators can set up, process locally, and serve demand wherever it appears. If fentanyl demand existed, someone would meet it.

Fact versus interpretation

Fact: the death figures, the prescription history, the persistence of heroin, the Calabrian seizures. Interpretation: that weak demand is the primary cause. It is the reading that best fits the known mechanics of both markets and mafias — but Europe's opioid scene is shifting, so treat it as the strongest current explanation, not a certainty.

Where else this shows up

Once you can name the bias, you see it everywhere. A company assumes a rival "chose not to" enter its market, when really the market was too thin to bother with. A government credits tough border enforcement for low smuggling, when demand was low all along. A manager believes a problem employee is "finally behaving," when the situation that triggered the behaviour simply disappeared. Attributing an absent outcome to a deliberate decision flatters the supposed decider and hides the real driver. Before you hand anyone credit — or blame — for something that didn't happen, check whether the underlying pressure was ever present.

What to watch

The genuine risk is not a mafia changing its mind. It is new synthetic opioids — nitazenes in particular — already circulating in Europe, and the chance that demand conditions change. If this model is right, the effective defences are public-health ones, not policing: drug monitoring, early-warning systems, drug-checking services, and easy access to naloxone, the overdose antidote.

Expectation: ~70% that over the next three years European synthetic-opioid deaths rise meaningfully but stay an order of magnitude below US levels — because the dependent population that drove America's crisis still does not exist in Europe, and the current rise is coming from supply-side novelty rather than new demand. Watch for the reverse signal: a sharp, sustained rise concentrated among new users would falsify this and mean demand, not just supply, has shifted.

Distilled from The Conversation