The Fentanyl Story Europe Tells About Italy's Mafias, and Why It Does Not Fit

A widely repeated explanation for Europe's comparatively low fentanyl death toll holds that Italy's mafia groups have deliberately kept the drug out of the market, wary of killing customers and drawing police attention. Writing in The Conversation, an author argues that this does not fit what is known about drug markets or organised crime, and that the real explanation is simpler: there is very little demand.

The figures the analysis cites are stark. Fentanyl and its derivatives were linked to around 210 drug-induced deaths across 16 reporting countries in 2024, up from about 130 in 2023, and much of that rise may involve medicines rather than illicitly made fentanyl. Italy's own addiction report counted five fentanyl-related deaths in 2025. In the United States, by contrast, fentanyl was involved in around 38,000 of roughly 70,000 overdose deaths in 2025, according to the CDC.

The argument turns on how America's crisis began. Prescription painkillers were marketed aggressively from the late 1990s with their addictive potential played down, creating millions of dependent patients through legal channels; when access tightened, they moved to heroin and then to fentanyl. Europe, the analysis says, never had that prescription wave, and heroin remains its most commonly used illicit opioid.

The Conversation's piece is an opinion analysis rather than a report of a new event, and it should be read as such. Its value for readers in the South is that it takes a story the international press has told about Italian organised crime and tests it against the drug data, concluding that the story is cinematic rather than accurate.

The supply side of the argument is equally relevant to Calabria. The analysis notes that most of Europe's heroin has historically come from Afghanistan, entering through the Balkans, and that the market has proved resilient and stable even after Afghan opium cultivation collapsed following Taliban bans. Trafficking routes that run through the Balkans and across the Mediterranean are the terrain on which Calabrian groups have historically operated, according to the international coverage of their networks.

What the analysis does not do is name Calabrian clans, cite specific investigations, or describe any particular trafficking operation. It speaks of Italian mafia groups in general terms. That restraint matters: the temptation in this region is to accept the flattering version, in which the local criminal economy is credited with a kind of market discipline, and the less flattering version, in which the absence of a drug is evidence of a sophisticated conspiracy rather than of a public health system that never created the demand.

The policy consequence the analysis points toward is that Europe's defences against a fentanyl wave should be built around prescribing practice and surveillance of synthetic opioids such as nitazenes, which have driven recent peaks in deaths in several countries. Italy's count of five fentanyl-related deaths in 2025 is a figure to watch rather than a guarantee.

For a region that the world notices mainly for crime and boats, the piece is a reminder of how such narratives form. A claim about mafia restraint travels further than a table of prescription rates. The wire this week offers no evidence that Calabrian groups have taken any position on fentanyl at all, and the analysis argues there is no reason to think they have.