The Fentanyl Story the Wires Say Does Not Fit the Mafia

The Conversation published an analysis this week taking apart a story that has circulated widely: that Italy's mafia groups have chosen to keep fentanyl out of Europe, wary of a drug that kills their customers and draws police attention. The piece does not dispute the premise that Europe's fentanyl toll is low. It disputes the explanation. In 16 countries reporting data, fentanyl and its derivatives were linked to around 210 drug-induced deaths in 2024, up from about 130 in 2023, and most of that rise may involve medicines rather than illicitly made fentanyl. In Italy, the government's latest report on addiction counted only five fentanyl-related deaths in 2025.

The comparison the analysis draws is with the United States, where fentanyl and other synthetic opioids were involved in around 38,000 of roughly 70,000 overdose deaths recorded in 2025, according to the Centers for Disease Control and Prevention. The Conversation's argument is that America's crisis was largely manufactured: from the late 1990s, aggressively marketed prescription painkillers such as OxyContin were handed out widely with their addictive potential played down, and millions developed opioid dependence through legal channels. When access was tightened in the 2010s, that dependence moved to the illicit market.

Europe, the analysis says, never had an equivalent prescription wave. Opioid painkillers are prescribed far more cautiously, so there was no large population suddenly cut off from a legal supply and looking for a substitute. Heroin never went away either: it remains Europe's most commonly used illicit opioid, according to the EU Drugs Agency, historically sourced from Afghanistan and entering through the Balkans, and the market has proved resilient and stable.

That last point is the one with a Piemonte edge, though the source does not name the region and this desk will not pretend it does. The western Alpine passes and the Po valley sit on the freight geography of a continent whose opioid market the analysis describes as Balkan-routed and heroin-based. The Conversation's claim is about market structure, not about any particular border. Its relevance to northern Italy is that a stable heroin market is a stable criminal economy — one that does not need a new product to stay in business.

The analysis is also careful about what it is not saying. It notes that other potent synthetic opioids, notably nitazenes, have driven recent peaks in deaths in several countries, which is a warning against reading low fentanyl numbers as low synthetic-opioid risk overall. And it is explicit that the mafia-restraint theory, however cinematic, does not fit what is known about drug markets or organised crime. Organised crime, on this reading, follows demand; it does not police it.

For readers in the north, the practical takeaway is a measurement one. Italy's five reported fentanyl deaths in 2025 are a small number from a reporting system the analysis itself cites, not a guarantee. The Conversation's piece is an argument about why the number is low, not evidence that it will stay low. La Veduta will keep reading the foreign public-health and drug-policy coverage for the next data release rather than the next theory.