The Mafia Did Not Keep Fentanyl Out of Europe, and Naples Knows Why

A striking explanation has circulated for why fentanyl has not ravaged Europe as it has the United States: that Italy's mafias, wary of a drug that kills their customers and draws police attention, have chosen to keep it out. Writing in The Conversation, an academic analysis argues that this theory does not fit what is known about drug markets or organised crime, and that Europe's comparatively low fentanyl numbers are better explained by something less cinematic — very little demand.

The figures the essay cites are stark. Fentanyl and its derivatives were linked to around 210 drug-induced deaths across the 16 countries that reported data 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 essay traces the American crisis to its root: 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 did not vanish; people turned to the illicit market, first heroin and then fentanyl, which is cheap to make, easy to smuggle and potent enough that tiny amounts go a long way. Trafficking groups already supplying heroin simply added a product to their range.

Europe never had an equivalent prescription wave, the essay argues. 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, meanwhile, never went away and remains Europe's most commonly used illicit opioid, according to the EU Drugs Agency, most of it historically from Afghanistan and entering through the Balkans.

For the South, the argument cuts against a familiar narrative. The romantic version — the Camorra as a kind of ruthless gatekeeper, protecting its market from a product too dangerous to sell — flatters the organisation and misreads its logic. Criminal groups respond to demand and to enforcement risk; where a market is thin, they do not need a moral code to stay out of it. The essay's point is that the absence of fentanyl in Italy is evidence about consumers and prescription practice, not about the conscience of the clans.

The essay also notes that other potent synthetic opioids, notably nitazenes, have driven recent peaks in deaths in several countries. That is the more useful warning for Campania: the danger is not a hypothetical shipment turned back at the port, but the arrival of a new synthetic into an existing heroin market. On that reading, the vigilance belongs in health services and prescribing practice as much as in the prosecutor's office. The Conversation's piece is an opinion analysis, not a report of a new operation or seizure, and it should be read as an argument about how Europe explains its own drug numbers.