--:-- [Theme music fades out]
--:-- Jessica Mendoza: Welcome to The Journal, our show about money, business, and power. I'm Jessica Mendoza.
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--:-- Jessica Mendoza: There's a drug that's fueling a growing crisis of overdose deaths. And it's not fentanyl. A new substance is emerging in illicit drug markets. It's the most deadly drug you've probably never heard of. It's an opioid called nitazines.
--:-- [Audio clip of a news report continues to play]
--:-- Jessica Mendoza: A synthetic opioid so potent that this makes fentanyl look weak. And it's been killing hundreds of people. Super strength synthetic opioid drugs linked to hundreds of deaths have been found in samples of fake medicines sold online.
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--:-- Jessica Mendoza: The drug has led to deaths and overdoses all over the world, from West Africa to Australia, even some in the U.S. But it's had the most impact in Europe. Europe for a long time has kind of evaded the type of opioid crisis that has hit the U.S. and that the U.S. has been suffering under for three decades now.
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--:-- Jessica Mendoza: That's our colleague Suna Rasmussen, who covers security and organized crime.
--:-- Suna Rasmussen: And once these nits and things started hitting the streets of Europe, and overdoses just shot up in those countries and those communities where they landed, I think a lot of people watching this stuff was concerned about whether this might be Europe's opioid moment.
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--:-- Jessica Mendoza: Welcome to The Journal, our show about money, business, and power. I'm Jessica Mendoza. It's Tuesday, August 12th.
--:-- Suna Rasmussen: Coming up on the show, the drug you've never heard of that's wreaking havoc across Europe. Nitazines are a synthetic opioid, like fentanyl. But unlike fentanyl, nitazines have never been approved for medical use.
--:-- Suna Rasmussen: Nitazines were developed in the 1950s, and they were never approved to market because they were found in trials to cause breathing difficulties. And that's maybe the main difference between nitazines and fentanyl, at least to understand sort of why nitazines, we only see them now, is that fentanyl does have a medical usage. You can get fentanyl on prescription in patches, for example.
--:-- Suna Rasmussen: As a synthetic opioid, nitazines are made in labs. Today, mostly labs in China. But it's much more powerful than other opioids. 50 to 250 times more powerful than heroin and up to 15 times stronger than fentanyl.
--:-- Suna Rasmussen: Let's try and visualize the amount of these drugs that are required for an overdose in what we call an opioid-naive person. That would be you and me, people I assume don't have like a sort of regular opioid habit, an adult of normal size.
--:-- Suna Rasmussen: So around 30 milligrams of heroin would usually be a potentially lethal dose. That amount of heroin takes up the size of the head of a matchstick. For fentanyl, just two milligrams can cause an overdose. For nitazines, it takes an even smaller amount.
--:-- Suna Rasmussen: The most common street nitazines in Europe at the moment, you'd only require one milligram, maybe only half a milligram to potentially overdose. We're talking, you know, a few grains of table salt. That's the amount. So incredibly small, vanishingly small amounts.
--:-- Suna Rasmussen: It's not something that you can really identify just by sight. Yeah, it's basically trace amounts.
--:-- Jessica Mendoza: In 2019, nidazine started showing up in drug seizures in Europe, and authorities took notice. Since then, hundreds have died from fatal overdoses.
--:-- Suna Rasmussen: Countries where heroin already has a significant foothold have been particularly vulnerable. Like Estonia, where nearly half of all drug-induced deaths since 2023 involved nitazines.
--:-- Suna Rasmussen: In the UK, during a period of over 18 months until January of this year, at least 400 people died. That's a lot of people in a country of the size of the UK.
--:-- Suna Rasmussen: And we should also say that those numbers are likely underestimates. Because testing for nitazines is so limited because people aren really aware of them.
--:-- Jessica Mendoza: Have you talked to anyone who knows someone who died from the effects of netazines?
--:-- Suna Rasmussen: Yeah, I spoke to Anne Jacques, who is a mother who lives in Wales and who, in the summer of 2023, was woken up when police knocked her door and told her that her 23-year-old son had died in his sleep in his student accommodation in London.
--:-- Suna Rasmussen: Her son, Alex Harpam, was a college student and rising opera singer. Here he is in a video he posted to YouTube. His mother said that he was healthy. In an interview with the BBC, she said that he occasionally took Xanax to help him sleep.
--:-- Suna Rasmussen: He was always having trouble sleeping, and this had got worse with his ADHD medication. And my hunch is he probably bought them to calm himself down and try and get some sleep, I think.
--:-- Suna Rasmussen: But the police found out that the Xanax Harpam took had come from the black market. Xanax is not that easy to get in the UK, so people will often buy them illicitly from drug dealers.
--:-- Suna Rasmussen: At first, authorities didn't think the black market Xanax was related to what happened. They attributed Harpam's death to something called sudden adult death syndrome, a type of heart attack.
--:-- Suna Rasmussen: But Harpam's mom didn't buy that. She's a medical professional herself, and she consulted with friends. And they recommended that she do some research into drug contaminants. And then she came across nitazines and specifically asked the coroner to test the tablets in her son's room for nitazines.
--:-- Suna Rasmussen: And then they came back months after his death and confirmed that there had been nitazines in these Xanax pills. So she essentially had to do her own research to be able to find out that that was the actual... Yeah, she told me she basically had to investigate her own son's death, yeah.
--:-- Suna Rasmussen: But this is something that really concerns health professionals here in the UK, is that one thing is that nitazines are in the heroin supply, because that's sort of the most, I guess, obvious place where it would be, and it's maybe a bit more predictable, but if it's also circulating and if it's also contaminating the supply of much more harmless medication, really, Valium and Xanax, that poses a whole other level of threat.
--:-- Suna Rasmussen: Most of the overdoses from netazines happened to people unaware they were even taking the drug. And that's because netazines are cut into other drugs, most commonly heroin. But it's also been found in popular party drugs like cocaine, ketamine, and ecstasy. Or, like in Harpam's case, Xanax.
--:-- Suna Rasmussen: If they're so potent and so deadly, why would drug dealers cut netazines into drugs in the first place?
--:-- Suna Rasmussen: It kind of depends on maybe what kind of drugs they're found in. Like, mostly netazines are found in heroin. And I think the reasoning there would be that you try to cut heroin with a contaminant that gives a similar effect to heroin, but it's much more cost-effective.
--:-- Suna Rasmussen: And if you get the dose right, you can increase your profits. And maybe I think the theory that people go by now is drug suppliers are experimenting with netizens to see how they can achieve an effect that mimics the drugs at a lower cost, maybe even sort of give people a stronger high at a lower cost.
--:-- Suna Rasmussen: That's at least the assessment from British law enforcement is that this is pure greed and drug suppliers are trying to maximize profits.
--:-- Jessica Mendoza: This kind of opioid crisis hasn't ravaged Europe the way it has the U.S. And there's a reason for that. The U.S. has suffered from this opioid epidemic since the 1990s, basically.
--:-- Suna Rasmussen: And there's two big waves of opioids that have hit the U.S. The first was in the 1990s, and it was fueled by aggressive marketing and private prescriptions of synthetic opioids.
--:-- Suna Rasmussen: And European medical practices are different. So you can't get synthetic opioids prescribed in Europe in the same way that you can in the U.S. Like Oxy you wouldn be able to get that prescribed there
--:-- Jessica Mendoza: Yes exactly Oxycontin was the big one in the U.S.
--:-- Suna Rasmussen: And then in the 2010s the second wave hit the U and that was fentanyl specifically
--:-- Jessica Mendoza: And that was because Mexican cartels began funneling fentanyl into the U
--:-- Suna Rasmussen: So those are the two big events
--:-- Jessica Mendoza: Since Europe didn't have Oxycontin or fentanyl circulating in its drug market, nitazines have filled a hole for synthetic opioids.
--:-- Suna Rasmussen: The UK government has said that this is the most dangerous time ever to take drugs, and that's partly because of nitzazines.
--:-- Suna Rasmussen: I spoke to a director of a British drug treatment organization here in the UK, and she said that nitzazines pose the biggest public health risk to British drug users since the AIDS pandemic in the 1980s.
--:-- Jessica Mendoza: So we've talked about where nidazines are coming from. We've talked about sort of the causes of why it's surging in Europe right now. But how are nidazines getting into Europe?
--:-- Suna Rasmussen: Yeah, so nidazines, interestingly, nidazines are not that difficult to get a hold of, it appears, and they're not that difficult to source.
--:-- Suna Rasmussen: Just how easy it is to get nidazines? That's next.
--:-- Jessica Mendoza: For this story, our colleague Suna texted a number of NitaZine's suppliers.
--:-- Suna Rasmussen: I asked him to read out one of those exchanges.
--:-- [Audio clip of a text message conversation plays]
--:-- Suna Rasmussen: Hello, can you send NitaZine's to Europe?
--:-- Suna Rasmussen: Hello, friend. Yes. How much do you need?
--:-- Suna Rasmussen: We used a bot to voice the supplier Suna was texting.
--:-- Suna Rasmussen: To the UK as well? Can you clear customs?
--:-- Suna Rasmussen: Yes, we can ship to the UK. We offer door-to-door delivery with double customs clearance and tax included.
--:-- Suna Rasmussen: Suna found the supplier online.
--:-- Suna Rasmussen: What's the max quantity you can send?
--:-- Suna Rasmussen: It depends on your needs. We use disguise packaging, which is very safe.
--:-- Suna Rasmussen: Large quantities can be shipped. Kilos?
--:-- Suna Rasmussen: After Suna sent that last message, the person on the other end responded with a picture of two boxes filled with bags of cat food.
--:-- Suna Rasmussen: The presumption is that they were filled with nidazines.
--:-- Suna Rasmussen: Suna found this person on a site called TradeKey, an online marketplace based in Pakistan.
--:-- Suna Rasmussen: Usually, businesses use it to import or export things like furniture and appliances between different countries.
--:-- Suna Rasmussen: But Suna learned it was really easy to find nidazines on the site too.
--:-- Suna Rasmussen: I just typed into the search bar, I typed in a couple of different types of netazines.
--:-- Suna Rasmussen: I typed in proto-netazines and isoto-netazines. And then I got like, the first time around, I got 88 different ads for this.
--:-- Suna Rasmussen: Wow. And they come complete with phone numbers for WhatsApp or Signal, Telegram, sometimes even an email.
--:-- Suna Rasmussen: And then I just started texting them and most people got back to me.
--:-- Suna Rasmussen: TradeKey said it has a zero-tolerance policy toward the sale of opioids on its site and has added nitazines to its registry of banned products.
--:-- Suna Rasmussen: And since Suna's story was published, those ads he found have been removed.
--:-- Suna Rasmussen: In his conversation with a drug supplier, Suna tried to learn more about how they were justifying their business.
--:-- Suna Rasmussen: I'm a reporter with the Wall Street Journal, and I reached out to you because I'm writing a story about nitazines.
--:-- Suna Rasmussen: Would you mind if I asked you a few additional questions?
--:-- Suna Rasmussen: Okay.
--:-- Suna Rasmussen: Nitazines are a highly potent and dangerous type of opioid. It's killed hundreds of people in Europe.
--:-- Suna Rasmussen: Do you have any reservations about selling these drugs, given how dangerous they are?
--:-- Suna Rasmussen: We are a legitimate manufacturer and only work with licensed pharmaceutical companies.
--:-- Suna Rasmussen: The dangers you mentioned are the results of misuse and abuse by individuals, not the product itself.
--:-- Suna Rasmussen: This question shouldn't be directed at me. You should be asking how your own country is managing this issue.
--:-- Suna Rasmussen: Why can't your own country control the misuse of drugs?
--:-- Suna Rasmussen: This is a little bit sort of boilerplate drug supplier.
--:-- Suna Rasmussen: Is that typically what they say?
--:-- Suna Rasmussen: I mean, Suna, I don't engage in text messages with drug suppliers very often, I've got to be honest with you.
--:-- Suna Rasmussen: Yeah I mean it a shifting blame right I mean when I used to report from Afghanistan I would sometimes go to poppy fields in Helmand and report on the poppy trade there
--:-- Suna Rasmussen: And I also spoken to Taliban fighters and later Taliban officials
--:-- Suna Rasmussen: And they would say sort of similar things, right?
--:-- Suna Rasmussen: They would say, well, if there wasn't a demand in Europe, there wouldn't be a market for us.
--:-- Suna Rasmussen: So, I mean, they're not wrong, right?
--:-- Suna Rasmussen: But also, it doesn't absolve them of responsibility, obviously.
--:-- Suna Rasmussen: And I mean, the other thing about the exchange was that the person didn't sound like they were worried about getting caught.
--:-- Suna Rasmussen: It was very straightforward. And like, here's how we're going to do it. We offer door-to-door delivery is really interesting.
--:-- Suna Rasmussen: So I don't know.
--:-- Suna Rasmussen: What do you make of that?
--:-- Suna Rasmussen: Yeah, no, totally.
--:-- Suna Rasmussen: It was very brazen. And also, there's nothing preceding that.
--:-- Suna Rasmussen: They didn't ask who I was.
--:-- Suna Rasmussen: They didn't ask for reference from a trusted customer or anything like that.
--:-- Suna Rasmussen: Just straight in offering to send netazines to Europe.
--:-- Suna Rasmussen: And I think that is kind of evidence of they work with impunity.
--:-- Suna Rasmussen: And I just took that as a sign that they weren't really worried about law enforcement clamping down on them.
--:-- Jessica Mendoza: The people that Suno was texting had phone numbers from Hong Kong or mainland China.
--:-- Suna Rasmussen: China is where most ingredients for netazines come from, just like fentanyl.
--:-- Suna Rasmussen: Recently, China has cracked down on fentanyl producers as part of trade negotiations with the U.S.
--:-- Suna Rasmussen: As a result, Suna says many drug suppliers in China could be turning to Europe to find a new market.
--:-- Suna Rasmussen: That's one going theory, at least.
--:-- Jessica Mendoza: We should caveat this by saying that this is still such a—we're still in the beginning of this wave of medicines hitting Europe, so law enforcement is still grappling with what's going on and the causes of it.
--:-- Suna Rasmussen: But yes, one theory is that because China has cracked down on precursors for fentanyl, suppliers might be pivoting into nitazines instead and then sending it into Europe.
--:-- Suna Rasmussen: So that is one ongoing theory.
--:-- Suna Rasmussen: And I think this speaks to the ability of drug suppliers to adapt to various restrictions that they might face in a changing drug market.
--:-- Suna Rasmussen: And while China has regulated certain kinds of nitazines, it hasn't been able to ban all of them.
--:-- Suna Rasmussen: And that's because if you just tweak the formula of a synthetic opioid a little bit, it kind of evades these controls.
--:-- Jessica Mendoza: As a European sitting in Europe, I think, you know, we for decades looked at the U.S. and saw how synthetic opioids ravaged America.
--:-- Suna Rasmussen: And Europe never really had this kind of problem.
--:-- Suna Rasmussen: And I and the other people, the other few people who follow Nitzitzin are watching to see whether this is Europe's opioid moment.
--:-- Jessica Mendoza: I guess we'll see now how vulnerable Europe really is to a big opioid epidemic and how serious the influx of opioids will be.
--:-- Suna Rasmussen: Do you think they could proliferate more here in the U.S.?
--:-- Jessica Mendoza: I don't think our American listeners should go into panic mode just yet.
--:-- Suna Rasmussen: The American market is already, to put it bluntly, is already saturated with fentanyl.
--:-- Suna Rasmussen: There has been rare good news on the fentanyl front in the US in recent months.
--:-- Suna Rasmussen: The number of overdose deaths has declined.
--:-- Suna Rasmussen: I think the main reason for that is better harm reduction, better access to treatment, better access to naloxone, this antidote that you can administer.
--:-- Suna Rasmussen: Better information.
--:-- Suna Rasmussen: But part of it could also be that China has sort of squeezed the supplies of precursors for fentanyl.
--:-- Suna Rasmussen: But drug traffickers and organized gangs, they are very good at adapting.
--:-- Suna Rasmussen: And netizens could be a way that they could adapt.
--:-- Suna Rasmussen: And American authorities are watching this to see if that's going to happen.
--:-- Jessica Mendoza: That's all for today, Tuesday, August 12th.
--:-- Jessica Mendoza: The Journal is a co-production of Spotify and The Wall Street Journal.
--:-- Jessica Mendoza: Additional reporting in this episode by Ming Lee.
--:-- Jessica Mendoza: Thanks for listening. See you tomorrow.
