TALLINN, Estonia (AP) — Igor Smirnov was introduced to opiates the day his first son was born, when he got celebratory drunk and a neighbor injected him with an intoxicating extract of opium poppies.
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Smirnov has lived the arc of illicit drug abuse in Estonia, a tiny Baltic state that for nearly two decades has battled a fentanyl epidemic so severe its overdose death rate was almost six times the European average.
Once fentanyl landed in Estonia, heroin disappeared. Even after poppies started growing again in Afghanistan and Estonian police choked off fentanyl supply in 2017, heroin didn’t come back. Instead, users turned to cocktails of other kinds of synthetic drugs, including amphetamines, alpha-PVP, a dangerous stimulant also known as flakka, and prescription drugs, harm reduction workers, users, public health officials and police told The Associated Press.
There are signs that the U.S. is on a similar path, tipping from plant-based drugs like heroin to synthetic ones like fentanyl and methamphetamine. That could herald big changes in global narcotics supply chains and cement the role of China -- an important source of illicit synthetic drugs -- as a vital link in the worldwide drug trafficking business.
“The trajectory is toward full synthetics,” said Daniel Ciccarone, a professor at University of California San Francisco School of Medicine, who researched heroin and opioid supply chains under a federally-funded study. “Name the major drug producers in world – Afghanistan, Colombia -- only people in the know would say China. Well, guess what? China.”
