The synthetic opioid drug fentanyl, which has resulted in more than 100 000 deaths in the US this year alone, has made its way to South Africa, and, due to SA’s high levels of opioid use and dependence, it poses a threat.
The National Head for the Directorate for Priority Crime Investigation, Lieutenant General Godfrey Lebeya, warned on Sunday that fentanyl has entered the drug trafficking network in South Africa.
Lebeya said while it was known that traffickers were distributing dagga, cocaine, heroin, methamphetamine and nyaope, the highly potent synthetic opioid called fentanyl had recently entered the trafficking network.
“One kilogram of fentanyl has the potential to kill 500 000 people. As reported by the Drug Enforcement Agency of the United States, more than 107 000 Americans died of fentanyl overdose this year alone,” said Lebeya.
In July 2024, Lebeya said a suspect was arrested in Cape Town with fentanyl.
“He reported to have received this drug from someone in Johannesburg to try the market in Cape Town,” he said.
Board chairperson of the South African Network of People Who Use Drugs (Sanpud), Shaun Shelly, said there was no hard evidence that fentanyl addiction is present in KZN and the rest of the country yet; however, he warned that it was likely to occur.
Shelly said fentanyl was manufactured in a lab with no natural plant derivatives.
It is an analgesic for acute pain in post-operative pain management and is sometimes used in the management of severe chronic pain where people are intolerant or unresponsive to morphine, diacetylmorphine, or other synthetic analgesics.
“It is 100 times stronger than morphine and 50 times more potent than diacetylmorphine (aka heroin, nyaope, whoonga, unga),” he said.
Shelly added that one of his research projects tested samples of heroin from all over the country, and recently one community was found to have tested positive for fentanyl through urinalysis.
“We are hoping to verify the drugs they are using in due course. This was near Coega in the Eastern Cape,” he said, adding that the majority of fentanyl for unregulated markets comes from China.
Shelly further explained that the drug naloxone is used to reverse a fentanyl overdose, and the user will suddenly become alert again.
The KZN Provincial People Who Inject Drugs (PWID) coordinator said there was currently no access to fentanyl testing strips in the country, and having these testing strips available would save a lot of lives.
“Active drug users wouldn't necessarily know if their drug of choice contains other substances; this is merely because the drugs found on the streets have been mixed to bulk up their size for dealers to profit more,” he said.
Dr Andrew Scheibe, national technical advisor for TB/HIV care, who works with organisations like the Bellhaven Harm Reduction Centre (BHRC) in Durban, said there was widespread heroin use in SA.
“The increase of synthetic opioids in SA is very likely as we have high levels of opioid use and dependence in KZN and SA, and there has been a reduction of opium production in Afghanistan, and that gap in the market will be filled by opium from other areas and synthetic opioids,” he said.
South African Health Products Regulatory Authority (Sahpra) spokesperson Madimetja Mashishi said there are fentanyl-containing medicines registered in South Africa.
Madimetja said fentanyl-containing products, when intended for therapeutic use, are classified as Schedule 6 substances in the country.
He said fentanyl is used in the management of chronic pain and as a narcotic analgesic supplement in general or regional anaesthesia. It is available as an injection and as a transdermal patch.
“There are immediate health dangers relating to the abuse of opioids such as fentanyl, including the risk of death due to suppressed breathing and a slow heart rate resulting from constant use. Death may also occur due to overdosing,” said Madimetja.
The Mercury