A man who is an intravenous drug user says that there is a fentanyl epidemic among drug users in Iceland today. He says that three young men he knew died due to a fentanyl overdose last year. He says there very well may have been more. Fentanyl is a prescription-only drug.
Kristján Hafberg Einarsson, a 51-year-old man, claims to be an intravenous drug user who mainly uses amphetamine. With the help of doctors, he is trying to gain some control over his addiction. He is a regular at the ER due to his diabetes, which he was diagnosed with in 2008. His amphetamine addiction has, understandably, made his condition worse. He says that there is a fentanyl epidemic in Iceland.
„I knew three young men who passed away with not a lot of time in between them and I was just struck. I do not have a morphine addiction myself, but fentanyl truly is the biggest killer on the streets today. I really only know a fraction of the morphine addicts but I met these guys at the shelter and at half way houses.“
But what is this fentanyl drug? According to Lyfja.is, website for one of the largest drug store chains in Iceland, the drug in question is a pain reliever, related to morphine. Here is Lyfja’s description of the drug:
Fentanyl Actavis is a pain-relieving drug. The drug is related to morphine and works very strongly as a pain reliever, in addition to being a sedative. It is used for long-term pain that reacts well to morphine, for example pain due to cancer.
The drug should not be used to treat sudden pain or pain following surgeries. A tolerance can be formed, and increasingly larger doses of the drug therefore needed. It does however differ greatly between people how fast the tolerance builds up. There is some risk of addiction.
For Fentanyl Actavis, the active ingredient, fentanyl, is bound in a type of band aid that releases the drug steadily through the skin and into the bloodstream. That way, an even pain relief is achieved.
Please regard that if the patient develops a fever, more of the drug may travel from the band aid and into the bloodstream. If this happens, the patient needs to be kept under close watch and possibly a smaller dose is required. The area on which the band aid is placed should not heat up.
Kolbeinn Guðmundsson, former head doctor of the Icelandic Medicines Agency, stated in an interview with Vísir in 2016 that fentanyl was one of the strongest pain relievers in Iceland. „This is one of the strongest pain relievers on the market. Fentanyl is about 100 times stronger than morphine, if we measure it milligram to milligram, and about 50 times stronger than even heroin. So obviously, this is a very powerful drug, and therefore a dangerous one.“
According to Kristján Hafberg, there is a lot of fentanyl on the market. He sees it quite clearly on Telegram, which is a messaging app commonly used for black market business, where you can remain anonymous. „I know that there is quite a lot of oxycontin coming in from Spain, because the doctors there are very willing to prescribe it to people, so this may very well be coming from over there. But if these drugs are commonly being prescribed by Icelandic doctors and reaching the drug market from there, then that is of course a huge scandal.“ Kristján says that one can make large sums of money by selling morphine-related drugs on the black market. „I could easily sell the drugs that I own for a few hundred thousand, this is big money.“
In 2018, Svandís Svavarsdóttir, Iceland’s Healthcare minister at the time, was asked by a journalist at RÚV whether requests for doctors not to over-prescribe had not been fully heard, and whether it was being monitored which doctors are over-prescribing these morphine-related drugs.
„This is one of the things that we are looking at, and even though we try to maintain that we are dealing with comparable issues to the countries closest to us, it has become quite clear that we are prescribing way too much of psychiatric drugs and pain relievers in Iceland. The quantity may even be double compared to the other Nordic countries. It does not matter how much we try to explain the reasons that these drugs are being prescribed, no matter what, this cannot be the situation we want to be in. So yes, this is something that needs to be examined,“ Svandís said.
She also added that there were examples of doctors in Iceland losing their license for overprescribing these drugs.
This article was originally written in Icelandic by Björgvin Gunnarsson.