Italy's Low Fentanyl Crisis Linked to Mafia Control of Drug Markets

Italy has remained largely insulated from the fentanyl epidemic that has devastated drug users across North America and parts of Europe. Researchers and analysts suggest that organized crime groups, including the Mafia, may be a key factor in keeping the synthetic opioid out of the country. Criminal organizations that dominate Italy's drug trade are believed to prefer established substances like cocaine and heroin, which offer reliable profit margins and familiar supply chains. By controlling distribution networks, these groups may be effectively blocking the entry of fentanyl, which they have little incentive to introduce. The Economist reported on this paradox in September 2026, highlighting how criminal monopolies can inadvertently shape public health outcomes.