A new drug combination shows how quickly drug markets can change.
Helsingin Sanomat reported this week on a new and dangerous drug combination spreading in Canada. This is yet another example of how rapidly and unpredictably the drug market can change. When the strong opioid fentanyl is combined with medetomidine, a substance used in veterinary medicine, the consequences have been serious, particularly in the western Canadian province of British Columbia. Overdose cases have increased rapidly, and the phenomenon has also spread to Toronto and the United States, including Philadelphia.
The central problem is that the drug market is not stable or predictable. Substances are mixed, potencies vary, and users often do not know what they are actually taking. Even more worrying is that standard overdose antidotes do not work for all combinations. This makes situations even more dangerous.
But the situation in Canada is not just a Canadian problem. It is a global problem that also concerns Finland.
Finland is not safe
It is a mistake to think that similar developments could not affect Finland. International drug markets operate across borders. Synthetic opioids and new pharmaceutical derivatives move quickly from one country to another. What appears in Canada today may appear tomorrow in Europe and Finland.
In Finland, drug-related deaths have long been high relative to the population. The current substance policy model relies heavily on control and the criminal justice system. However, it has not succeeded in preventing the availability of substances or eliminating their use. Instead, use has moved increasingly out of sight and at the same time become more dangerous.
When use takes place in hiding, without knowledge of what substances contain and without a safety net, the risks increase. If a combination similar to fentanyl and medetomidine were to appear on the Finnish market, would we be ready to react quickly?
The honest answer is: we would not.
Finland’s substance use service system is already under serious strain, and the strong emergence of alpha-PVP on the Finnish drug market has exposed the inadequacy of our policies in a troubling way.
Prohibition alone does not protect lives
Drug policy has traditionally been built on the idea that strict control reduces use. Reality is more complex. Prohibition does not prevent substances from being developed, it does not prevent them from being mixed, and it does not stop new and even more dangerous compounds from entering the market.
At worst, it can increase risks: when the contents of substances are not monitored, users operate in complete uncertainty. Synthetic opioids are an extreme example of this— even a small dosage error can be fatal.
If our goal is to reduce deaths, the measure of policy must be the preservation of human lives, not symbolic toughness.
Drug checking and consumption rooms are preparedness, not approval
One key way to reduce risks is drug checking. The ability to analyze what a substance sold on the street actually contains could reveal dangerous combinations in time. It would also create a real-time understanding of the situation for authorities and healthcare services.
Another internationally studied measure is supervised consumption rooms. Their purpose is not to encourage use, but to prevent deaths and enable health advice and rapid first aid. At the same time, they provide contact with social and health services, often as the first step toward treatment.
This is about risk management. The same logic by which we accept seatbelts in cars or needle exchange services to prevent infectious diseases. We do not approve of accidents or illnesses, but we reduce their consequences.
Courage is measured now
Canada’s crisis shows that the drug market can become far more deadly in an instant. We have a choice: do we react only after tragedy, or do we build a system capable of anticipating and minimizing harm?
Finland is not protected from such situations either—at least not with the current substance policy model.
If we want to prevent clusters of deaths like those seen in Canada, we must have the courage to update our policies. Drug checking, supervised consumption rooms, and a stronger harm reduction approach are not ideological concessions; they are pragmatic responses to reality.
In the end, the question is not about drugs.
The question is how many lives we are willing to lose before we change course.