CNN
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Fentanyl is a powerful synthetic opioid that can be up to 100 times stronger than morphine.
It can be prescribed in formal medical environments to relieve intense pain and treat severe pain when prolonged action analgesics are not enough. For example, injections can be used during or after surgery, while patches help treat persistent pain in patients who may have become tolerant of other treatments. It can also be administered through a slow solution pill.
However, fentanyl has become the most common drug in overdose deaths in the United States, feeding what centers for the control and prevention of US diseases (CDC) have identified as the “third wave” of the opioid overdose epidemic. Producing fentanil is relatively cheap and its high power allows the supply to pay more, which makes it attractive in the illicit market. The illegally produced fentanyl is usually found in the form of dust or pressed in false pills that mimic prescription opioids. It can also be mixed with other drugs, such as heroin, to increase power at a lower cost.
The US president, Donald Trump, is using the drug epidemic as a key justification for imposing tariffs on the goods from Mexico, Canada and China. An informative sheet of its administration indicates that “the flow of smuggling drugs such as fentanyl to the United States, through illicit distribution networks, has created a national emergency, including a public health crisis.” The general tariffs to Mexico and Canada were suspended for 30 days after these countries committed to reinforce border security, but a 10% tariff on goods from China entered into force in early February.
The United States imports the vast majority of medical fentanil from China, where it is sent directly in its final form.
The illicit fentanyl supply in the US also has its origin in China. Initially, this illegal supply was sent directly from China to the United States, but over time it has evolved towards more dispersed flows. Currently, there is no evidence that legal fentanil is being diverted to the black market. Instead, large cargoes of chemical precursors for illegal fentanyl production are sent from China to Mexico, where they are prosecuted in laboratories and the final product is introduced to smuggling in the US.
“Most precursor ingredients are quite basic chemicals with large-scale applications, so hiding shipments is not very complicated,” said Vanda Felbab-Brown, senior researcher at the Brookings Institute, who has led various initiatives on the epidemic of opioids and the global drug policy.
Mexican cartels depend on drug trafficking routes established for a long time, often using legal entry ports and recruiting US citizens such as mules.
Almost 10,000 kilograms of fentanil were seized at the borders of the United States during fiscal year 2024, according to data from the US Customs and Border Protection (CBP). Almost the whole – around 97 % – was confiscated on the southwest border, with seizures in Tucson, Arizona, which represented more than half, and another 30 % in San Diego.
In contrast, only some kilograms of fentanil were seized on the northern border with Canada last year, according to CBP data. Experts point out that illegal networks in Canada are almost completely separated from the US.
“We do not receive a significant amount of fentanyl from Canada,” said Vanda Felbab-Brown. “The small seizures that have been made on the northern border are mostly related to American citizens who buy fentanyl in Canada for personal consumption and then introduce it to contraband themselves.”
Although the unquality of illicit fentanyl by the authorities have increased in recent years, there are indications that the supply of the drug is changing again. According to experts, the drug epidemic is dynamic and the market can quickly evolve in response to different supply and demand factors, a phenomenon that has occurred for decades.
According to CDC, the first wave of the opioid overdose epidemic began in the 1990s with the abuse of prescription opioids. This year, Purdue Pharma and its owners, members of the Sackler family, reached a multi -million dollar agreement to resolve thousands of demands that alleged that the Oxycontin analgesic caused a generalized crisis of opioid addiction in the US.
As of 2010, heroin -related overdose increased rapidly, which CDC considers the second wave. But synthetic opioids – mainly fentanyl – took control around 2013.
The overdose shot during the Covid-19 pandemic, reaching a peak between the autumn of 2022 and the summer of 2023, when the CDC estimate that there were almost 115,000 deaths due to overdose in a year. Synthetic opioids, mainly fentanyl, were involved in approximately two thirds of those deaths.
However, overdose deaths began to decrease rapidly at the beginning of last year. Although fentanil is still present in most cases, the most recent data show that annual deaths have dropped 22% compared to the previous year. In the 12 months prior to August, about 58,000 deaths related to synthetic opioids were recorded.
Some experts suggest that a “fourth wave” of the opioid epidemic is underway, in which illicit fentanyl is mixed more frequently with other drugs, and the combination of fentanyl and stimulants can be especially dangerous. While opioid -related overdose deaths have decreased, which involve cocaine and psychostimulants such as methamphetamine have increased, according to preliminary data from CDC.
Experts point out that it is difficult to attribute the rapid decrease in overdose deaths to a single factor. On the other hand, it is probably the result of a wide range of persistent efforts that begin to generate an impact.
The changes in the supply began long before Trump’s tariffs were announced. In November, the US drug control administration (DEA) reported that it was finding lethal doses of fentanyl in less pills than the previous year. Approximately 5 out of 10 fentanyl pills analyzed by the agency last year contained lethal doses of the synthetic opioid, a reduction compared to 7 out of 10 of the previous year.
The drug samples analysis carried out by the Forensic Science Research and Education Center also showed a slight downward trend in the average purity of fentanyl powder, although the variation in drug supply remains high.
Under the administration of President Joe Biden, the US Department of Health and Human Services launched a national coordinated strategy to prevent overdose. These efforts have focused on reducing damage – such as the use of reactive strips to detect fentanyl, medications to reverse overdose and supervised consumption sites – as well as on the prevention, treatment and recovery of substance use disorders.
“Finally, dealing with this as a public health condition, after so many years of effort and care, can be beginning to bear fruit,” said Dr. Sarah Wakeman, senior medical director for substance use disorders in Mass General Brigham, in statements to CNN in September.
In a detailed analysis of the trends, the specialized scientist in street drugs Nabarun Dasgupta and his colleagues from the University of North Carolina found that non -fatal overdose have also decreased significantly and that trends are relatively consistent at the state level, signs that reinforce The confidence of experts in which the general trend is solid.
(Tagstotranslate) Fentanyl
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