Is Fentanyl Addiction America’s Number One Drug Problem?

Fentanyl addict

Fentanyl, the highly potent and addictive synthetic opioid pain reliever, has captured news headlines and American minds for several years. The drug is said to be 10 times more potent than heroin and 50 to 100 times more potent than morphine. With just as much fentanyl as can fit on a thumbtack, a user can overdose and die. Is that why most opioid deaths in the U.S. now involve fentanyl? And if that’s the case, why is fentanyl still used in medical settings?

While there is a wide range of addictive drugs that can cause harm in the U.S., fentanyl is “public enemy #1” as far as addiction problems go.

Fentanyl Defined

Fentanyl is a powerful synthetic opioid similar to morphine but much more potent. Fentanyl is a prescription drug made for medicinal uses, but it is also made illegally in clandestine drug labs. In medical settings, it is usually used to treat patients with severe pain, especially after surgery. It is also sometimes used to treat patients who are physically tolerant to other opioids. But even when it is used exactly as intended, fentanyl carries serious risks for addiction, as well as other side effects.

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body’s opioid receptors. Such receptors are located in the brain and control the body’s pain response. When someone takes fentanyl (or any opioid for that matter) several times, the body builds up a tolerance to the drug. This phenomenon diminishes sensitivity and makes it more difficult for the person to feel pleasure from anything besides the drug, and it also causes them to require more of the drug to get the same sensation from it.

Fentanyl Overdose Statistics

Girl in the hospital after overdose

As the human body builds up a tolerance to fentanyl, the user must take more and more of it to get the euphoric high they’ve come to expect from it. But every time fentanyl is used, the addict exposes themselves to risk for an overdose. According to the National Institute on Drug Abuse, “In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses. The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare.”

Sadly, overdoses involving fentanyl are becoming increasingly more common with each passing year. Again according to NIDA, synthetic opioids like fentanyl have been the main driver of drug overdose deaths, with a nearly 14-fold increase from 2012 to 2019. In 2012, fewer than 4,000 Americans died from fentanyl. But by 2019, more than 40,000 Americans were dying every year from the drug.

Fentanyl Seizures are on the Rise, Despite Efforts to Reduce Supply

As fentanyl addiction has surged, so has the market grown for illicit fentanyl. Drug cartels saw the demand for fentanyl go up, and before too long, illicit fentanyl was being made in clandestine drug labs in Mexico, the U.S., and overseas.

One of the metrics by which illicit fentanyl production is measured is by drug seizures. According to the journal Addiction, “U.S. Customs and Border Protection (CBP) has announced that 2.5 tons of fentanyl were seized between October 2020 and March 2021. This marks a continued increase in fentanyl seizures since 2014 and is more than three times the amount seized during the same period in the previous year.” A spike in fentanyl seizures strongly suggests that illegal fentanyl is being made to meet the rising demand of drug users who are sorely addicted to it.

As a side note, the Drug Enforcement Administration attempted to reduce the supply of fentanyl by putting a cap on legal fentanyl manufacturing and increasing its efforts to crack down on illegal fentanyl production.

Unfortunately, the pressure of the Covid-19 pandemic compelled the DEA to reduce its restrictions on fentanyl production. Again quoting an Addiction Journal news brief, “The U.S. Drug Enforcement Agency (DEA) has temporarily lifted a cap on fentanyl production. The Aggregate Production Quota (APQ) for fentanyl production was reduced by 31% in December 2019 to reduce supply in response to the opioid crisis in the U.S. However, fentanyl is commonly used when placing patients on ventilators and so there has been increased demand for fentanyl from medical practitioners since the beginning of the COVID-19 pandemic.” The allowance of an increase in fentanyl production may help Covid patients on ventilators, but it will undoubtedly also have the harmful effect of increased diversion of fentanyl into the hands of addicts.

Fentanyl is Being Mixed into the Supply of Non-Opioid Drugs

Paramedics at emergency call
Photo by gorodenkoff/

Fentanyl is increasingly being found in toxicology reports from not just opioid deaths but also for other drugs, like cocaine and meth. According to NIDA director Dr. Nora Volkow, “Overdose deaths involving methamphetamine started rising steeply in 2009, and provisional numbers from the CDC show they had increased 10-fold by 2019, to over 16,500. A similar number of people die every year from overdoses involving cocaine (16,196), which has increased nearly as precipitously over the same period. Although stimulant use and use disorders fluctuate year to year, national surveys have suggested that use had not risen considerably over the period that overdoses from these drugs escalated, which means that the increases in mortality are likely due to people using these drugs in combination with opioids like heroin or fentanyl or using products that have been laced with fentanyl without their knowledge.” This is highly concerning, as the effects of taking opioids at the same time as stimulant drugs like cocaine or meth can be extremely harmful even when not lethal.

Fentanyl is permeating the drug supply, causing untold harm and surges in overdose deaths every step of the way. If massive action is not taken to address the fentanyl problem, it will continue to spread into the supply of non-opioid drugs. Soon, even drug addicts who are actively trying to avoid fentanyl will be exposed to it.

The Importance of Treatment for Fentanyl Addiction

Fentanyl addiction is an extremely difficult and highly dangerous crisis of the mind, body, and soul. Because fentanyl is so potent, those who take it immediately put their lives in danger. Given that fentanyl overdoses are on the rise, and given that fentanyl is being added into other drug supplies and fentanyl trafficking is becoming more problematic, it seems safe to say that fentanyl is America’s #1 drug problem.

For these reasons and others, if you know someone who is experimenting with fentanyl, please get them into a drug and alcohol treatment center as soon as possible. Any incident of fentanyl use could be fatal.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP, LCDC



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.