Why Fentanyl Is Still the Most Threatening Illicit Drug

Fentanyl powder in a glass jar.

The ravages created by fentanyl may not be obvious to you as you walk down the main street of your town. But factually, in some strata of life in America, fentanyl is creating unprecedented devastation. This drug (actually a family of drugs) is taking as many as 78 lives every day. That means that across America, 78 families are losing loved ones every day. EMTs or other first responders are being called out many more times than this each day to administer naloxone, the antidote to opioid overdose. This antidote enables them to save some but they lose many.

I shudder to think what our overdose rate would be if we did not have this antidote. If we didn’t, I don’t believe we would see the modest decreases in overdose deaths that we have seen over the last year or so.

This drug presents such a massive threat to health, happiness and security in America that I believe it is important to stay informed on what developments are taking place in relation to its production, trafficking and effects on human lives.

Law Enforcement Efforts to Seize This Drug

Of course, law enforcement is making serious efforts to find and seize this drug and they succeed often enough to paint an alarming picture of the quantities of drugs coming into the U.S. from Asia or Mexico. Most of the drug is manufactured by Chinese pharmaceutical companies. Huge shipments leave China for Mexico where it is trafficked in to the U.S. on established routes. Chinese chemical companies also ship precursor chemicals to Mexican traffickers to they can turn them into fentanyl. And it’s mind-bogglingly easy to buy fentanyl directly from Chinese sellers and have it shipped via postal services.

So while it can be difficult to find and seize this drug, here are some of the recent seizures that did occur:

  • In July, a former Amarillo, Texas police officer was charged with transporting 72 pounds of fentanyl.
  • On August 22, the Drug Enforcement Agency announced that so far in 2019, they had seized 1,138,288 illicitly manufactured fentanyl pills in the Arizona region alone. (Compare that to the 380,000 pills that were seized in all of 2018.)
  • In September, Customs and Border Patrol agents reported that they had seized 2,400 pounds of fentanyl as of the end of August 2019 which is enough to kill 475 million people.

Pills or Powder

Pills and powder drugs.

Why are there fentanyl pills on the illicit market? Fentanyl pills are the result of drug traffickers binding fentanyl powder into pills that resemble commonly abused prescription drugs like OxyContin or Vicodin. Those pills seized in the DEA’s Arizona region were probably the result of shipments of fentanyl powder or fentanyl’s precursor chemicals being shipped to cartels in Mexico. These products are used to create counterfeit prescription drugs which are then trafficked into the U.S. on their usual channels. These pills are purchased by people who lack the money or doctor’s approval to get their preferred pills to abuse.

Powdered fentanyl is often added to heroin, of course, to give it more kick. But fentanyl is also found in cocaine, methamphetamine, and MDMA (Ecstasy). People buying these drugs aren’t intending to purchase or consume fentanyl so it is easy for them to overdose on this powerful ingredient.

Of course, some people seek out fentanyl, too. But when a person seeks out fentanyl, at least they know what they are dealing with and can be appropriately cautious.

Our Losses to This Drug

No matter what law enforcement agencies do, the rate of loss to this category of drug has climbed dramatically as production and supplies have increased.

  • In 1999, the rate of loss to synthetic opioids was 0.3 deaths per 100,000 Americans.
  • By 2013, this rate had tripled to 1 per 100,000 people.
  • In 2014, it was 1.8 per 100,000.
  • In 2015, it was 3.1 per 100,000.
  • In 2016, the rate doubled again to 6.2.

This means that the rate of death increased by a factor of 20.6 between 1999 and 2016.

In this chart from the Centers for Disease Control and Prevention, you can see how much our losses from fentanyl have outstripped our losses to any other drug on the illicit market in America. Look at the yellowish line that rockets up in 2015.

OD graph

(The synthetic opioid category excludes methadone but includes tramadol, a pain reliever about one-fifth as strong as morphine. For comparison, fentanyl is typically 80 to 100 times stronger than morphine. It’s not that easy to overdose on tramadol.)

In all, the Centers for Disease Control and Prevention estimates that fentanyl was responsible for 28,466 deaths through the 12-month period ending May 2018. This is 28,466 families that will never get their loved one back again, just in this one twelve-month period.

Controlling the Production of Fentanyl

In 2017 and 2018, the Chinese government made some attempts to regulate the flow of illicit fentanyl but it appears that these attempts have had little effect. Why is it so hard to curb the production and trafficking of this drug?

China’s pharmaceutical industry is vast and lucrative. It’s a $122 billion industry with an estimated 160,000 pharmaceutical businesses operating legally or illegally. In addition to these businesses, more clandestine labs are run by Chinese criminal organizations using precursor chemicals from legitimate chemical companies. Precursor chemicals essential to the production of fentanyl are less likely to be monitored or restricted than finished fentanyl.

Fentanyl is easy and cheap to make and can be sold directly to buyers in the U.S. for huge markups. It’s easy to see why criminal elements in China and Mexico would be interested in trafficking this substance. It requires no plant components like marijuana, cocaine, heroin and many other drugs do. It’s purely a lab-created substance.

Is the intense trafficking of this drug the result of a deliberate assault on America? One exiled Chinese businessman says it is. Or is it the result of amoral greed on the part of Chinese pharmaceutical manufacturers and Mexican drug cartels? The answer to this question is so obvious it doesn’t even need to be spoken.

There are signs that pharmaceutical companies in India may be getting into the act as well. The very last thing we need is any more production of fentanyl, anywhere on the planet.

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


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.