Fentanyl is a synthetic opioid that is approximately 50 times more potent than heroin and 100 times more potent than morphine.
Fentanyl is classified as a Schedule II narcotic, meaning it has a high potential for abuse and limited medical purposes, such as for treating severe pain in a hospital. Its recreational use remains illegal.
The increasing prevalence of illicit fentanyl has contributed to an unprecedented number of overdose deaths––just 2 mg of fentanyl, the size of 10-15 grains of table salt, can be a lethal dose.
The number of annual users has more than doubled since 2019, when 269,000 people misused it.
Among those 18 or older who misused a pain reliever in 2021, 20.9% misused fentanyl.
That same year, 2.58 million Americans used fentanyl, illustrating how many do in fact use it and receive it in a controlled medical setting with minimal side effects.
Prescription diversion, counterfeit pills
Combined with other opioids, cocaine, methamphetamine, marijuana – you get the idea
The numbers are growing exponentially
Desirable: 50 to 100 times more potent than morphine, and people are seeking it out
Profitable: cheaper and easier to obtain than other opioids
Deadly: especially when unanticipated presence in other drugs
In 2021, there were 1.06 million opioid-related emergency department visits, of which 124,000 were fentanyl-related, according to the Drug Abuse Warning Network.
Approximately 63% of the patients who had a fentanyl-related emergency department visit were between the ages of 26 and 44––a negligible percentage were below the age of 18.
Additionally, 66% were male and 67% were white. Methamphetamine, heroin, alcohol, cocaine, and marijuana were the five substances most commonly involved with polysubstance fentanyl-related emergency department visits.
4 out of 10 pills contain enough fentanyl to be lethal (2mg – a small mosquito)
77% of teen overdoses involve fentanyl
Fentanyl deaths increased by a factor of 2.7 (almost tripled!) in just one year
Naloxone. Administered to reverse an overdose, with multiple doses often required.
One recent study indicated a 79.8% positive test rate for the drugs tested, so we know Fentanyl is extremely prevalent. Almost half of the individuals either disposed of the drug or reduced its dose based upon the positive result. The remaining half did nothing. Where people are seeking out Fentanyl, they remain undeterred by tools like fentanyl testing strips. Here are the responses from that studySource: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-018-0252-8
In 2021, there were nearly 108,000 overdose deaths, of which more than 71,000 were caused by synthetic opioids, with fentanyl as the primary cause, compared to nearly 58,000 in 2020.
There were 4,697 reports in 2014, compared to 117,045 in 2020 and 153,949 in 2021.
Additionally, theyfound, “Fluorofentanyl reports increased from 2 reports in 2016 to over 10,000 reports in 2021.” Fluorofentanyl is more potent than fentanyl.
In 2022, U.S. Customs and Border Protection (CBP) seized 14,700 pounds of fentanyl, up from 11,200 in 2021 and 4,800 in 2020.
Similarly, in 2022, the Drug Enforcement Administration (DEA) seized 50.6 million “fentanyl-laced, fake prescription pills” and more than 10,000 pounds of fentanyl powder––they announced that “these seizures represent more than 379 million potentially deadly doses of fentanyl.”
In August 2023, Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, designated the combination of fentanyl and xyalzine, an animal sedative also known as “tranq,” an emerging drug threat.
They announced that the Biden-Harris Administration “will take steps to publish a whole-of-government response that includes evidence-based prevention, treatment, and supply reduction.”
The DEA reported that 23% of seized fentanyl powder and 7% of fentanyl pills contained xylazine in 2022.
In August 2022, the DEA warned the public about “rainbow fentanyl,” stating, “this trend appears to be a new method used by drug cartels to sell highly addictive and potentially deadly fentanyl made to look like candy to children and young people.”
Fentanyl pills are increasingly being sold in different colors, shapes, and sizes, potentially to mimic the appearance of candy.
Close the treatment gap and encourage individuals with a substance use disorder to seek treatment, helping to reduce demand for illicit fentanyl in the short term
Invest in evidence-based prevention programs, as well as awareness campaigns, helping to reduce demand for illicit fentanyl over the long term
Increase the adoption of drug courts, which provide individuals who come into contact with the criminal justice system an alternative to incarceration that emphasizes abstinence and recovery
Target efforts to vulnerable populations, including unhoused individuals and those with mental health issues, who may be more likely to misuse illicit drugs
Adopt stricter drug controls on the precursor chemicals used to produce fentanyl
Adopt stricter measures to secure the US-Mexico border and prevent illicit drugs from being trafficked, which will help reduce the supply of illicit fentanyl in US communities
Increase access to Narcan, also known as naloxone, which can reverse overdoses caused by opioids
Increase access to fentanyl test strips, which can inform drug users whether their drugs contain fentanyl
The DEA’s 2020 National Drug Threat Assessment noted, “Mexican transnational criminal organizations continue to supply most of the cocaine, methamphetamine, heroin, and fentanyl smuggled into the country, while violent street gangs dominate the retail sale and distribution of these illicit drugs at the local level.” They added, “Mexican TCOs [transnational criminal organizations] have established clandestine laboratories in Mexico for the synthesis of fentanyl, and Mexican authorities have encountered a rise in illegal fentanyl pill press and tableting operations.” Fentanyl is oftentrafficked across the US-Mexico border and distributed throughout the country, where it is then sold by local dealers.
They also reported, “The spread of fentanyl-laced counterfeit pills in the United States is likely due to Mexican TCOs seeking to further distribute fentanyl into prescription opioid user populations as there is no licit production of pills containing fentanyl.”
Moreover, “Since at least 2019, Mexican TCOs’ supply to the U.S. fentanyl market is increasing while supply of fentanyl directly from China to the U.S has decreased substantially.” The DEA also reported, “TCOs use a combination of methods to obtain chemicals used for fentanyl production in Mexico, primarily from sources originating in China, including purchases made on the open market, smuggling chemicals hidden in legitimate commercial shipments, mislabeling shipments to avoid controls and the attention of law enforcement, and diversion from the chemical and pharmaceutical industries.”
Further, the DEA noted, “The primary fentanyl threat to the United States is most likely the Sinaloa Cartel due to their demonstrated ability to run clandestine fentanyl synthesis labs in Sinaloa Cartel dominant areas in Mexico,” adding that the Cartel Jalisco Nuevo Generacion “is a polydrug trafficking group, manufacturing and distributing large amounts of fentanyl, heroin, methamphetamine, and cocaine.”
Source: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-018-0252-8