America Must Address Its Other Epidemic: Fentanyl Overdoses

COMMENTARY Public Health

America Must Address Its Other Epidemic: Fentanyl Overdoses

Aug 2nd, 2021 5 min read

Commentary By

Alexander Phipps

Administrative and Research Assistant, Meese Center

Matthew Samilow

Summer 2021 Member of the Young Leaders Program at The Heritage Foundation

An officer from the U.S. Customs and Border Protection finds Oxycodon pills in a parcel at John F. Kennedy Airport on June 24, 2019 in New York. JOHANNES EISELE / AFP / Getty Images

Key Takeaways

The Centers for Disease Control and Prevention announced that a record 93,331 Americans died from drug overdoses in 2020.

Most of the U.S.’ supply of fentanyl comes from Mexico, where it is produced by cartels using precursor chemicals sourced from China.

The other major factor driving the increased supply of fentanyl is lax enforcement at the southwest border.

The Centers for Disease Control and Prevention announced that a record 93,331 Americans died from drug overdoses in 2020.

Some 75% of them involved opioids, the latest sobering statistic in the United States’ 2 decades old opioid epidemic.

Overuse and misuse of prescription opioids, and later heroin, drove the first two waves of the epidemic. Now the epidemic is in a deadlier third wave, caused by synthetic opioids, such as fentanyl, which is cheaper and easier to produce, as well as far more potent than its natural analogues.

The U.S. government must do more to combat illicit fentanyl importation into the country or else the opioid epidemic will only get worse.  

Unlike heroin, whose production requires large amounts of land to grow poppies, fentanyl can be produced in a laboratory and is a more lucrative investment.

One study estimates that “heroin appears to be at least 100 times more expensive than fentanyl in terms of [morphine-equivalent dosage] at the import level.” An investment of several thousand dollars in fentanyl can make a dealer millions.

Fentanyl is far more lethal than heroin because of its potency and because it is intentionally or negligently added to other drugs (like heroin or cocaine). It is 50 to 100 times more powerful than morphine and 10 to 20 times as potent as heroin. A mere 2 milligram dose can be fatal.

Most fentanyl users are unaware that they are even taking the drug. They tend to be heroin or cocaine users who are unaware that the Mexican cartels use fentanyl to cut their drug of choice, which are also white powders.

Doing so saves the cartel money and gives its product an extra “kick.”

As if using heroin or cocaine wasn’t dangerous enough, taking them now is like playing Russian roulette because of how often they are laced with fentanyl. Moreover, because the cartels use crude methods to lace their drugs, the amount of fentanyl in their products is not consistent.

As journalist Ben Westhoff notes in his book “Fentanyl, Inc.,” this “lack of dosage information, at root, is … the reason so many people are dying.”

Most of the U.S.’ supply of fentanyl comes from Mexico, where it is produced by cartels using precursor chemicals sourced from China.

While not intoxicants themselves, fentanyl precursors are the chemical building blocks used to manufacture the drug. Some have legitimate commercial, medical, or scientific uses, but are sometimes strictly controlled because of their potential for the production of illicit drugs.

A 2017 report by the U.S.-China Economic and Security Review Commission identified 16 known fentanyl precursors, though there are potentially many more.

Although China finally placed fentanyl and its analogues on its list of controlled narcotics in 2019, it has done little to limit the supply of precursor chemicals. There are multiple ways to produce fentanyl, and producers are continually modifying the processes they use in response to new chemical controls.

For example, 4-ANPP, a direct precursor to fentanyl, has been banned in the U.S. and China since 2010 and 2018, respectively. Producers figured out, however, that they could swap 4-ANPP with a different precursor that is still legal, called 4-AP, to create fentanyl.

According to a report from the Center for Advanced Defense Studies, 4-AP is an example of “‘masked’ precursors, or chemicals that are designed to disguise their relation to a scheduled substance.”

The relative ease with which fentanyl producers can change precursor chemicals poses a great challenge to regulators seeking to identify which chemicals should be controlled.

The bottom line, as the Drug Enforcement Administration reports, is that the cartels’ access to precursors and their ability to produce fentanyl have been undiminished, and the supply of fentanyl from Mexico has continued to increase.

That underscores the need for a multifaceted enforcement strategy.

At a recent event at The Heritage Foundation, “The Challenge of Fentanyl: The China-Mexico Connection,” Uttam Dhillon, a former acting administrator of the Drug Enforcement Administration, and James Carroll, a former director of the Office of National Drug Control Policy, recommended three significant policy changes to combat the threat of opioids.

  • Increase resources for law enforcement: Reducing supply saves lives, and doing so requires greater law enforcement resources. Dhillon noted that Interpol Washington has been underfunded and understaffed for years.
  • Designate Mexican drug cartels as foreign terrorist organizations: A foreign terrorist organization designation would give federal law enforcement authorities and American prosecutors additional tools to go after drug traffickers overseas. Dhillon said the recent deterioration in ties between American and Mexican law enforcement officials “gives us no choice” but to consider foreign terrorist organization designation.
  • Declare fentanyl a weapon of mass destruction: Such a designation, they argued, would allow our national security agencies to devote resources to the fentanyl crisis.

The other major factor driving the increased supply of fentanyl is lax enforcement at the southwest border. Most fentanyl is smuggled across that border, and the cartels are adept at exploiting its weaknesses.

Arizona Attorney General Mark Brnovich, who joined Dhillon and Carroll at the Heritage event, thinks the Biden administration’s lax border enforcement policies are contributing to the surge in fentanyl.

“One of the most important things a state attorney general can do at the moment is push back against the Biden administration and its failure to control our southern border,” he said.

While addressing the fentanyl crisis is among the most critical public policy concerns we face today, it’s also important for policymakers to realize the full scope of the related issues we may well face tomorrow.

In a Heritage Foundation report two years ago, former DEA official John Coleman and former National Institute of Drug Abuse Director Bob DuPont described fentanyl as a “sentinel calling our attention to the potential for a slew of laboratory-based drugs produced by an ever-expanding illegal global drug market to meet a growing demand.”

To truly protect our communities, our enforcement strategy must be geared toward not only addressing the present crisis, but also toward preventing future ones.

This piece originally appeared in The Daily Signal