America needs to take the fentanyl crisis more seriously

The United States is in the grips of a fentanyl crisis that doesn’t get nearly the attention it deserves.

Yes, it’s important who owns Twitter, and interesting what some Republicans might have texted former Trump White House chief of staff Mark Meadows after the 2020 election, but none of this matches the significance of a hideously insidious drug devastating American communities.

According to the National Center for Health Statistics, more than 100,000 Americans died of drug overdoses during the first year of the pandemic. That’s double the figure from 2015 and, as The New York Times notes, more than were killed in car crashes and gun fatalities combined. Since 1999, roughly 1 million Americans have died of drug overdoses. About two-thirds of the deaths now are from synthetic opioids, primarily fentanyl.

We all know about the prescription drug crisis, which began to get attention in the 2000s, but now we are in a different phase. Around 2014, fentanyl and other synthetic opioids began to push aside prescription painkillers and heroin. “Drug seizure data shows that, in some parts of the country,” the Commission on Combating Synthetic Opioid Trafficking reported earlier this year, “fentanyl has largely replaced heroin. Not since the early 20th century, when heroin replaced morphine, has the United States seen one major opioid found in some illegal markets largely replaced by another.”

Something like 50 times more potent than heroin by weight, fentanyl is the perfect drug for producers and dealers. It’s easy and fast to make and readily transportable. If 10 kilos of heroin are interdicted, it will take considerable time and effort to replace that shipment — beginning with a poppy crop that needs to be cultivated, perhaps somewhere in Afghanistan. If 10 kilos of fentanyl are interdicted, it’s relatively easy for a hard-to-detect lab in Mexico to produce more and get it into the United States. Huge shipments aren’t necessary — a small amount can be secreted in a package or in a vehicle or on a person. Someone in the United States only needs an internet connection and mailing address to acquire and distribute fentanyl. According to the commission, three to five metric tons of the drug would cover the annual consumption of all illegally supplied opioids in the United States. By way of comparison, in 2016, Americans used 47 metric tons of heroin and 145 metric tons of cocaine.

People might knowingly seek out fentanyl, or it might be mixed into other drugs or fashioned to look like a prescription medicine. With such a potent drug, bad dosing or taking it without knowledge is potentially deadly.

The drug is a clear and present danger to the 3 million Americans addicted to opioids, and anyone consuming anything on the illegal drug market. In a testament to its power, two young men who hadn’t taken the drug were still overcome by it while performing mouth-to-mouth resuscitation on their friends who went into cardiac arrest after taking fentanyl-laced cocaine in a terrible incident in Wilton Manors, Florida, in March. Five of the victims were West Point cadets.

All of this is to say that in the long competition between the authorities and drug traffickers, fentanyl represents an evolutionary leap ahead for the traffickers. We will have to innovate in turn. Most fentanyl comes across the Southwestern border, and we can do more to try to interdict the supply. We need to push China and India to crack down on the manufacture and export of precursor chemicals that feed the Mexican labs. We should encourage the Mexican government to do more to address the cartels that dominate the drug trade. None of this will be easy or decisive, though.

Then, there’s the all-important demand side. Greater access to methadone and buprenorphine to treat addiction is important, as is wider availability of Narcan, a medicine that rapidly reverses an opioid overdose. We are in for a long struggle. The first step is to acknowledge the severity of the fentanyl crisis and give this ongoing tragedy the attention and resources it is due.