TORREVILLAS

are cheaper to produce than heroin and 50 times more potent.

Ciccarone and his UCSF colleague Sarah Mars have conducted research “showing that the fentanyl wave is a product more of supply than of demand. Most users don’t particularly want fentanyl – they know the risks of overdosing on a much stronger drug – but it’s what’s available now. And it is often branded and sold in powder form as heroin, or formed into counterfeit pills, making it difficult for users and even street-level sellers to know what they’ve got.

“Fentanyl is used for medical purposes, such as pain relief in cancer and epidurals in childbirth, and is manufactured aboveboard in this country, where it is classified as a controlled substance. But illicit fentanyl, which is now at the leading edge of overdose deaths in the United States, has a much more complicated provenance. According to the DEA, most of it is made in clandestine laboratories in China. Though some are then smuggled across the southwest border, much of it is mailed or shipped. Last June, at the port of Philadelphia, US Customs and Border Protection agents seized a hundred and ten pounds of fentanyl that was concealed in a shipment of iron oxide from China.

“When the DEA takes action to ban the import of certain chemicals, ‘Clandestine chemists can easily continue developing and synthesizing new synthetic opioids that do not appear on any schedule of controlled substances,’ Knierim said, sometimes in a matter of weeks.

“The fact that only small amounts of fentanyl are needed to supply a very large population makes detecting and disrupting imports that much harder, Mars told me. This is even more the case with fentanyl substitutes such as carfentanil, a synthetic opioid that is a hundred times more powerful (it’s used as a tranquilizer for elephants and horses) that has begun to turn up in the US heroin supply over the past few years.

“Fentanyl is also increasingly sold on the dark Web, using cryptocurrency. In August, a joint investigation by the DEA, the Department of Justice, the FBI, ice, and the US Postal Inspection Service, called Operation Darkness Falls, led to the arrest of a San Antonio couple, Matthew and Holly Roberts, who allegedly ran dark-Web marketplaces for fentanyl and other drugs. The San Antonio Express-News described them as ‘an ordinary couple’ who taught themselves how to conduct their drug trafficking online, disguising it behind a mail-order business for glow bracelets. (They later pleaded guilty to conspiracy to distribute controlled substances and other crimes.)”