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Fentanyl — What is it and where does it come from?

Fentanyl is one of the deadliest opioids in the world. Fueled by the coronavirus pandemic and an increase in fentanyl use.

Photo of elaborate cross-border drug smuggling tunnel discovered inside a warehouse near San Diego. U.S. Immigration and Customs Enforcement Photo by Ron Rogers Date Taken:11.29.2011 Location:SAN DIEGO, CA, US. Source - DVIDSHUB, CC SA 2.0.
Photo of elaborate cross-border drug smuggling tunnel discovered inside a warehouse near San Diego. U.S. Immigration and Customs Enforcement Photo by Ron Rogers Date Taken:11.29.2011 Location:SAN DIEGO, CA, US. Source - DVIDSHUB, CC SA 2.0.

Fentanyl is one of the deadliest opioids in the world. Fueled by the coronavirus pandemic and an increase in fentanyl use, the US drug epidemic exploded while Americans were locked down.

From May 2020 through April 2021, more than 100,000 people died from drug overdoses in the US, according to provisional data released Wednesday by the US Centers for Disease Control and Prevention (CDC).

Synthetic opioids like fentanyl – a painkiller 50-100 times more potent than morphine – accounted for the bulk of those drug overdose deaths: around 64,000.

The history behind fentanyl

Janssen Pharmaceutica first developed fentanyl in 1959. Then, it was primarily used as an anesthetic and pain reliever for medical purposes. During the 1960s, fentanyl started being used as an intravenous anesthetic called Sublimaze. Being an IV opioid, this made Sublimaze an extremely high-risk drug for abuse.

 However, it wasn’t until the mid-1990s that the fentanyl patch was introduced and could be used in the treatment of chronic pain. By the year 2014, the U.S. was emersed in the start of the fentanyl crisis.

It was also during this time that new source countries and new transit countries emerged as significant trafficking began to pick up. With the right equipment and base ingredients available, fentanyl in powder form – as well as unregistered pill presses, stamps, and dyes found their way into the country via mail services.

The US Drug Enforcement Agency (DEA) noted fentanyl has been seized in every state and it issued an urgent warning in September this year about fake prescription pills laced with the drug.

“DEA laboratory testing reveals that today, four out of 10 fentanyl-laced fake pills contain a potentially lethal dose (2 milligrams),” the agency said in a news release.

Powder sample, containing (as two main ingredients): mannitol (62%), fentanyl (23%). Quoting from the source: “The exhibit was seized by a Lake County Deputy Sheriff from the floor of a gas station restroom in Painesville, Ohio. Source – DEA Microgram Bulletin, June 2006, Public Domain

Where Does Fentanyl Come From?

Most fentanyl in the United States comes from China. While China isn’t where fentanyl originated, with the lack of regulations in the pharmaceutical industry there, the country is a large distributor of drugs and chemicals that are illegal in other countries.

While some fentanyl comes directly from China, many other Chinese shipments of fentanyl will enter the United States through Mexico. Fentanyl may come through Canada before entering the United States, though it is uncommon.

To show how quickly the 2014 start of the fentanyl crisis grew, in 2015, United States border agents seized approximately 200 pounds of fentanyl among other synthetic opioids. In comparison, in 2014 they seized around 8 pounds.

Currently, China remains the primary source of fentanyl and fentanyl-related substances trafficked through international mail and express consignment operations environment, as well as the main source for all fentanyl-related substances trafficked into the United States.

A Port of Nogales canine sits nearby while Port Director Michael Humphries provides details to the press about the largest seizure of fentanyl in CBP history. U.S. Customs and Border Protection officers at the Nogales Commercial Facility seized nearly $4.6 million in fentanyl and methamphetamine totaling close to 650 pounds on Saturday, January 26, 2019, from a Mexican national when he attempted to enter the United States through the Port of Nogales. Source – Customs and Border Patrol/Jerry Glaser. Public Domain

What is our government doing to stop the crisis?

First of all, the CDC’s latest provisional report is disheartening, and a horrible new record for drug overdose deaths.

“What we’re seeing are the effects of these patterns of crisis and the appearance of more dangerous drugs at much lower prices,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, told CNN.

“In a crisis of this magnitude, those already taking drugs may take higher amounts and those in recovery may relapse. It’s a phenomenon we’ve seen and perhaps could have predicted.”

But the rise of fentanyl, a stronger and faster-acting drug than natural opiates, has made those effects even more deadly, she said.

Even with international travel limited over the past year and a half, cross-border distribution has increased, usually from Mexico, via China.

The US government has seized enough fentanyl this year to give every American a lethal dose, Drug Enforcement Administration Administrator Anne Milgram said Wednesday at a White House press briefing, calling the overdose epidemic in the US “a national crisis” that “knows no geographical boundaries, and it continues to get worse.”

In September this year, the DEA said Thursday it made 810 arrests and seized more than 1.8 million fake pills during a two-month sweep to stem the flow of counterfeit medications containing fentanyl.

During the sweep, the DEA also seized enough powder to make tens of millions of pills, more than 4,000 kilograms of methamphetamine, and more than 650 kilograms of cocaine.

“Illicit fentanyl was responsible for nearly three-quarters of the more than 93,000 fatal drug overdoses in the United States in 2020,” Deputy Attorney General Lisa Monaco said at Justice Department headquarters.

And here is what is particularly bad – Social media is being used to move this illicit drug. Milgram said the pills are widely available on social media platforms as well as on the streets – an issue that she said social media companies need to address.

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We are deeply saddened to announce the passing of our dear friend Karen Graham, who served as Editor-at-Large at Digital Journal. She was 78 years old. Karen's view of what is happening in our world was colored by her love of history and how the past influences events taking place today. Her belief in humankind's part in the care of the planet and our environment has led her to focus on the need for action in dealing with climate change. It was said by Geoffrey C. Ward, "Journalism is merely history's first draft." Everyone who writes about what is happening today is indeed, writing a small part of our history.

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