The market for fentanyl, the deadly synthetic opioid, is growing in rapid and disturbing ways, a series of advisories released Wednesday by the Office of National Drug Control Policy (ONDCP) indicate.
The advisories lay out the ways private enterprises—including e-commerce sites, shippers, and pharmaceutical interests—could help to combat what is likely the deadliest drug in U.S. history.
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In 2018, more than 30,000 drug overdose deaths involved fentanyl or its analogs, meaning that synthetic opioids killed more people than heroin, methamphetamine, or cocaine. Fentanyl is 50 to 100 times more potent than morphine, which means it packs a high potency into a small volume. Much of the U.S. drug supply is now adulterated with the drug, meaning that even users attempting to avoid opioids and control their use may accidentally overdose and die.
According to ONDCP, most of the fentanyl in the United States is produced in China, then smuggled in over the northern and southwestern borders or shipped in via shipping containers or the U.S. mail. On Wednesday, the Treasury Department announced that it had designated two Chinese nationals and a Chinese drug trafficking organization as "significant foreign narcotics traffickers" under federal law, adding yet another group to an already long list of Chinese drug smugglers.
The Treasury announcement is just the latest move in the Trump administration’s pressure campaign on the Chinese government to address the fentanyl problem. In April, Chinese officials announced that they would follow up on a promise to schedule fentanyl and its analogs, making it easier for drug enforcement officials to crack down on production.
If China delivers on its promised crackdown, however, U.S. officials indicated that there is a possibility of a mutation in the fentanyl market. The drug's appeal to traffickers is the ease with which it is produced. Although China's industrial infrastructure and lax oversight regime makes it a prime spot for production at present, drug traffickers may relocate based upon the shifting regulatory winds.
The administration issued the advisory to American shippers and pharmaceutical producers in an attempt to get ahead of such a change. One of the advisories cautioned that manufacturers in countries as diverse as "India, the Netherlands, and Bangladesh" have the possibility to pick up the lucrative task of fentanyl production. A brief published by Brookings last year added Indonesia, Nigeria, and South Africa to that list.
Manufacturers needed to be on the lookout not only for new international producers, ONDCP warned, but also domestic ones. Noting that, "instructions for manufacturing fentanyl and related substances are readily available on the Clearnet and Darknet, as is access to precursor chemicals and lab equipment," ONDCP predicted that a crackdown on current Chinese production might lead to an uptick in domestic, mom-and-pop-style fentanyl production.
"As authorities improve their ability to detect and interdict imported synthetic opioids and their precursors from unlawful sources, traffickers may look for opportunities to mitigate interdiction risk by synthesizing these substances closer to the U.S. market," the office said.
ONDCP said in a separate advisory to e-commerce platforms that the internet plays a key role in both the production and distribution of the deadly drug.
"Fentanyl, fentanyl analogues, and other synthetic opioids are marketed to consumers in several ways, most notably via online platforms like social media and special interest online forums," the advisory said. "These marketing innovations have allowed criminal groups to reach a broader audience, including those drug users who would not be comfortable purchasing drugs on the street but are comfortable searching for them online from the safety of their own homes."
Fentanyl and its analogs, as well as a host of synthetic substances, are available through the "Darknet"—sites not indexed by search engines. The market has also extended into major social media platforms. As the Washington Post reported in 2018, Instagram has served as a popular site for drug dealers to ply their trade. According to ONDCP, online dealers advertise "‘roxies,' ‘pressed pills,' ‘blues,' or other slang names for synthetic opioids."
"Customers seeking to buy synthetic opioids can readily find them on the Darknet and Clearnet," the advisory said. "Some Darknet marketplaces exist primarily to sell drugs, and the illicit substances available on those marketplaces vary greatly, ranging from diverted pharmaceutical products to illicit drugs with no legitimate medical purpose. Some Clearnet e-commerce websites also openly advertise and sell synthetic opioids and the chemicals or equipment used to make or process them; these websites are generally hosted outside of the United States but advertise their illicit products globally."
If preliminary data hold up, 2018 will have been the first year in more than a decade that the number of drug overdose deaths fell significantly. Whether that trend will hold depends a great deal on the future of the drug distribution supply chain. If ONDCP's conclusions are to be believed, America may simply be at the start of a revolution in how drugs are produced, marketed, and consumed.