Fentanyl overdoses are among the leading causes of death in America for people between the ages 18-45.
In 2022, the United States experienced a significant impact from fentanyl overdoses, with fentanyl being responsible for 200 deaths every day. Over a quarter of a million Americans have died from fentanyl overdoses since 2018, indicating a persistent and growing crisis. This crisis has been characterized by a sharp rise in deaths, with fentanyl deaths increasing every year for the past decade. Although there was a slight deceleration in the year-over-year growth rate to 4.3% in 2022, the number of fatalities reached 73,654, which was more than double the deaths from three years prior in 2019. This surge underscores the lethal nature of fentanyl, a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine, contributing to its high potential for overdoses.
Part of what makes fentanyl so dangerous is that most other illicit drugs — such as heroin, cocaine and methamphetamine — are now laced with it. Users may not know what or how much fentanyl they’re taking.
According to the Drug Enforcement Agency (DEA), in 2023, it seized more than 79.5 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder. The 2023 seizures are equivalent to more than 376.7 million lethal doses of fentanyl. The 2024 fentanyl seizures represent over 90.9 million deadly doses.
The National Center for Health Statistics (NCHS) collects information on deaths involving drugs commonly associated with fatal overdose.
More than 106,000 people in the U.S. died from drug-involved overdose in 2021, including illicit drugs and prescription opioids.
Deaths involving synthetic opioids other than methadone (primarily fentanyl) continued to rise with 70,601 overdose deaths reported in 2021. Those involving stimulants, including cocaine or psychostimulants with abuse potential (primarily methamphetamine), also continued to increase with 32,537 overdose deaths in 2021.
Further data from the Centers for Disease Control and Prevention (CDC) shows that:
• The age-adjusted rate of drug overdose deaths increased from 8.2 deaths per 100,000 standard population in 2002 to 32.6 in 2022; however, the rate did not significantly change between 2021 and 2022.
• Rates decreased between 2021 and 2022 for people ages 15–34 and increased for those age 35 and older.
• Between 2021 and 2022, rates increased for all race and Hispanic-origin groups, except Native Hawaiian or Other Pacific Islander non-Hispanic and White non-Hispanic people.
• Between 2021 and 2022, the rate for synthetic opioids other than methadone increased 4.1% from 21.8 to 22.7, while rates for heroin, natural and semisynthetic opioids, and methadone declined.
• Between 2021 and 2022, rates for cocaine and psychostimulants with abuse potential increased.
In August 2023, White House Office of National Drug Control Policy (ONDCP) Director Dr. Rahul Gupta addressed the CDC’s provisional drug overdose death data, which continue to show a flattening of drug overdose deaths in the United States from 2022 to 2023 as the Biden-Harris Administration works to fully implement President Biden’s National Drug Control Strategy.
“After years of tragic and rapid increases in the overdose death rate, we are encouraged to see progress in flattening this trend,” said Dr. Gupta.
According to the White House, part of its plan is to reduce the supply of illicit substances into the United States by 2025.
But the fentanyl crisis in the U.S. is a multifaceted public health emergency that demands a comprehensive and multi-pronged approach. Here are several key strategies that experts and policymakers often recommend to address this crisis:
• Enhanced Surveillance and Data Sharing: Improving the collection and sharing of data on drug usage, overdoses, and fatalities can help authorities understand the scope of the crisis, identify hotspots, and respond more effectively.
• Prevention Education: Public education campaigns targeting schools, communities, and healthcare providers can raise awareness about the dangers of fentanyl and other synthetic opioids. These campaigns can also educate on the importance of medication safety and the risks of substance abuse.
• Access to Treatment: Expanding access to treatment services, including medication-assisted treatment (MAT) for opioid use disorder, is critical. This includes removing barriers to treatment, such as insurance coverage limitations and the shortage of treatment providers.
• Support for Recovery: Supporting recovery programs and services, including peer support and housing, can help individuals sustain their recovery and reintegrate into the community.
• Harm Reduction: Implementing harm reduction strategies, such as distributing naloxone (a medication that can rapidly reverse opioid overdose) and establishing supervised consumption sites, can save lives and provide pathways to treatment.
• Regulatory Measures: Tightening regulations on prescription opioids can help reduce the availability of these drugs for non-medical use. This includes prescribing guidelines for healthcare providers and tracking systems to identify suspicious prescribing patterns.
• Law Enforcement and Border Control: Strengthening efforts to intercept fentanyl and its precursors before they enter the country and cracking down on the distribution networks within the U.S. are crucial steps. This requires cooperation between local, state, and federal agencies, as well as international partnerships.
• Research and Development: Investing in research to better understand opioid addiction and develop new treatment options, as well as non-addictive pain management alternatives, is essential for long-term solutions.
• International Cooperation: Since much of the fentanyl and its precursors come from abroad, international cooperation is necessary to disrupt the production and supply chains.
• Community-Based Solutions: Engaging communities in developing local solutions that address the unique aspects of the crisis in their area can be more effective than one-size-fits-all approaches.
Addressing the fentanyl crisis requires coordinated efforts across public health, law enforcement, healthcare, education, and community organizations.
Closing America’s southern border, or significantly increasing security measures, is a strategy that could help stem the flow of illegal drugs, including fentanyl, into the United States. Here’s how enhanced border security could theoretically contribute to reducing drug trafficking:
• Physical Barrier: A more secure physical barrier could deter smugglers from attempting to cross the border with drugs.
• Increased Surveillance and Technology: Deploying advanced surveillance technologies, such as drones, infrared cameras, and motion detectors, can help border patrol agents monitor remote areas more effectively.
• More Border Patrol Agents: Increasing the number of agents patrolling the border can enhance the ability to detect and intercept drug smugglers.
• Interagency Collaboration: Strengthening collaboration between various U.S. agencies (like the DEA, FBI, and DHS) and international partners, especially Mexico, can lead to more effective strategies to combat drug cartels and dismantle their operations.
• Targeting Supply Chains**: Enhanced border security can disrupt the supply chains of drug trafficking organizations by making it more difficult for them to transport drugs into the U.S.
• Reducing Drug Demand: While not directly related to border security, reducing the demand for drugs within the U.S. through education, treatment, and prevention programs is crucial.
A comprehensive approach that includes both border security and efforts to address the root causes of drug addiction and demand in the U.S. is necessary for a long-term solution to the drug crisis.
Addressing the fentanyl crisis and drug trafficking in general requires international cooperation, especially with countries where drugs are produced and through which they are trafficked. Efforts to improve economic conditions, law enforcement capabilities, and legal systems in those countries are also critical components of a broader strategy to combat drug trafficking.