Illicitly Manufactured Fentanyl Entering the United States

Abstract

The 'third wave' of the ongoing opioid overdose crisis in the United States (US) is driven in large measure by illicitly manufactured fentanyl (IMF), a highly potent synthetic opioid or an analog developed in clandestine laboratories primarily in China and Mexico. It is smuggled into this country either as IMF or as precursors. The southern border of the US is a frequent point of entry for smuggled IMF and the amounts are increasing year over year. IMF is also sometimes mixed in with other substances to produce counterfeit drugs and dealers as well as end-users may not be aware of IMF in their products. IMF is inexpensive to produce and when mixed with filler materials can be used to cut heroin, vastly expanding profitability. It is an attractive product for smuggling as very tiny amounts can be extremely potent and highly profitable. Drug trafficking over the border also involves the tandem epidemic of money laundering as drugs enter the country and cash payments exit. While drug smuggling in and out of the US (and other nations) has been going on for decades, the patterns are changing. Highly potent and potentially lethal IMF is a dangerous new addition to the illicit drug landscape and one with disastrous consequences.

Keywords: china; drug smuggling; fentanyl; fentanyl analogs; illicit fentanyl; immigration; mexico; narco trafficking; opioid epidemic.

Figure 1. The opioid epidemic in the United States has been defined as having three distinct waves.

Figure 2. About 2 mg of a harmless powder representing the amount that would be a lethal dose of intravenous illicit fentanyl.

Potency is defined as the measure of a drug’s effect relative to dose and is assessed in terms of intravenous use of the drug. Fentanyl is 50 to 100 times more potent than morphine. While fentanyl may be absorbed cutaneously, a small amount of fentanyl in brief contact with intact skin is usually insufficient to cause intoxication. Inhalation of fentanyl or fentanyl in contact with mucus membranes is potentially more dangerous [6].

Figure 3. Deaths from synthetic opioid overdose remained relatively stable from 2005 to 2013 but increased sharply with the introduction of illicit fentanyl.

Source: Centers for Disease Control and Prevention

Figure 4. Drug smuggling over the border has been an ongoing concern for decades, but it appears that patterns of drug smuggling are changing. Fentanyl has been reported to date at San Diego and Tucson.

Note that marijuana smuggling has gone down in San Diego, El Paso, Big Bend, Del Rio, and Rio Grande Valley; cocaine has decreased substantially in Del Rio. Otherwise, most areas report increases in drug activity [13]. It should be noted that these figures represent confiscated drugs and are likely vastly under-reporting actual drug activity. Map drawn by Todd Cooper, professional artist and owner of Coyote Studios in Green Valley, California, from data provided by the DEA.