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. 2025 Apr:138:104417.
doi: 10.1016/j.drugpo.2024.104417. Epub 2024 May 13.

National and regional trends in fentanyl seizures in the United States, 2017-2023

Joseph J Palamar  1 , Nicole Fitzgerald  2 , Thomas H Carr  3 , Linda B Cottler  2 , Daniel Ciccarone  4
Affiliations

National and regional trends in fentanyl seizures in the United States, 2017-2023

Joseph J Palamar et al. Int J Drug Policy. 2025 Apr.

Abstract

Background: Rates of synthetic opioid-related deaths over time and across regions have been compared within the US, but other indicator data could help inform prevention and harm reduction as well. We compared regional trends in fentanyl seizures to examine potential shifts in illicit fentanyl availability.

Methods: Annual trends in fentanyl seizures were examined using data from High Intensity Drug Trafficking Areas for the US overall and by region from 2017 through 2023. Multiple measures included the number of seizures, the number of powder seizures, the number of pill seizures, the total weight of seizures, the number of pills seized, and the percentage of the number of pill seizures relative to the number of total seizures.

Results: The percentage of seizures in pill form in the US increased from 10.3 % in 2017 to 49.0 % in 2023 (adjusted annual percentage change [AAPC]=25.2, 95 % CI: 17.6, 33.2), with 115.6 million individual pills seized in 2023. Pill weight related to total seizure weight also increased from 0.4 % to 54.5 % (AAPC=112.6, 95 % CI: 78.6, 153.2). In 2023, the plurality of seizures was in the West, in seven out of eight of our measures, with 77.8 % of seizures in the West being in pill form. Although the Midwest had lower prevalence of seizures than the West, there were notable increases in the Midwest in the number of pill seizures (AAPC=142.2, 95 % CI: 91.9, 205.8) and number of pills seized (AAPC=421.0, 95 % CI: 272.7, 628.4). Total weight of fentanyl seized increased the most in the West (AAPC=84.6, 95 % CI: 72.3, 97.8).

Conclusions: The number and size of fentanyl seizures is increasing in the US, with the majority of seizures, especially in pill form, in the West. Continued monitoring of regional shifts in the fentanyl supply can help inform targeted prevention and public health response.

Keywords: Annual trends; Drug seizures; Drug surveillance; Fentanyl.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Joseph Palamar reports financial support was provided by National Institute on Drug Abuse. Linda Cottler reports financial support was provided by National Institute on Drug Abuse. Joseph Palamar reports a relationship with Washington Baltimore High Intensity Drug Trafficking Area that includes: consulting or advisory. Daniel Ciccarone reports a relationship with Celero Systems that includes: consulting or advisory. Joseph Palamar and Daniel Ciccarone are on the editorial board of the International Journal of Drug Policy. Joseph Palamar is also on other Elsevier journal editorial boards. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

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