The What, When and Where of Fentanyl: Part 2
The public has become habituated to hearing the high death numbers associated with fentanyl. Year after year, we learn that tens of thousands die (112,000 in 2023)1, but there is rarely mention of a realistic resolution. The tragedy goes on and on with no end in sight.
At least, that has been the story until now.
Remarkably, for the first time in decades, drug overdoses were down in 2024. Albeit, it’s not enough - overdoses are still too high. But the number was down by at least 10%, according to the CDC. That translates to about 11,200 fewer deaths.
Not many people noticed except those intimately involved with fentanyl – the users on the street, law enforcement and addiction professionals.
This series suggests areas to research to discover what caused the decrease in overdoses in 2024. Finding the causes could help establish workable public policies and significantly reduce deaths.
In part one, we examined the 60-year history of fentanyl – how it went from therapeutic painkiller to people killer.
In part two, we review the manufacturing and distribution lines that make fentanyl so deadly and readily available. We also examine factors that may have contributed to downtrends in overdoses – recently and in the past.
There are two factors contributing to the skyrocket in fentanyl deaths:
- Fentanyl is often mixed with other drugs such as cocaine, heroin and methamphetamine, to increase potency. This mixture of drugs increases the chance of a fatal interaction. Sometimes there are no traces of the promised drug – only fentanyl. The person taking the drug might not even be aware that it contains fentanyl.
- There is no oversight of the manufacturing of fentanyl, and it is not an exact science. So, a person ingesting a fentanyl pill might unknowingly be taking a lethal dose.2
Where Does Fentanyl Come From?
The precursor chemicals used to make fentanyl travel from places like China and arrive at clandestine labs in different parts of the world, where the final product fentanyl is manufactured. Many of these labs are in Mexico.
The origin and routes of travel of the precursor chemicals to the labs are complex. The routes that the final product of fentanyl travels from the labs before reaching a customer in the United States can be challenging to follow.
The DEA has made it a point to track these flows.
DEA Reports on Fentanyl
In 2020, the DEA reported that China and Mexico were the main sources of the fentanyl trafficked into the US, with China being the largest.
The same DEA report stated that in 2019 President Xi announced China’s plans to control fentanyl coming out of China. In response, by 2020, Mexican cartels increased the number of manufacturing labs. But the precursor chemicals continued to come from China.
Drug Cartels
In May 2024, the DEA announced that Sinaloa and Jalisco Cartels “are at the heart” of the synthetic drug crisis. These criminal enterprises reportedly control global supply lines and the vast distribution lines of the final product.
The precursor chemicals travel from China to Mexican labs where the fentanyl is made. From Mexico, the drugs are distributed to the U.S., and associate dealers sell them.
And from there, fentanyl kills tens of thousands – which is at the heart of the matter and would be the only point of such extensive tracking by the DEA.
Decreasing Deaths – What Works?
The DEAs extensive (and obviously costly) research begs the question: Did their efforts contribute to the slight decrease in overdose deaths being reported?
Is Interdiction Finally Working?
In October of 2023 Customs and Border Control reported that they had seized more fentanyl in the previous two years than in the five years before combined.
90% of the seizures occurred at Ports of Entry, where the drugs, supplied by the cartels, were smuggled in. They were attempted to be smuggled in primarily in vehicles driven by US citizens.
September 2024 figures showed a 16% decrease in seizures, though they are still high.
Presumably, the significant fentanyl seizures at the border translates to less of the killer fentanyl on the streets. But it is, at best, a presumption without full information. We don’t have consumer street sales statistics of fentanyl. And we don’t know the prevalence or impact of fentanyl manufacturing in the US.
Naloxone
Naloxone is a medication that rapidly reverses an opioid overdose.
Some experts and drug abusers attribute the decline in fentanyl overdose deaths to the higher availability of free naloxone to people with addiction.
In Seattle, it is reported that 85% of the at-risk addicts carry naloxone.
While naloxone helps save lives, naloxone doesn’t handle addiction. The life of the person with the addiction remains difficult. Driven by addiction, they will still spend a good part of their life hunting down drugs while maneuvering the dangers of the streets.
People with a substance abuse disorder commonly have health issues and are often harassed by the police.
Why not search for drug-free solutions that offer a better quality of life?
Drug Education – an Historical Overview
There were 3,612 overdose deaths in 1985 - remarkably low compared to the high numbers of today. Yearly overdose deaths in the 80s were lower on average than in the 70s and 90s.
Not only were the overdoses in lower ranges, but the use and abuse of illegal recreational drugs declined significantly during Reagan's presidency.
Though drug education is not credited with the lower incidence of drug abuse during the Reagan administration, it should be studied as a possible factor.
In 1980, Nancy Reagan embarked on the iconic "Just Say No" campaign.
“Just Say No” became part of the pop culture, vernacular. The slogan was mentioned in TV series, and there were “Just Say No” clubs in schools nationwide.
By 1985, the First Lady had appeared on 23 talk shows, a rock music video called Stop the Madness and had traveled 250,000 miles with her message.
Did it work? Why has the abstinence-based “Just Say No” campaign been virtually ignored and even criticized these last decades?
Drug Treatment
According to a 2024 report by SAMHSA (Substance Abuse and Mental Health Services Administration), 23.6 % of persons classified as needing drug treatments, received it in the previous year.
It’s difficult to determine percentages of success for those who received treatment – especially since success is not clearly defined by addiction professionals.
There are different philosophies about addiction and varying approaches to treatment. It can be difficult for families to determine which program is best for their loved one
The Drug Free Approach with Narconon
Narconon has a well stated and clear philosophy concerning addiction and a structured path of treatment. The Narconon program is not based on the belief that addiction is an incurable disease or that someone is an addict for life.
At Narconon we believe that a drug abuser can take their life back and live a drug free and productive life.
The entire program is tailored to help the client learn skills to remain drug free, happy and productive.
If you are looking for a program for a loved one and would like to learn more about our drug free approach, give us a call at.
Back To: Part 1
Sources:
- “NPR Exclusive: U.S. overdose deaths plummet, saving thousands of lives” NPR Health September 18, 2024
- “Facts About Fentanyl” DEA
- “Fentanyl Flow to the United States” DEA INTELLIGENCE REPORT 2020
- DEA National Drug Threat Assessment 2024 “Letter from the Administrator”
- “Frontline Against Fentanyl US Customs and Border Control” Oct 26 2023
- “How Much Fentanyl is Seized at US Borders Each Month” USA Facts Oct 2024
- “United States drug overdose death rates and totals over time” Wikipedia
- “Just Say No” Wikipedia
- “SAMHSA Releases Annual National Survey on Drug Use and Health” July 30, 2024
