Learn / At a Glance: The Fentanyl Crisis in America
At a Glance: The Fentanyl Crisis in America
September 30th, 2024| Clinically Reviewed by
Key Points
- Synthetic opioids like fentanyl cause 150-300 deaths daily.
- Many people take it by accident.
- Heightening awareness and providing overdose kits can save lives.
Headlines about fentanyl being ‘a crisis’ increasingly pepper local and national news outlets.
At first thought, a drug may not seem like a crisis in the same way floodings, pandemics, and wars do. But fentanyl has thoroughly earned its label as a crisis, and this article will delve into why—plus, how you can keep yourself and others safe.
What Is Fentanyl?
Definition and Uses
Fentanyl is a synthetic opioid1, deadly at extremely small doses (less than a couple grains of salt). In the medical setting, opioids and its synthetic versions, like fentanyl, are used to manage pain. After surgery, for example, most patients receive a few days’ worth of opioid pain medications since they’re much more potent than NSAIDS like ibuprofen. Small doses of prescribed fentanyl can relieve after-surgery pain and pain from chronic conditions like cancer.
The medical uses for fentanyl aren’t why it’s become a crisis. It’s outside this setting where people in America lose their lives daily.
Dealers of drugs like cocaine, heroin, and meth often cut the pure substance with fentanyl to make it stronger and more addictive. In theory, this means their customers will buy more because they become addicted faster and increase their tolerance. They’ll keep coming back and buy in higher quantities.
Potency and Risks
A deadly dose of fentanyl fits on the tip of a pencil. It’s 100x more potent than morphine and 50x stronger than heroin1. Anyone who’s unfamiliar with its potency and how much they can safely take runs an extremely high risk of overdose. Those with more experience taking fentanyl and a higher tolerance for opioids run a lower risk of overdose. Most overdoses happen by accident, with the consumer unaware the drug they took had any fentanyl in it. Or, they take the drug after a period of abstinence, and their usual dose overwhelms their body and causes an overdose.
Fentanyl-laced drugs kill people of all ages and experience levels. A first-time drug user could die as easily as someone who’s been taking heroin for decades. Even ‘safe’ drugs like synthetic marijuana have been found laced with fentanyl2 or other opioids, leading to accidental dosing. Some may also choose to mix fentanyl with other drugs, like adding it to a stimulant to make a speedball.
Shockingly, the Drug Enforcement Administration (DEA) found 7 out of 10 confiscated pills had a lethal dose of fentanyl3, over 2mg.
Causes of The Fentanyl Crisis
Fentanyl’s deadly potency and the way people often have no idea they’re taking it (and subsequently overdose) makes it an urgent health crisis in America.
Illegal Production and Distribution
Fentanyl has made its way into more and more drugs as dealers clamor to up their profits and get their customers hooked. Clandestine labs make fentanyl, which cartels and other illicit networks then distribute to reach drug dealers. It may be cut into pure drugs before it’s given to the dealers, or the dealers may use it as a cutting agent themselves. Sometimes, the dealers aren’t even aware what they’re selling has fentanyl in it.
It’s not legal to make fentanyl on your own, purchase it, or sell it—you can only take it legally if you have a prescription. Getting a prescription is also the only way you can know the pill (or other substance) contains what you think it does, and in the correct dosage. Even someone who regularly takes opiates and considers themselves pretty tolerant to its effects can experience a fatal fentanyl overdose, since they can’t test the potency or know for sure how much fentanyl is in what they’re taking.
Prescription Practices
Some people have turned to fentanyl as a cheaper alternative to opioids. The heavy-handed use of opioids for pain relief largely contributes to this, as people can quickly become addicted to the opioids they were prescribed after a surgery or other short-term need. Once their prescription runs out, they face several options: buy it illegally from drug dealers (with no insurance coverage), try to find another doctor that will prescribe it, or go for the cheaper alternative, fentanyl.
Accessibility and Affordability
Fentanyl is easier to access than pure drugs like cocaine, heroin, and prescription opioids. It’s also cheaper, which can drive people to make it their substance of choice. The lower costs also encourage drug dealers to supplement pure drugs with fentanyl, saving them money by creating a drug that has less of the pure substance but is still ‘just as strong.’
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Impact of The Fentanyl Crisis
Overdose Deaths
Overall, fatal drug overdoses have gone down4. But fentanyl-caused deaths continue to rise and contribute more and more to the total death rate, making fentanyl the primary cause of drug overdose deaths5 in America (not including deaths caused by alcohol).
In 2022, 76,226 out of 108,000 reported overdose deaths were due to fentanyl4, per the Center for Disease Control. That dropped to 74,702 in 2023. Synthetic opioids like fentanyl kill 150-300+ people each day. That’s the equivalent of a commercial plane crashing and killing everyone inside, every day. If that were happening, could you imagine the outcry?
Public Health
People who experience an overdose need medical care as soon as possible. Naloxone (or Narcan) reverses overdoses for opioids and synthetic opioids like fentanyl. With fentanyl use and overdoses going up, emergency rooms and other treatment centers receive an influx of patients. Other non-deadly effects of fentanyl, like organ damage, also require medical care. This can strain the health system nationwide.
Social and Economic Consequences
Using opioids, synthetic or natural, contributes to economic issues through workplace accidents6, not going into work due to substance use, quitting work, and leaving gaps in the workforce due to deaths and resignations. Workplaces and businesses overall function less efficiently with these challenges, contributing to a poorer economic state.
Taking a substance can change how you behave, which can lead to criminal activities and legal consequences. Illegally procuring fentanyl can also get you into trouble. These consequences put strain on the judicial system and can affect the workplace through firings.
Efforts to Combat The Crisis
Many organizations, state-level and federal, are actively working to uproot the fentanyl crisis. And thankfully, they and others have had some success.
Law Enforcement Actions
Law enforcement’s primary role in stopping the fentanyl crisis isn’t to arrest people who take fentanyl; it’s to stop its distribution and production. Most of America’s fentanyl comes from China7, Mexico, and more recently, India. It’s smuggled through America’s borders through craftier and craftier ways, making it harder to catch. But advanced technologies, searching techniques, and more stringent rules vastly reduce the total amount of fentanyl that could make its way in.
American law enforcement has collaborated with Mexican officials to find and shut down fentanyl labs in Mexico, often operated by cartels. Recent collaborations with China aim to stem the flow of fentanyl there8. The United States Drug Enforcement Administration (DEA) focuses much of their operations on reducing fentanyl’s flow into the U.S., preventing over 381 million lethal doses of fentanyl3 from reaching consumers. This includes arresting distributors and drug dealers. Those who buy fentanyl illegally may also face legal consequences.
Public Health Initiatives
While public health organizations and programs can’t make arrests or shut down fentanyl labs, they can spread education and awareness on the dangers of fentanyl and its rising prevalence. Proper education on where it’s found, what happens if you take it, and what to do in the case of an overdose can prevent people from taking it entirely, and save their lives if they do.
The Center for Disease Control (CDC) has a Stop Overdose campaign, which offers education on fentanyl and its dangers. Similarly, the DEA’s One Pill Can Kill campaign highlights fentanyl’s dangers and the public’s need to carefully weigh the risks before taking illicit drugs. It also reinforces the safe practice of only taking pills prescribed to you, as buying pills elsewhere could mean you take a counterfeit laced with fentanyl.
Many cities, universities, corporations, and commuting hubs are joining the Naloxone distribution project (funded by SAMHSA) to place Naloxone kits in easily accessible areas. Think of the fire extinguishers you see in a glass case—that’s the hope for Naloxone kits.
Treatment And Support Programs
Addiction treatment from medical and therapeutic professionals can save lives. Attending treatment as early as possible can prevent addiction from worsening and leading to a potential overdose. Many addiction treatment centers specialize in treating fentanyl addiction, offering services like detox, residential treatment, and outpatient levels of care.
Treatment programs often provide a blend of medical and therapeutic care, with 1:1 and group therapies focused on underlying conditions and building coping tools for relapse prevention. Evidence-based and holistic therapies form personalized treatment programs to comprehensively address fentanyl addiction.
Preventative Measures
Prescription Regulations
Since opioid use can lead to fentanyl use, regulating opioid prescriptions can lead to fewer mishandled prescriptions, opioid addictions, and fentanyl reliance. The recent settlement cases against big pharmaceutical companies have made other entities, including the general public, more aware that opioids aren’t always necessary, and that even prescription medications can lead to addiction.
In 2016, the Center for Disease Control (CDC) released the CDC Guideline for Prescribing Opioids for Chronic Pain which details 12 recommendations for safe, effective opioid prescribing. The guidelines are meant to reduce addiction and overdose rates while still prioritizing the patient’s health and well-being. When used properly, these guidelines can save and improve lives.
Some states put caps on the amount of prescription opioids9 for acute pain (like after a surgery) to 7 or less. Other states mandate Naloxone with each opioid prescription with risk factors like a high dose or if it’s prescribed alongside a benzodiazepine.
Safe Use and Harm Reduction
Harm-reduction strategies for fentanyl use include distributing fentanyl test strips10, Naloxone, and clean syringe needles to reduce the spread of HIV and other diseases. Fentanyl strips test substances for fentanyl, which can make drug use safer and reduce overdoses.
Community and Education
The DEA aims to partner with more and more local communities11 to educate people of all ages and backgrounds on the dangers of fentanyl. They’re calling it Operation Engage—educating, broadening awareness, and creating a sense of community in the effort to stop fentanyl overdoses.
More schools and businesses have begun incorporating educational material on fentanyl to support these efforts. For those in recovery from fentanyl use, local peer support groups offer community and connection.
Curing a Crisis
New initiatives and harm-reduction strategies can’t bring back the lives lost from fentanyl, but they can slow the spread and eventually mitigate the crisis. America and other countries see a future where fentanyl overdose deaths no longer make the news—because they’re not happening at all.
Treatment marks a big step towards this goal. You can use Recovery.com to find a fentanyl rehab and see photos, reviews, insurance information, and more.
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