How Fentanyl Changed The Opioid Crisis

By Beth Leipholtz 09/12/18

The prevalence and potency of illicit fentanyl has changed the course of the opioid crisis for the worse. 

Doctor with defibrillator paddles

While prescription painkillers were previously attributed to the most deaths in the opioid epidemic, they no longer do. Instead, the leading cause of death in this context is now illegal fentanyl, according to a recent Bloomberg editorial.

The National Center on Health Statistics states that in 2017, illegal fentanyl played a role in 60% of opioid deaths, in comparison to 11% of opioid deaths five years ago. 

Fentanyl was created in 1960 and was used as a treatment for cancer pain. Illicit fentanyl has become common in the black market because it can be easily manufactured in a lab. Its potency also means it can be put into very small packages that are easy to conceal. 

“Drug labs in China fulfill online orders from American users, or from traffickers in the U.S. and Mexico who add the fentanyl to heroin and other drugs to boost their effect, or press it into phony prescription-opioid pills,” the editorial reads. 

Because of this, the editorial states, addressing the issue of illegal fentanyl needs to be focused first on China, which U.S. law enforcement officials claim is the source of nearly all illegal fentanyl. 

The editorial states that the Obama administration had reached out to the Chinese government to ask for help in policing producers of fentanyl. But, with the Trump administration in place, that cooperation appears to have fallen by the wayside. 

“What’s needed is a steady and purposeful diplomatic push, along with expert support for fortifying China’s capacity to inspect and regulate its thousands of drug labs,” the editorial board writes. 

When fentanyl is exported from China, it mainly comes through the mail to both users and dealers. While Congress has allotted Customs and Border Protection more chemical-detection equipment, it is not possible to scan all packages entering the country. 

“The task would be easier if Congress passed pending legislation to require the U.S. Postal Service to obtain basic identifying information from senders—including the name and address of sender and a description of package contents—as private parcel services do,” the editorial board writes.

In addition to being sold on the dark web, fentanyl can also be found on regular websites, the board says. Scott Gottlieb, commissioner of the Food and Drug Administration (FDA), has spoken out about the need for internet companies to put more effort into taking down those listings. 

While this all has to do with the supply, the aspect of demand must also be addressed, the board says. The more than 2 million Americans struggling with opioid or heroin use disorder need access to treatment, specifically medication-assisted treatment (MAT) and behavioral therapy.

“Fentanyl and other opioids are killing more than 130 people a day. The crisis demands a thorough, well-coordinated national response. What the White House and Congress have come up with so far falls short,” the board concludes.

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Beth is a Minnesota girl who got sober at age 20. By day she is a website designer, and in her spare time she enjoys writing about recovery at, doing graphic design and spending time with her boyfriend and three dogs. Find Beth on LinkedInInstagram and Twitter.