Fentanyl Overdose: How do we reverse the curve?

The rise of overdose deaths in America.

The dark realities of drug use

In the United States, overdose deaths have increased by more than 200% over the last two decades. Fentanyl, along with other synthetic opioids have become widely available at extremely affordable prices, putting opioid addicts or those experimenting with pills at significant risk. First responders are put at risk, children are in danger, and the United States system is not successfully reforming drug laws. Overdose numbers continue to skyrocket, and without change, the curve will continue to grow.

Real Oxycodone vs. Fake Fentanyl-Laced Opioids

My Research Questions:

  1. Where are synthetic opioids being produced? How do they enter our country?
  2. What restrictions or efforts can be made by our system to slow the import of fentanyl into the US?
  3. What attracts users to synthetics? Is it deeper than being more affordable?

Overdose death by year, and by gender (2021)

I chose to research overdose rates in America. Additionally, I studied the importance of targeting to smuggling and consumption of illicit opioids/synthetic narcotics in America. A few major themes that I noticed when studying the issue include; low-income areas are targeted in illicit substance trade, men are at substantially higher risk than women, and there is significant stigma around addiction. I am choosing to focus on this issue because it has been an American crisis for decades. The target of the war on drugs shifts from drug to drug every several years, but continues to evolve into something even more potent and more dangerous. In Portland, my hometown, teens are dying. Kids younger than me are consuming substances without knowing what is really in them, and they're dying. There has been no sufficient or significant effort to reverse the increase in deaths nationwide.

Lethal doses of Fentanyl, Carfentanyl, and Heroin


Annotations // Sources

Bottari, S. (2023, May 8). Newly published report shows dramatic increase in fatal fentanyl overdoses in teens. WMUR. https://www.wmur.com/article/increase-fatal-fentanyl-overdoses-teens-5823/43829673

This news article demonstrates the cold reality of the drug trade, and how children are often targeted. The source speaks about the rapid increase in fentanyl-related overdoses across the last year, along with providing statistics regarding the increase in minor overdoses in recent years. Teens, between ages 15 and 19 are being targeted by dealers by selling colorful cheap pills that are laced with the drug. Research and police records suggest that child-related overdose has increased by over 3000% over the last 10 years.

Teen Overdoses Through The Last Decade

This article contributes to my research because it demonstrates the raw danger of fentanyl. Across all regions, but mostly in North America, the illicit drug trade is now targeting children as well. Most individuals do not know that they are consuming fentanyl, making it even more dangerous. In discussing how the war on drugs has evolved, the article helps support me in demonstrating that the market has shifted from targeting drug users to targeting poverty-ridden areas, and children who aren't capable of making rational decisions.

U.S. Department of Health and Human Services. (2023, March 31). Drug overdose death rates. National Institutes of Health. https://nida.gov/research-topics/trends-statistics/overdose-death-rates

In this article, the U.S. Department of Health and Human Services breaks down the increase in overdose deaths by countless backgrounds. It uses graphs and other visuals to show the overdose rate by gender, specific drug types, ages of victims, and several other demographics. Despite any differences that people may have, the majority of the graphs prove fentanyl to be the leading cause of overdose deaths across America.

This article provides detailed insight into overdose deaths. The graphs and images are helpful for the development of my story map. Every demographic breakdown in the document comes with a 1-2 paragraph description of what is being depicted, along with a variety of images and graphs to support the research. It breaks down the drug epidemic into a variety of insightful sub-topics.

The 3 waves of the opioid crisis

"Opioid Crisis." Gale In Context Online Collection, Gale In Context: High School, link.gale.com/apps/doc/ENFUD420152524/SUIC?u=oregon_sl&sid=bookmark-SUIC&xid=146ea3cc. Accessed 8 May 2023.

This peer-reviewed article discusses the history and importance of the opioid crisis. It discusses the evolution of the crisis in a timeline format, the background of the drugs, up-to-date (for the most part) statistics about the overdose rate across the country, heavily affected demographics, and more.

This article shares many viewpoints that I find important regarding the opioid crisis. Additionally, it shares responses from affiliates around the pharma industry and their thoughts. Analysis of the overdose rate over the last decade feeds directly into my argument, and will develop my final story map.

Unclassified fentanyl flow to the United States - dea.gov. (n.d.). https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf

This article published by the DEA details on the process of manufacturing and smuggling synthetic drugs into the United States. International mail, online marketplaces, and shipments are among the most common. It's important to note that these smuggling methods may evolve and change over time as law enforcement agencies and border control authorities enhance their efforts to detect and prevent the illegal importation of drugs. However, in the time being, there is knowledge of the methods in which the drugs are coming in, we need to begin seizing them

This source is important to my research because it talks about the stem of the issue. If it couldn't find its way into the country, there would be no dilemma. However, mass-production pharmaceuticals overseas are smuggling small batches of illicit opioids into the United States along with shipments of legitimate opioids. Often, precursor chemicals are brought over the border, where they are then manufactured into fentanyl at a high rate.

Chinese Fentanyl

Following over three years of illicit fentanyl manufacture and exportation, the United States has sanctioned multiple Chinese pharmaceutical companies. Although it is just a start, sanctioning these corporations is a step in the right direction. The treasury-issued sanctions are set to target all parts of the supply chain and hopefully expand to other corporations that have become a part of the deadly business. On top of the sanctions, the Treasury Department has created a team that will work to locate companies laundering money related to the illicit fentanyl exportation. This is important because it shows that the United States is making a step in the right direction.

The source provides limited but sufficient information regarding the Chinese-American fentanyl trade, along with potential next steps for the United States. So far, the US has been able to identify symbols on the illicit pills back to where they were produced, because many symbols match those of large pharmaceutical groups. There is a long way to go before we can slow the curve, but sanctions and hunting down the illegal source of money and chemicals will work wonders.

Fentanyl Flow From China, Mexico, and Canada to the United States

Centralia police find 200,000 fentanyl pills hidden inside vehicle. KOMO. (n.d.). https://komonews.com/news/local/gallery/centralia-police-department-search-warrant-washington-crime-traffic-stop-k9-fentanyl-pills-illegal-drugs-chehalis-corrections-hidden-suspicious-identity-joint-narcotics-enforcement-team?photo=1

The West Coast has become heavily affected by the fentanyl crisis. Considering how cheap the pill is, it is extremely easy to buy in bulk, transport, and sell in mass quantity. Recently, on the morning of June 12th, over 200,000 fentanyl pills were seized from a car driving to Seattle. The police department executed a warrant after the driver appeared suspicious and confrontational. He was pulled over for failing to keep his car in one lane. Further investigation will continue. Our community continues to be put at risk by counterfeit pills.

I found this article important and relevant for a number of reasons. I've grown up on the West Coast, as are many of us within the Oregon State community. After seeing the effects of this drug crisis take down the community around us, the article details how many narcotics a single dealer/distributor can carry. This single driver was in possession of over 200,000 pills, and there are millions upon millions more out there. Continuing to seize these drugs from distributors has potential to slow the death rate of those consuming it.

Seized fentanyl from Centralia distributors

Centers for Disease Control and Prevention. (2020, February 11). Fentanyl: Emergency responders at risk. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/topics/fentanyl/risk.html

Fentanyl poses risks to more than just its users. For first responders, there have been reported incidents in which working with overdose victims or working to resuscitate an individual having an overdose in which the first responders suffer from the effects of the drug. Although considered rare, incidents involving first responders demonstrate how potent fentanyl can be. For law enforcement, first responders, and investigators, fentanyl exposure is considered high-risk for respiratory, face/eye, hand, and dural protection, per the CDC.

This article is extremely important to my research and the point of my topic. Fentanyl is a leading killer because of its price point and potency. Despite being nearly 30 times more potent than morphine, on the market, fentanyl-laced pills cost 30% or less of the price of morphine. In 2022, the DEA seized over 50 million fentanyl-laced pills. Additionally, over 10,000 pounds of fentanyl powder this calendar year (DEA.gov). Despite the elevated seizure rate, overdose deaths were still at an all-time high, with an even larger number of deaths expected this year.


Synthetic opioid overdose from a distance - Conclusion

With the completion of my research, I have learned a lot about the true dangers of the drug market, along with how dark the fentanyl market is. Children are being targeted with colorful pills and lower price points. Synthetic opioids can be produced exponentially faster because they are not derived from plants, and can be turned around for a third of the price. Foreign pharmaceuticals make precursors and ship them across the Pacific Ocean, where they are smuggled into the country and have since wreaked havoc.

Seized Chinese Fentanyl

The export, smuggling, and consumption of synthetic opioids have significant overlap with the importance of region/location. Commonly, low-income areas are used as holding positions for such drugs. Low-income communities also account for nearly 75% of all synthetic sales across the country. Everything from harbors, weak border security points, to communities that are torn apart by these drugs all play into the importance of region and location.

Map of Americans Below the Poverty Line

A main claim I can make regarding the fentanyl crisis is that deaths are increasing astronomically. If we do not act soon there will be no end to the crisis. In 2020, just under 100,000 people died because of overdoses in the United States. Last year, the number was near 120,000. This year, we are on pace to reach 120,000 deaths by October. This issue affects all of us. From low-income families to first responders, to loved ones who may have a family member suffering from addiction. We need to institute change, and need to do it now.

Drug-related protest


The dark realities of drug use

Real Oxycodone vs. Fake Fentanyl-Laced Opioids

Overdose death by year, and by gender (2021)

Lethal doses of Fentanyl, Carfentanyl, and Heroin

Teen Overdoses Through The Last Decade

The 3 waves of the opioid crisis

Chinese Fentanyl

Fentanyl Flow From China, Mexico, and Canada to the United States

Seized fentanyl from Centralia distributors

Seized Chinese Fentanyl

Map of Americans Below the Poverty Line

Drug-related protest