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The New Killers In The Opioid Crisis

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Hayden Daniel Associate Editor

Fentanyl, which is much more powerful than traditional opiates like morphine and heroin, has become the flagship opiate of the growing opioid crisis in the United States. Its offshoots, most notably carfentanyl, are in some instances hundreds of times more powerful than their parent drug and threaten to become the biggest killers in the opioid epidemic.

While fentanyl first entered the national stage as an import from China, brought in through parcels in the mail, the Mexican drug cartels have reclaimed their dominance over the American illicit drug market and are now the number one producers and distributors of synthetic opioids.

Fentanyl is a fully synthetic opioid, meaning it is entirely produced in a laboratory instead of extracted from poppies on large farms like morphine, codeine and heroin. It’s also 50 times more powerful than heroin. In the hospital, fentanyl is usually administered in small patches that allow the drug to be absorbed by the skin. On the streets, fentanyl is usually cut with heroin by drug dealers to give the heroin more power.

Carfentanyl is a chemical offshoot of fentanyl. It is 10,000 times more potent than morphine and 100 times more powerful than regular fentanyl, according to the DEA. A dose of carfentanyl as small as two milligrams can be fatal. For comparison, the average penny weighs about 2500 milligrams. Carfentanyl is distributed in several different forms, including powder, blotter paper and tablets. It is usually absorbed through the skin or inhaled. (RELATED: Maine AG Warns Synthetic Opioids Have ‘Invaded Our State’ And Are Spreading Death)

Unlike fentanyl — which is used as an extremely powerful painkiller that was developed as an anesthetic for patients about to undergo surgery and as a painkiller to treat people with terminal cancer — carfentanyl is not approved for use on humans. It was developed as a tranquilizer for large animals like elephants. Carfentanyl is so powerful that it can pose a threat to medical personnel responding to an overdose who touch it by accident and have it absorbed through their skin. Sometimes, not even multiple doses of the anti-overdose medication Narcan, which is used regularly to treat victims of heroin and fentanyl overdoses, can save someone from even minuscule exposure to carfentanyl.

NEW YORK, NEW YORK – SEPTEMBER 23: New York Attorney General Eric Schneiderman speaks during a press conference regarding a major drug bust, at the office of the New York Attorney General, September 23, 2016 in New York City. (Photo by Drew Angerer/Getty Images)

Fentanyl first appeared as a major street drug in 2014, but carfentanyl has only entered into America’s drug scene recently. According to the DEA, its National Forensic Laboratory Information System found zero samples of carfentanyl in the confiscated drugs that it analyzed in 2015. In 2016, 2.74% of samples contained carfentanyl. Carfentanyl’s representation within the opioid epidemic has only increased.

According to the Centers for Disease Control and Prevention (CDC), of 11,045 opioid deaths from July 2016 to June 2017, 2,275 of those deaths were caused by a fentanyl analog. Carfentanyl alone accounted for 1,236 of those deaths. Additionally, the CDC found that the number of deaths caused by fentanyl analogs, including carfentanyl, doubled from the second half of 2016 to the first half of 2017. Whereas 764 people were killed by fentanyl-related opiates in the last six months of 2016, 1,511 people were killed by the same drugs in the first six months of 2017. (RELATED: There Are Now More Overdose Deaths In Major Cities Than In Urban Areas)

Synthetic opioids like fentanyl and carfentanyl accounted for just 14% of opioid overdose deaths in the U.S. in 2010, a total of 3,007. By 2016, synthetic opioids accounted for 50% of opioid overdose deaths, a total of 19,413, according to the National Institute on Drug Abuse. Synthetic opioids killed more people in 2016 than heroin, which killed 15,469 people, and prescription opioids like Vicodin, which killed 17,087 people. In 2018, more than 31,000 people died from overdoses caused by fentanyl or one of its relatives.

Nationally, drug overdose is the leading cause of accidental death for Americans under 50.

Previously, China was one of the top importers of synthetic opioids into the U.S., often getting the drugs into America by smuggling them in via U.S. Mail. China began exporting shipments of synthetic opioids to the U.S. via mail in 2013, and they were the top producer and supplier of synthetic opioids throughout the early years of the opioid epidemic.

However, U.S. officials now say that the majority of synthetic opioids are produced in Mexico. Most of the chemicals used to make fentanyl and its relatives are imported from China into Mexico, manufactured into fentanyl in Mexico and then smuggled into the U.S. through traditional routes along the southern border. U.S. officials also report that synthetic opioids are quickly overtaking heroin as the preferred opioid of choice for Mexican drug cartels since it is far easier to produce fentanyl and other synthetic opioids in a lab than to cultivate and protect a poppy field to produce heroin.

A soldier stands guard beside poppy plants before a poppy field is destroyed during a military operation in the municipality of Coyuca de Catalan, Mexico April 18, 2017. Picture taken April 18, 2017. REUTERS/Henry Romero

Fentanyl is also far more profitable for the cartels than traditional heroin. For an initial investment of about $32,000, a fentanyl cook can produce 2.2 pounds of fentanyl, which can be used to produce almost one million pills. That could net the cartel almost $20 million on the street. Demand for Mexican heroin has dropped by nearly $362 million per year since the beginning of the opioid crisis in 2014,” according to the DEA.

Overall, Mexican drug cartels are able to smuggle far more fentanyl and other synthetic opioids across the southern border than China can send into the U.S. by mail. In January 2019, U.S. agents at the border seized 254 pounds of fentanyl in both powder and pill form from the back of a truck trying to cross the border into Nogales, Arizona. Overall, seizures of fentanyl at the southern border increased by 135% from 2016 to 2017. Fentanyl seizures at the southern border totaled 524 kilograms in 2017, while seizures of Chinese fentanyl sent through the mail totaled only 165 kilograms. (RELATED: Police Seize Enough Fentanyl To Kill 14 Million, Make 35 Arrests In Massive Drug Bust)

Opium, the primary ingredient in heroin, went for $600 a pound in the early 2010s. And now, it goes for about $100 a pound, putting many poppy farmers who had depended on the traditional heroin economy out of business as the Mexican drug cartels increasingly turn to synthetic opioids.

President Donald Trump has repeatedly pressured China to crackdown on the production of fentanyl and other synthetic opioids as part of ongoing trade talks between the U.S. and China. China agreed to ban fentanyl and restrict its production in April 2019. However, the Chinese government has failed to adequately inspect factories that produce synthetic opioids, allowing some companies to circumvent the new regulations and continue supplying large quantities of fentanyl to the drug cartels.