Drug addicts, especially in the United States and Canada, are increasingly using fentanyl. Fentanyl is a painkiller which was initially used to treat serious cancer cases. The medical profession has been prescribing the product since the 60s. In the 70s, however, fentanyl began to flood the streets on the other side of the Atlantic in the form of a “fentanyl-heroin cocktail”. The effects of the cocktail are immediate and a single dose can be fatal. Fentanyl quickly became sought after in Quebec and in the United States, and it now causes more deaths than heroin in some American states. In recent decades, illicit fentanyl has become widely available and has generated a rise in falsified pills which sell between $10 and $20 on the street; a financial windfall of several millions for traffickers.
Fentanyl hauls surge 72% between 2015 and 2016
Out of the 64,000 opioid overdose deaths recorded in the United States last year, more than 20,000 were caused by fentanyl and synthetic opioids. This is double the 2015 figures.
A DEA (the American Drug Enforcement Administration) report , published in October 2017, clearly confirmed the rise in illicitly-produced fentanyl in the United States and its contribution to the numerous deaths recorded in 2017. The report states that: “Illicitly-produced fentanyl is increasingly available in falsified-pill form. Fentanyl traffickers use fentanyl powder and pill presses to produce pills that resemble common prescription opioids, such as oxycodone and hydrocodone. The pills are sold in the US black market, and users generally do not realize that the pills are laced with fentanyl. In many cases, the colorings, markings, and shape of the falsified pills are consistent with authentic prescription medications. The presence of fentanyl may only be determined during laboratory analysis.”
A Partnership for Safe Medicines report reveals that falsified prescription pills containing fentanyl were found in 40 states and have caused deaths in several states.
China and Mexico: trafficking hubs
The DEA reports that whilst fentanyl is sometimes diverted in health facilities, this only represents a small fraction of the trafficking. Most of the fentanyl available on the streets is illicitly manufactured, mostly in China and in Mexico, and then smuggled into the United States by post. The report reveals that: “The relatively small-scale quantities of licit fentanyl being diverted, compared to kilogram seizures of illicitly produced fentanyl, indicates that illicitly-produced fentanyl is responsible for the current fentanyl epidemic in the United States.”
In response to increasing demand from the United States, Mexican cartels have jumped on the bandwagon and are setting up their own fentanyl manufacturing laboratories. Mexican cartels currently control almost all heroin and synthetic drug production for the north of the border. “Mexican gangs are showing continued signs of growth and expansion […] no other criminal group can compete with them.”
China is also a major supplier; in many cases, traffickers import active ingredients and buy Chinese pill presses to produce falsified pills. The DEA discovered that pill press traders falsify transport documents or ship the equipment as a “kit” to avoid being caught at customs. In December 2017, two Americans suspected of running a falsified oxycodone pill manufacturing operation were arrested in California. The men had nine pill press machines which they used to condition fentanyl imported from China. The bulk-imported fentanyl was transported with falsified transport documents which mislabeled the goods as “food and beauty products” and the falsified pills were traded on the dark web for Bitcoin payments.
A flawed system: internet and postal services
Chinese traffickers widely exploit internet’s anonymous network to illegally sell fentanyl, a US Senate report revealed. In two years, almost $800m worth of fentanyl pills were shipped to the United States via illegal websites and the US postal service. This figure is confirmed in the January 2018 edition of the National Association of Boards of Pharmacy (NABP) report on 100 illegal e-pharmacies:
• more than half of the sites (54%) offered CS (controlled substances) – a substantial increase in comparison to the 13% of all the sites NABP reviewed and listed over the past nine years;
• 98% offered medication without a prescription;
• 76% sold foreign medicines or non-FDA approved products;
• 40% offered CS including fentanyl-based opioids. The most frequently sold medicine without a prescription was Xanax.
The Senate’s report also raised a flag in terms of loopholes in the US postal service. Unlike shippers such as UPS and FedEx, which are required to provide customs documents for the parcels they ship, the US postal service does not require any official documents for shipments. It is thought that 318 million parcels arriving from overseas were not monitored because they were sent via the postal service.
New legislation in China now categorizes fentanyl and other synthetic opioids as controlled substances and this should reduce the impacts of the problem. “Regulations for certain substances published in October 2015 led to a drop in availability in the United States. Additional scheduling is expected to yield similar results”, said the DEA.
Several cases:
• Nine people died in Pinellas, Florida, after taking what they thought to be Xanax pills but were, in fact, falsified fentanyl.
• An orthopedic surgeon was indicted by a federal grand jury in West Palm Beach for providing a young woman with falsified oxycodone, which caused her to overdose and die. Forensic analysis of the pills the doctor was supplying revealed they had been illicitly manufactured using fentanyl.
• More than twenty patients with the same symptoms, including organ failure and sepsis, were rushed to hospital in Georgia. The patients revealed a common thread: they had all taken what they believed were Percocet pills they had bought on the street.
KEY FIGURES
- 650,000:the total of opioid prescriptions issued per day in the United States: proof that the crisis is not simply due to illicit trafficking.
- 2 milligrams:the same volume as four grains of salt. This is the dose of illicit fentanyl which can kill a human being.
- 95% of global opioid consumptionis concentrated in North America, western Europe, New Zealand and Australia.