Opioid crisis has a new leading killer: fentanyl

The drug overdose epidemic you’ve been hearing so much about has a new leading killer. It is potent, speedy and unpredictable — making it all the more lethal.

Fentanyl, in all its many forms, is a synthetic opioid that’s easy to make, cheap for traffickers to buy, phenomenally profitable and popular on the street because it offers a powerful high that surpasses that of heroin.

Fentanyl is also laced into other drugs sold on the streets, where unsuspecting buyers might not even know what they’re getting. That’s one reason people across the country are dying from fentanyl and similar compounds at the rate of 55 each day.

For the first time, deaths from synthetic opioids, primarily fentanyl, have surpassed the number killed by prescription opioid painkillers.

If, as expected Thursday, President Trump declares an emergency, the most urgent element of that emergency is the spread of fentanyl. And that should mean stronger action on both the demand side, meaning stepped-up efforts to treat users, and the supply side, meaning more aggressive crackdowns on the sources of fentanyl and its traffickers.

There’s not a minute to lose. As legal opioids become harder and more expensive to obtain, addicts are increasingly turning to heroin, and heroin is increasingly spiked with fentanyl or even carfentanil, a powerful derivative used to tranquilize elephants.

As few as 2 to 3 milligrams, which looks like a few grains of salt, can kill. It’s invisible when mixed into other drugs and is so lethal that police have found addicts dead while still injecting.

One reason for the rapid spread of fentanyl is that it’s so enormously profitable. A kilogram brick laced into other drugs can bring in anywhere from $2.5 million to $20 million.

Cracking down won’t be easy. Fentanyl is a particularly elusive quarry. A decade ago, law enforcement could put a dent in fentanyl deaths by shutting down a single source. In June 2006, for example, Mexican authorities raided and closed a long-operating laboratory in Toluca, Mexico. Within several months, overdose deaths in six U.S. jurisdictions, which had spiked to 150 that same month, dropped to one death per month.

Today, the chief source of fentanyl, similar compounds and raw ingredients is China, where illicit labs can hide in that nation’s huge chemical industry and where the United States has little leverage.

The Justice Department has made some progress with China, announcing the indictment this month of two Chinese nationals, large distributors who sold fentanyl to Americans over the Internet. While Justice called it a “major milestone” in the fentanyl battle and now says China “played a supportive role,” it’s unclear whether the two men are in custody in China or whether their labs have been shut down.

This is all the more reason, during Trump’s trip to China next month, for the president to press Chinese leader Xi Jinping to follow up on China’s recent ban on the manufacture and sale of fentanyl. Among the steps Beijing could take: Shut down illegal laboratories in China. Apprehend and extradite anyone indicted on fentanyl charges in America.

Fentanyl is easy to get into the USA in ways that are hard to track and can’t be stopped by building a wall. It can be purchased online by those who know where to look. And it flows into U.S. destinations, often by way of Latin America, not only through all the usual ports of entry for illicit drugs but also in innocent-looking packages in the U.S. mail or by private shippers.

It’s time for federal agencies to come together to fight this latest scourge. The U.S. Postal Service, Customs and Border Protection, the Justice Department, the Food and Drug Administration, the Drug Enforcement Administration and the State Department all have roles to play. Each of these agencies needs to know what the others are doing and coordinate their efforts.

Local coroners’ offices and federal agencies that are experts in finding where and when fentanyl deaths occur should be working together in a speedy surveillance system so statistics are not a year behind. Law enforcement needs to know where to target its resources immediately. Dealers should be dealt with harshly by the criminal justice system.

A focus on fentanyl is a vital part of any comprehensive approach to the opioid crisis. Declaring a federal emergency could help bring resources together, break through bureaucracy, and open the flow of more money from Congress.

The deadliest drug overdose crisis in U.S. history began with addictive, legal painkillers being handed out like Halloween candy. Today, the body count is being driven by an elusive and even deadlier poison.

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