Oct 14, 2019

Synthetic opioid crisis still growing, often among unwitting users

A bag of fentanyl seized by law enforcement. Photo: David L. Ryan/The Boston Globe via Getty Images

Although opioid prescriptions in the U.S. have fallen, opioid overdose deaths — 47,000 in 2018 — remain at historic levels. The continued spread of fentanyl and other illicitly manufactured synthetic opioids suggest the problem could still get worse.

The big picture: Inexpensive and widely available on the internet, fentanyl is attractive to dealers who make counterfeit prescription pills or mix it into heroin. Fentanyl, however, is extremely potent, leading more users to fatally overdose.

What's happening: So far, fentanyl deaths are largely concentrated in parts of Appalachia, the mid-Atlantic and New England, with western states less exposed.

Between the lines: Fentanyl isn’t attracting new drug users. Rather, it’s an ingredient suppliers use to cut costs but most consumers seek to avoid (heroin import prices are at least 100 times higher per dose).

  • The problem is thus more like a poisoning outbreak than a traditional drug epidemic driven by user demand.
  • Meanwhile, the rise of e-commerce has made it easier to order fentanyl online, most often shipped from China.
  • Synthetic opioids are also mentioned in an increasing number of cocaine and methamphetamine deaths (though it is unknown if fentanyl was added by suppliers or taken separately by users). One analysis from Ohio, however, found fentanyl in 12% of retail-level cocaine seizures.

What to watch: With the Oct. 2 federal ruling in favor of Philadelphia’s proposed supervised consumption site, other jurisdictions may give such facilities a more serious look. Expect further discussion about improving fentanyl detection technologies and pilot programs for prescription heroin too.

Go deeper: Read “The Future of Fentanyl and Other Synthetic Opioids” from RAND.

Bryce Pardo is an associate policy researcher at the RAND Corporation. Beau Kilmer is the director of the RAND Drug Policy Research Center.

Go deeper

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 5,410,228 — Total deaths: 345,105 — Total recoveries — 2,169,005Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 1,643,499 — Total deaths: 97,722 — Total recoveries: 366,736 — Total tested: 14,163,915Map.
  3. World: White House announces travel restrictions on Brazil, coronavirus hotspot in Southern Hemisphere Over 100 coronavirus cases in Germany tied to single day of church services — Boris Johnson backs top aide amid reports that he broke U.K. lockdown while exhibiting symptoms.
  4. Public health: Officials are urging Americans to wear masks headed into Memorial Day weekend Report finds "little evidence" coronavirus under control in most statesHurricanes, wildfires, the flu could strain COVID-19 response
  5. Economy: White House economic adviser Kevin Hassett says it's possible the unemployment rate could still be in double digits by November's election — Public employees brace for layoffs.
  6. Federal government: Trump attacks a Columbia University study that suggests earlier lockdown could have saved 36,000 American lives.
  7. What should I do? Hydroxychloroquine questions answeredTraveling, asthma, dishes, disinfectants and being contagiousMasks, lending books and self-isolatingExercise, laundry, what counts as soap — Pets, moving and personal healthAnswers about the virus from Axios expertsWhat to know about social distancingHow to minimize your risk.
  8. Other resources: CDC on how to avoid the virus, what to do if you get it, the right mask to wear.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

Updated 2 hours ago - Politics & Policy

U.S. coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

The CDC is warning of potentially "aggressive rodent behavior" amid a rise in reports of rat activity in several areas, as the animals search further for food while Americans stay home more during the coronavirus pandemic.

By the numbers: More than 97,700 people have died from COVID-19 and over 1.6 million have tested positive in the U.S. Over 366,700 Americans have recovered and more than 14.1 million tests have been conducted.

World coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

Japan's economy minister outlined plans on Monday to end the nationwide state of emergency as the number of new novel coronavirus cases continues to decline to fewer than 50 a day, per Bloomberg. Japan has reported 16,550 cases and 820 deaths.

By the numbers: Over 5.4 million people have tested positive for the virus as of Monday, and more than 2.1 million have recovered. The U.S. has reported the most cases in the world (over 1.6 million from 13.7 million tests). The U.K. is reporting over 36,800 deaths from the coronavirus — the most fatalities outside the U.S.