Understanding how fentanyl ‘saturated the US drug supply’ could help tackle the addiction crisis

Naloxone can prevent overdose deaths, but it is expensive. (Adobe stock photo)

The current opioid crisis in the US started with painkiller prescriptions in the early 2000s, but as medical providers began cutting these drugs, heroin’s popularity soared, and then fentanyl and its ‘tsunami’ of death entered the market, reports Maia Szalavitz van The New York Times. “Understanding how fentanyl saturated the drug supply moving from the US East Coast to the West is critical to ending the worst drug crisis in US history.”

The greed of the drug cartels led to the creation and use of fentanyl. “In 2013, cartels realized they could reduce their labor, production and transportation costs by replacing heroin derived from farm-grown opium with a powder made in a laboratory: fentanyl,” Szalavitz writes. “Before 2018, 80% of all fentanyl-related deaths occurred east of the Mississippi… As of 2021, at least two-thirds of the 100,000 annual overdose deaths in America involved a synthetic opioid such as fentanyl.”

While heroin was considered a more urban drug, “an increase in opioid prescriptions – followed by sharp reductions – resulted in new heroin users in rural areas,” Szalavitz explains. “Illegally manufactured fentanyl began appearing in both urban and rural drug markets… Rural West Virginia and other Appalachian regions were the center of the earliest surge of prescription opioids during the crisis, which led to the creation of new heroin markets in places where employment could be expected. loss.”

Combating opioid addiction and fentanyl overdose deaths is difficult because the drug’s supply chain and use are now deeply entrenched across the country. The drug is cheap to make and buy, and provides an extremely powerful high for the user. “So what can be done? The answer is to focus on the drivers of demand, not supply. This means addressing the roots of addiction and dealing with it compassionately,” Szalavitz writes . “We have a great generic antidote for opioid overdose, naloxone… And two drugs – methadone and buprenorphine – have been proven to reduce the risk of death among people with opioid addictions by 50% or more when used long-term.”

Szalavitz adds that people often turn to drugs because their lives feel hopeless. ‘Addiction is usually an attempt to escape despair. The condition itself is defined by compulsive drug use despite negative consequences, which is why threats of punishment or even death rarely lead to recovery. It is not coincidental that the exponential rise in overdose deaths has occurred in tandem with a profound increase in income inequality.”