The Fentanyl Pipeline to the US May Be Drying Up: NPR

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Is the US finally gaining ground against street fentanyl? Some experts say yes. New data indicates a sharp decline in supply and far fewer overdose deaths. NPR addiction correspondent Brian Mann reports.

BRIAN MANN, BYLINE: This summer, Dr. Dan Ciccarone, a street drug expert at the University of California, San Francisco, a research team to study the use of fentanyl on the streets of his city. They found something unexpected.

DAN CICCARONE: The fentanyl supply is drying up for some reason. I hang out on the street. I talk to people. The medicines are difficult to find and more expensive.

MANN: When street fentanyl entered the U.S. drug supply, most experts believed the deadly synthetic opioid was unstoppable. Fentanyl is cheap. It’s easy to make and extremely profitable. But Ciccarone says he’s heard from street drug investigators in the U.S. in recent months

CICCARONE: And they’re all telling me the same thing: some kind of shortage of supply on the streets.

MANN: There are skeptics – people who question this trend. But some of the most respected drug policy analysts in the US believe something big is happening, disrupting the deadly fentanyl supply chain.

VANDA FELBAB-BROWN: It’s a development that many drug policy experts couldn’t have imagined.

MANN: Vanda Felbab-Brown of the Brookings Institution is an expert on the criminal organizations that make and traffic fentanyl. She says drug gangs suddenly appear to be adulterating or diluting fentanyl.

FELBAB-BROWN: Everyone is surprised by the extent of fentanyl adulteration. And even more importantly, I would say, because of claims in certain places in the US, there is not enough fentanyl available.

MANN: In July, researchers discovered what they call an unprecedented dilution of street fentanyl that is now being mixed with an industrial chemical known as BTMPS. This chemical is considered unsafe in humans, but does not cause overdoses or instant death. Nabarun Dasgupta is an addiction researcher in North Carolina.

NABARUN DASGUPTA: We’ve had samples that were just BTMPS and no fentanyl.

MANN: Why drug cartels seem to be smuggling less fentanyl and using an industrial chemical to weaken its power is a mystery. But Dennis Cauchon, a harm reduction activist in Ohio, believes these trends are leading to a precipitous drop in drug deaths — down by about a third in his state this year.

DENNIS CAUCHON: If you look at the share of fentanyl in Ohio’s drug supply, you can predict how many deaths there will be. So the real question is: why has fentanyl declined?

MANN: This question: Why is the fentanyl supply suddenly shrinking? – It is hotly debated. Some experts believe international pressure on Chinese companies making fentanyl precursor chemicals may be a factor. Jen Daskal is an assistant to President Joe Biden on the National Security Council, focusing on fentanyl policy. She says the escalating U.S. crackdown on Mexican drug cartels also shows progress.

JEN DASKAL: And we’re seeing the effects. And most importantly, we see the effects in terms of lives saved.

MANN: U.S. deaths from fentanyl are down 20% by 2023, according to the U.S. Drug Enforcement Administration. Some in law enforcement believe this decline in fentanyl trafficking will likely be a hiccup in the supply chain, rather than a permanent change. And in some cities, fentanyl is still readily available. Dr. Rachel Winograd, a drug policy researcher in St. Louis, thinks other factors, including the use of the overdose drug naloxone, are likely to save more lives.

RACHEL WINOGRAD: Drug seizures at the border and elsewhere have really increased in 2023, but I don’t think that has anything to do with the decline – at least not here in Missouri.

MANN: While this debate about why drug deaths are falling so quickly is just beginning, San Francisco researcher Dan Ciccarone believes the data suggests that the decline in fentanyl supply is driving up the number of overdose deaths slows down.

CICCARONE: The only thing that could really explain this is a supply shock: the supply of fentanyl is drying up for some reason.

MANN: San Francisco has seen a 15% drop in drug deaths this year, hitting the lowest level in four years.

Brian Mann, NPR News.

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