The United States witnessed a grim milestone: for the first time, drug overdoses killed more than 100,000 people nationwide in a single year. Of those deaths, more than 66% were related to fentanyl.
In contrast in 2010, fewer than 40,000 people died from overdoses across the United States and less than 10% of those deaths were related to fentanyl. However, the increase in fentanyl-related deaths has been observed since 2015.
However, this opiate is increasingly being analyzed both in the press and in the geopolitical sphere. In this article, some light will be shed on what fentanyl is and its repercussions.
Fentanyl is a pharmaceutical drug that can be prescribed by a doctor to treat acute pain. Fentanyl belongs to a group of medications called narcotic analgesics , known as opiates, it works by changing the way the brain and nervous system respond to pain . This drug is synthetic, it is developed in laboratories following the structure of opiates .
There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl . Both are considered synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and in advanced stages of cancer. Currently and thanks to its powerful analgesic action, cardiac safety and low cost, fentanyl is widely used in the medical area.
Its effect is very powerful and effective immediately after taking it and generates a power and effect in our body up to 50 times more powerful than that produced by heroin. Fentanyl can be consumed in a variety of ways, including inhalation, injection, oral, and rectal. When used illegally, fentanyl is often mixed with other drugs, such as heroin or cocaine.
Fentanyl is distributed through the bloodstream and reaches the central nervous system in search of its target: opiate receptors, elements of neurons to which they bind, slowing down their activity and reducing the signals that transmit pain. When a person becomes addicted , the search for and use of the drug takes over their life. When a fentanyl overdose occurs , breathing can become very slow or stop completely. For most people, 2 milligrams is enough to cause cardiac arrest .
Fentanyl was first synthesized by Paul Janssen in Belgium in 1959. Janssen was a pharmacist and chemist who worked for the pharmaceutical laboratory Janssen Pharmaceutica. Fentanyl was initially developed as an intravenous anesthetic. It should be mentioned that in 1963 it was used for the first time in the United States as an intravenous analgesic. Likewise, this drug was approved for medical use in the United States in 1968.
Fentanyl was initially prescribed to treat severe chronic pain, such as pain caused by cancer. Starting in the 1970s and 1980s, its use was extended to other purposes, especially recreational. A decade later, in the 1990s, it began to be used to treat postoperative pain. Starting in the 2000s, fentanyl began to be used illicitly.
One of the main causes of the rise of fentanyl is that since the 90s, American doctors have increased the prescription of opioids , highly addictive, to alleviate pain. Among these, OxyContin, from the pharmaceutical company Purdue Pharma, which minimized the addictive risks of the drug and paid doctors to promote its product. Over time, many patients became addicted.
Another determining factor is that fentanyl is very cheap to produce because it is created synthetically in laboratories and drug traffickers have seen great profits from it.
The “ fetty ”, as fentanyl is called in the jargon of American addicts, arrived for the first time in 2006 in Chicago. Starting in 2015, fentanyl-related deaths would increase . Its consumption skyrocketed during the Covid-19 pandemic. According to data from the United States Center for Disease Control and Prevention (CDC), the consumption of this pain reliever grew by 38% during the SARS-CoV-2 pandemic.
Since then, the drug has spread throughout the US and death rates have risen sharply.
Its characteristics and the expansion of this opiate in the illegal market has contributed to an epidemic of deaths in the United States.
Consequently, Washington is trying to confront the illegal market for this drug. Likewise, this fight against fentanyl has strained relations between the US and China and to a lesser extent with Mexico.
Fentanyl is primarily produced in China, where it is relatively cheap and easy to manufacture. Beijing also exports many of the precursor chemicals needed to synthesize fentanyl. From China, fentanyl is transported to other countries, mainly the United States and Mexico.
Map 1: main route in the production and distribution of fentanyl. Source: https://www.20minutos.es/noticia/5183904/0/ruta-fentanilo-como-llega-droga-mortal-calles-eeuu/
The main routes detected by the United States are those to Hong Kong and Shanghai, in China, but also those to Bombay and Chennai, in India . The cargoes arrive at the Mexican ports of Veracruz, Ensenada, Manzanillo and Lázaro Cárdenas. The containers usually pass through Germany and even Brazil, before reaching their destination in Mexico.
In Mexico, the precursors are used for the mass production of fentanyl in clandestine laboratories in the state of Culiacán, a stronghold of the Sinaloa cartel. Control of the fentanyl market is one of the keys to the confrontation between the Sinaloa Cartel and the Jalisco Cartel, the two main criminal organizations in the country. From there, the drug with dangerous doses of fentanyl finally enters the United States in pills or powder.
The United States has complained in the past about China's lack of commitment to disrupting narcotics chains.
Although Beijing placed all fentanyl-type drugs and two key fentanyl precursors under a controlled regulatory regime in May 2019, it remains the largest (if indirect) source of fentanyl in the US.
Recently, the United States Department of Justice, following an investigation, has charged eight Chinese companies and twelve of their executives with crimes related to the production, distribution and importation of fentanyl and other opioids in the United States.
During the 2023 Asia-Pacific Economic Cooperation summit, US President Joe Biden and Chinese President Xi Jinping reached an agreement to combat fentanyl trafficking.
Over the years, the U.S. government has pursued various strategies to restrict the flow of illegal opioids from abroad, including providing Mexico with $3.5 billion in security and counternarcotics aid through the Initiative. of Mérida (2008-2021) and coordinate efforts with China to end fentanyl production.
In 2021, the United States and Mexico announced the Bicentennial Framework for Security, Public Health and Safe Communities , a new security cooperation relationship focused on finding public health solutions to drug use, reducing trafficking of weapons and people.
Fentanyl consumption has not only increased in the United States. The latest data provided by the Survey on alcohol and other drugs in Spain (EDADES). They point out that this has multiplied by four in just two years . Thus, its sporadic use has risen from 1.9% in 2018 to 14% in 2022. The effects of fentanyl, and other drugs, are reaching levels never seen before and affecting the relationships between different potencies.
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