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Commission Identifies Priorities for Addressing Synthetic Opioid Crisis
With synthetic opioids fueling the nation’s substance use disorder crisis, a federal commission on Tuesday released an extensive report on the persistent threat it has deemed a matter of national security and ways in which federal policies should be crafted to address it.
The Commission on Combating Synthetic Opioid Trafficking was established under the National Defense Authorization Act for the 2020 fiscal year. Led by co-chairs Rep. David Trone (D-Maryland) and Sen. Tom Cotton (R-Arkansas) and comprised of representatives from multiple federal departments and agencies, as well as 4 outside members appointed by Congress, the commission was tasked examining the threat of synthetic drugs to the United States and developing an approach to stopping their flow into the country.
>> READ Commission on Combating Synthetic Opioid Trafficking: Final Report
After studying the issue for 12 months, the commission has identified areas in which it believes the federal government should place more emphasis and developed a series of action items.
The commission noted that over the span of a decade, the nation’s illegal drug markets that were once dominated by diverted prescription opioids and heroin have seen a meteoric rise in illegally manufactured synthetic opioids, which are cheaper and easier to produce than heroin. The synthetics surge in the US started around 2014. The commission’s report pinpoints Mexico as the current principal source of illicit fentanyl and its analogs, as cartels manufacture the substances with precursor chemicals largely sourced from China.
“Because illicit fentanyl is so powerful and such a small amount goes such a long way, traffickers conceal hard-to-detect quantities in packages, in vehicles, and on persons and smuggle the drug across the US-Mexico border,” the commission wrote. “It is difficult to interdict given that just a small physical amount of this potent drug is enough to satisfy US demand, making it highly profitable for traffickers and dealers.”
Current Challenges
The commission identified the following 7 challenges related to synthetic opioids as essential for policymakers to understand when developing a response:
- Illegal drug manufacturing is now easier to conceal as operations move from large poppy fields to small laboratories, creating a more simplified and condensed supply chain.
- Geopolitical issues are impeding actions to disrupt supply. The commission noted the vast majority of illegally manufactured fentanyl in the US is coming from Mexico, with 2 cartels dominating trade. The cartels’ “financial prowess and extensive use of weapons, bribery, threats, and murders of politicians and members of the public” have limited the state’s ability to control them, the commission wrote.
- Synthetic opioids are both highly potent and easy to make, creating a scenario in which small, hard-to-detect quantities can be transported for large profits.
- Social media and encryption platforms, along with established logistics systems, are enabling vendors to evade law enforcement.
- Synthetic opioids’ pill form leverages Americans’ familiarity with taking pills and offers an alternative to the social stigma associated with injection, snorting, and smoking other illicit drugs. The commission notes that most consumers, at least initially, are not specifically seeking fentanyl. Instead, it is being laced into heroin or manufactured as counterfeit versions of brand-name medications such as OxyContin, Percocet, Vicodin, Adderall, and Xanax.
- The increased depression, anxiety, trauma, and suicidal ideation fueled by external factors in recent years, particularly the COVID-19 pandemic, have driven increases in substance use in the US.
- Overall, synthetic opioids offer economic and tactical advantages that are allowing criminal operations to outpace law enforcement.
Action Items
With overdose deaths involving synthetic opioids showing no signs of abating, the commission offered 5 areas of priority for policymakers to focus on:
- Develop a more unified, central body to coordinate all US drug policies' planning, implementation, and evaluation. The commission recommends that the Office of National Drug Control Policy be elevated to a cabinet-level position to support its role as a central authority for policymaking and interagency coordination on all drug policy matters.
- Disrupt drug supply through targeted oversight and enforcement. The US must improve its oversight of large chemical and pharmaceutical sectors, and enhance investigations of vendors and importers in key foreign countries to disrupt flow. Domestically, actions should focus on how drug supply investigations are conducted and strengthening law enforcement intelligence sharing and training.
- Make public health demand-reduction approaches central to reduce the number of potential buyers. “Better access to and continued scientific understanding of treatments for opioid use disorder (OUD), including through medication, are primary needs,” the commission wrote. “Innovative prevention messaging must inform entire communities—including those with OUD, those who casually use drugs, and the public at large—of the pervasiveness of synthetic opioids used as a lacing agent and resources available to those struggling with addiction.”
- Collaborate with other countries involved in the production of synthetic opioids and precursors.
- Improve surveillance and data analysis to allow for more timely and effective interventions.
“Given the gravity of this crisis, new approaches, additional resources, and a reconsideration of ongoing interventions are essential,” the commission wrote. “If such steps are not taken, the economic costs will continue to rise, and hundreds of thousands more Americans will perish from preventable drug overdoses.”
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