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After Boosting the Fentanyl Market, Drug Warriors Vainly Promise to Eradicate It

The government can't stop the flow of illegal drugs, but it can always make them more deadly.

Roger Bate / AEIRoger Bate / AEI

Here are some numbers from the Drug Enforcement Administration (DEA) that should, in addition to the challenges noted by Mike Riggs, put a damper on Donald Trump's dream of stopping the illicit fentanyl trade.

"Traffickers can typically purchase a kilogram of fentanyl powder for a few thousand dollars from a Chinese supplier," the DEA says, "transform it into hundreds of thousands of pills, and sell the counterfeit pills for millions of dollars in profit." Taking the average of two actual sales cited by the DEA, a kilogram of fentanyl that costs $2,600 can be pressed into 666,666 fake pain pills, each containing 1.5 milligrams of the active ingredient, generating about $10 million in revenue at $15 each.

By comparison, a kilogram of Mexican heroin might generate something like $840,000 in revenue, based on the average retail price per pure milligram reported by the DEA in 2016. In other words, fentanyl is more than 10 times as profitable as heroin, which helps explain why the former has displaced the latter in the United States, especially since smugglers are keen to squeeze as many doses as possible into a given volume.

Given those incentives, cutting off the illicit fentanyl supply will not be quite as easy as the president seems to think. "US government agencies have made considerable efforts to interdict fentanyl and its precursors from entering the US market, but the combination of its small size and high value makes this difficult," Roger Bate notes in a new American Enterprise Institute report. "Mexican gangs and Chinese criminal enterprises find it easy to hide the products through a variety of transit methods."

Bate found that it is easy to buy fentanyl through the Chinese business-to-business trading websites Weiku and Mfrbee. "Via Weiku and Mfrbee, it was possible to buy fentanyl, its analogues such as carfentanil, and their precursors," he says. "Some sellers would only trade in significant volumes (more than a kilogram of fentanyl), but many were happy to sell less than 100 grams of the potent product....Although I had no intention of making the purchases, I was only one click away from doing so....Even if the UK and US authorities did prevent or intercept these deals, I doubt other nations would intercept them, and a motivated user or dealer could use a more circuitous path."

Trump says "the results will be incredible" if the Chinese government cracks down on such websites. Bate is less sanguine. "While the US may come to an agreement with Beijing about closing down sales to the US from business sites such as Weiku, it is unlikely to be fully successful," he writes. "And even if it managed to stop 100 percent of direct sales to the US, enterprising dealers will simply sell into nations such as the UK, repackage the product, and then resell it into the US. Intercepting all packages from the UK and other EU nations to the US will not be possible." Furthermore, "whether or not drugs are available to the general public via the mail, drug dealers have domestic production and overland and sea routes and other courier services that deliver the product to the US."

The fentanyl conundrum is just the latest example of how prohibition undermines itself by enabling criminal organizations to earn a risk premium that motivates all manner of creative evasion. To the extent that increased enforcement has an impact, it tends to makes drug use deadlier. Interviewing drug users and dealers in the Philadelphia area, Bate found that fentanyl has swiftly replaced diverted pain pills, which are less dangerous because their potency and dosing are predictable. "It is arguable that policies to drive oxycodone and other prescription opioids from the illicit market are the main cause of the rise of fentanyl in these markets, and regrettably the resulting spike in fatal overdoses," he writes. "By making prescription opioids harder to come by, government policy has probably driven illicit actors to supply—and drug users to ingest—fentanyls."

That certainly seems to be what is happening. Nor does it stop there. If efforts to restrict the fentanyl supply are at all successful, they will encourage the shift toward still-more-potent fentanyl analogs. Earlier this year, the U.S. Centers for Disease Control and Prevention (CDC) reported that the number and proportion of deaths involving fentanyl analogs "nearly doubled" between the second half of 2016 and the first half of 2017.

In a blog post yesterday, Bate noted signs that fentanyl-related deaths may be leveling off. If so, he does not think the government's drug control efforts should get the credit. "While the numbers may be falling," he writes, "I think the main reason is not because of improvements in federal, state, or local policies, but because dealers—those breaking the law and supplying the deadly stuff—are getting better at controlling dosing. After all, it's bad for business to keep killing your clients and authorities are likely to clamp down on your activities if you keep doing so."

Despite the deadly effects of cracking down on pain pills, Bate says in his AEI report, "lowering the number of prescription opioids in circulation is the right policy—assuming that preventing new opioid addicts is of paramount importance." Even leaving aside the impact on bona fide patients who are losing access to the medication they need to make their lives bearable, that conclusion seems dubious to me.

As Jeff Singer notes on the Cato Institue's blog, data from the National Survey on Drug Use and Health (NSDUH) indicate that both nonmedical use of prescription opioids and "pain reliever use disorder" were essentially flat from 2002 (when the current version of the survey began) to 2010, a period when the volume of opioid prescriptions doubled. Those numbers remained flat from 2010 through 2014, while prescriptions declined. (The wording of the relevant NSDUH questions changed in 2015, so the numbers for more recent years are not comparable.)

According to the CDC, deaths involving pain pills more than doubled from 2002 to 2010. But they continued to rise after 2010, even as prescriptions fell by about a third between 2010 and 2017. More important, total deaths involving opioids, including heroin and fentanyl, rose dramatically, more than doubling between 2010 and 2017.

The NSDUH data suggest the relationship between pain pill prescriptions and "new opioid addicts" is not as tight as Bate implies. But opioid use clearly has become more dangerous during the last decade and a half. That may be partly due to larger doses or more reckless drug mixing. But the biggest factor in recent years has been the proliferation of fentanyl, the impact of which has been magnified by the deadly substitution effect that Bate notes.

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  • BigT||

    Decriminalization will greatly reduce deaths, but legalization would be best so dosages are subject to QC.

  • Jerryskids||

    What about the killer clowns that mix the fentanyl with the krokodil and the bath salts and then shove them up their butt with a tampon? You know, when every new drug that comes along is the Worst Thing Ever, maybe people stop paying attention to the warnings.

  • susancol||

    How the worm turns. China went to war with Britain twice in the 1800's to prevent it from importing opium into China. Now the we begs China to prevent its businesses from importing an opium relative here.

  • SQRLSY One||

    I say we (the USA) should pay them back by sending them un-prescribed cheap plastic flutes and get them all addicted!!!

    (But we in the USA need to stay AWAY from such demonic devices!)

    To find precise details on what NOT to do, to avoid the flute police, please see http://www.churchofsqrls.com/DONT_DO_THIS/ … This has been a pubic service, courtesy of the Church of SQRLS!

  • cynicalretiree||

    In addition, Britain forced Chinese businesses to market opium. No government in 2018, is forcing anyone to market opiates. Also opium itself is a natural gum that is smoked and far safer and practical than injected substances.

  • Sometimes a Great Notion||

    After all, it's bad for business to keep killing your clients and authorities are likely to clamp down on your activities if you keep doing so."

    You'd think so but I have heard from anecdotal sources that killing a customer can make the enterprise more profitable because addicts are looking for the best bang for their buck. Fucked up junkie logic.

  • Echospinner||

    Fucked up junkie logic.

    It is. The neural pathways and consequences are well known.

    Opiates are a zombie drug in many ways. They physically alter decision making and other centers in the brain.

    At the same time they have legitimate medical use.

  • Rich||

    National Survey on Drug Use and Health (NSDUH)

    How much did *that* acronym cost the taxpayers?

  • AlmightyJB||

    Most Americans support addicts dying from overdoses, not legalization. It "serves them right" for breaking the law don't you know. They don't care if they die, but they do care if they do drugs, if you can imagined how fucked up you have to be to think like that.

  • Ryan (formally HFTO)||

    Source?

  • Uncle Jay||

    Prohibition works.
    It worked with booze.
    It worked with marijuana.
    It will work with fentanyl.
    We just need to give the feds all of our money and surrender all our civil rights and liberties.
    What could possibly go wrong?

  • Gnosis||

    LOL I like your comment Jay. Yeah we need to hand everything over to them, no problems will arise whatsoever.... Sadly to many in this country believe this is true. We did not have a problem with drugs until the government stepped in and told us, no no no this is off limits. Thousands of years and society is just fine and the decade we decide to say such things are off limits huge problems arise, yeah we did the right thing. But people today are to lazy to go and look at history. The DEA is a waste of tax dollars and this suppose war on drugs does nothing but make the people importing the drugs more profit and power by making it harder to do so, not to mention more violent if they must resort to such means to sell their wares.Hell most of the substances they just have banned have been legal as a cup of coffee since the late 60s to early 70s when chemists discovered what we call research chemicals, sadly many of them do have value as medicine but like back in the early 70s when hundreds of unknown drugs became off limits for no reason with no testing we will never know if something that could have help countless millions was in the mix because of propaganda that there is a war on drugs.

  • Gnosis||

    Another fact on this subject that many do not know..... The united states government holds patents for all cannabinoids and within that patent is all the scientific proof of the medical value of cannabis and has been there since the 1970's but they tell us it has no value and is evil, of course they do.....waiting for the time to reap the most profits. Just wait until companies go to start trying to patent cannabis medicines for the pharma market, what huh, this patent was already put forth and belongs to the united states government 40 something years ago?????!?!?!?!?! huh what!!!! It is and always will be about the money, our well being is the last thing they care about.

  • susancol||

    I don't know why I bother attempting to inject a little reality in the conspiracy ramblings, but here goes: PATENTS DO NOT LAST FOR 40 YEARS. If the federal government patented a cannabinoid that long ago, it's now in the open market and, assuming it is otherwise legal, any person at all may manufacture or use it.

  • Echospinner||

    Fentanyl is like the smart phone. You cannot eliminate it from supply side.

    Do how does legalization work? Just show up at the Walmart counter with a pack of fentalyl and some gum?

    Who knows what the strength of the fentayl is without regulation. So unregulated fentanyl at Walmart.

    So far an unregulated market has heroin mixed with unregulated fentalyl. It has not turned out to be consumer demand in a classical sense. The consumers are dying and the demand is still there.

    Why should I care? Because the cost is there. Addiction results in cost to non users.

  • Wise Old Fool||

    Are you a bot or just high?

  • jmlandry||

    Authoritarian forces need to stay busy, after all idle hands are the devil's workshop.

    The good people at the DEA, FBI and locals need to keep that pump primed with their kidnapping (arrest), theft (asset forfeiture) and murder crusades.

    The simple solution to the "epidemic" is to repeal all drug laws. Let Walgreens sell weed and opium and shrooms. Three compounds that are demonstrably safer than alcohol in virtually every metric.

    As for this bullshit where any taxes collected for weed etc. Go to the schools. Tell the schools and they're bloated teachers unions to stick it up their ear.

  • chipper me timbers||

    public schools should be eliminated anyway. Everybody wins!

  • chipper me timbers||

    I hope every single one of these drug warrior motherfuckers comes down with an extreme high pain chronic illness that can't be solved dulled by Tylenol.

    They are evil bastards as far as i'm concerned.

  • AlmightyJB||

    I'm with ya on that.

  • GÄC||

    A couple months ago I had a partial knee replacement. Doctor prescribed Norco and tramadol for pain. Three days later he doubled the prescription as most opioids don't do much to relieve pain for me. Three days after that he took me completely off the meds and told me to take Tylenol. So six days after a fairly painful operation I was on Tylenol alone for pain. I could have been taking Tic Tacs for all the good it was doing me.

    I experienced several weeks of being basically bedridden because of the fear of opioids. Set my recovery back a good bit as during that time my muscles atrophied a lot more than they would have if I had been able to get up and move around more...

  • Trigger Warning||

    Fifteen milligrams of fentanyl would kill you the fuck dead.

  • cynicalretiree||

    Fentanyl as used in hospitals is checked for safety by MD's, pharmacists and RN's for safe limits measured in micrograms per kilogram of weight.

  • Gnosis||

    Mr. DEA you think you have such power yet you know as I that any organic chemist that wants to can go to the grocery store and hardware store to get all they need to whip up a batch of fentanyl and all analogs thereof, some stronger some weaker. And if they go as far as to ban the mother chemical sources I would imagine the US public may actually wake up and do what we should have done a long long time ago, and remove these abusers of power from their seats of power like is commanded to us by our founding fathers of this country we so live in.They take some, then more, then more, then there is nothing left of that to take so they look for something else to dip their fingers in. Drugs are not the problem, policies and culture is, all drugs were legal for thousands of years and not until the very decade we decide to make them off limits do they become an issue. see the problem people?

  • Gnosis||

    Opiates and opioids are evil they say?Tell that to the old woman or man dying from cancer,or that little bald kid in the wheelchair wearing the durag to hide their chemo. Tell it to the person limping with a cane. The vet missing limbs, tell it to, evil evil demon drug thou art..... Hydrocodone is so evil too... tell that to the millions it saved from addiction to morphine during the era of the "White Plague" which dropped census counts like a atom bomb. It was created to save people from having to be addicted to a quick onset not so effective opiate if they did actually survive or have at least a cough freeish okay existence while dying from a forgotten plague to which no cure still exists to this day. Only when abused in large amounts are these chemicals addictive, you have been lied to America. Taking Vicodin every day for several months for pain will not turn you into a junkie, but if you abuse it every day that is a different story.We think we know something, until the history and chemist stands up at tells you they are lying to you. This is a war on chinese fentanyl and mexican drug cartels not opiates and opioid medicines people.

  • cynicalretiree||

    Neonatal intensive critical care units use fentanyl drips, double and triple checked by RN's for safety by kg of weight per infant, after major surgery. Fentanyl is the quickest acting and fastest excreted narcotic. Every post operative neonate is placed on multiple monitors and life support until the effects of surgery diminish.Legal prescribed Fentanyl is valuable in critical care environments.[ am describing the prescribed drug's legal virtues].

  • cynicalretiree||

    Curious, weird or whatever is how when US industrialization and employment was high and mighty, long ago, alcohol, cocaine, marijuana and opium were all legal.

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