Breaking Bad: The surprising link between the fentanyl overdose epidemic and our dependence on foreign manufactured prescription pharmaceuticals.
Fentanyl is death incarnate. It is decimating American communities at the speed of blight and a scale that boggles the mind and overwhelms comprehension. Since 1999 more than 600,000 people in the USA and Canada have died from opioid overdoses, and a staggering 1.2 million more are estimated to die by 2029. Opiate overdose deaths increased 10-fold from 1999 to 2021 with synthetic opioids being responsible for most of them.
According to the CDC, 107,622 Americans died of drug overdoses in 2021, a 30% year-over-year increase, with 66% of those deaths related to synthetic opioids like fentanyl. Drug poisoning is now the leading killer of Americans between the ages of 18 and 45 and equates to 395 deaths every single day, or 16 deaths every hour from drug overdose, of which 195 were caused by fentanyl.
Fentanyl is 100 to 200 times more potent than morphine. Fentanyl is so incredibly potent that its dosage is measured in micrograms (1 microgram = 0.001 mg). One milligram is the size of a pinhead, one microgram is one-thousandth of that pinhead. A dose of 100 mcg (0.1 mg) of fentanyl is equal to 10 mg of Morphine. Just two milligrams of fentanyl, equal to just 10-15 grains of table salt, is enough to kill a person.
Most street fentanyl comes from illicit manufacture and drug trafficking by Mexican cartels across the southern US border. The flow of illicit fentanyl into the US is a carefully orchestrated symphony of destruction performed by the strangest of bedfellows: Mexican cartels and Chinese chemical manufacturers.
The Sinaloa Cartel and the Jalisco New Generation Cartel (CJNG) are the two main producers and traffickers of fentanyl into America. In a case of life imitating art, the actual process of homebrewing or “cooking” fentanyl is not dissimilar to the TV show “Breaking Bad.” Cartels set up makeshift labs in the middle of nowhere cow fields to evade law enforcement. However, unlike Walter White, these farmer-turned-self-taught-cooks have zero formal training in chemistry, work without protective equipment and drink beer believing it possesses mythical properties that protect them from the contact high of being in close proximity to the deadly brew’s fumes wafting atop open flames.
In grim irony totally lost on them and their brethren, some cooks die as a result of toxic exposure or inhalation suffering a fate as gruesome and tragic as those of their victims. But death is meager disincentive compared to the lure of lucre when cartel-engineered destruction of once-thriving agrarian communities has made earning a regular day’s livelihood well-nigh impossible for these people. Add in a dysfunctional and corrupt justice system that allows powerful cartels to get away with murder and you have the perfect petri dish to incubate the opioid epidemic.
Fentanyl is a drug trafficker's wet dream. It is ultrapotent, inexpensive, completely lab synthesized and unlike heroin or cocaine, requires no plant-based starting products. Thus, insuring a steady supply is only a matter of human resourcing and international operations management, rather than praying to God for rainfall and freedom from plant pestilence.
According to a 2016 Wall Street Journal report, producing 25 grams of finished fentanyl used to cost about $810. However according to a more current 2021 PBS investigation estimate, an 11 lb. package of fentanyl now sells for only $15,000 in Sinaloa's capital, Culiacan, reflecting rapidly declining costs of production with increasing scale of manufacture. The further the product travels, the more valuable it gets. By the time it arrives in America, 11 pounds sells for upwards of $100,000. A typical user requires less than a milligram for single use. That’s a phenomenal return on investment.
The role of cross-border trafficking in the genesis of the Fentanyl epidemic cannot be overstated. The state of Colorado seized more fentanyl in the first five months of 2022 than it did in all of 2021. San Diego is now the national epicenter for Fentanyl trafficking. More deadly fentanyl is being seized by border officials in San Diego and Imperial counties than at any of the nation’s 300-plus ports of entry. In the first nine months of FY 2022, they seized 5,091 pounds of fentanyl – which amounts to about 60 percent of the 8,425 pounds of fentanyl seized around the entire country.
At 2mg lethal dose per person, the 8,425 pounds of fentanyl seized in the first 9 months of fiscal year 2022 is enough to kill 1.9 billion adults. That’s almost twice more than the population of North and South America, combined.
And that’s not even counting the 12,000 fentanyl pills disguised as Halloween candy seized at LAX airport and the NY DEA seizure of 20 lbs. of powdered fentanyl along with 300,000 “rainbow” fentanyl pills. Common sense and logic—rarer than dodo bird sightings these days— would dictate that if this is what is being seized, the actual quantities of contraband lethal neurotoxin seeping unseized and undetected through the border is several orders of magnitude of this already massive payload.
While reams have been written about the sieve-like porosity of our current border policies and the role of border security in stemming the crimson tide of skyrocketing drug overdose deaths, barely anything is said about how China is integral to this symphony of destruction.
Mexican cartels manufacture fentanyl using precursors imported from China. According to the U.S. Department of State, more than half of the global suppliers of fentanyl precursors are based in China. Most drug-manufacturing equipment is also produced in China. This equipment is then shipped to places like Mexico where criminal cartels use it to manufacture Fentanyl and other synthetic opiates destined for drug trafficking to the US.
Until 2019, China directly and illegally exported massive quantities of illicit Fentanyl into the US using shady networks skirting legal roadblocks by hiding behind shell companies. However, yielding to international pressure, China was forced to place the entire class of fentanyl-type drugs under a controlled regulatory regime in May 2019. Following this scheduling, Chinese traders simply switched to selling precursor chemicals to Mexican drug cartels instead. These “masked" chemicals, which are chemically altered to escape detection can easily be transformed into a controlled fentanyl precursor through simple one or two-step chemical reactions. Thus, instead of shipping finished fentanyl to the US, Chinese Fentanyl precursors now make a pitstop in Mexico where the final manufacturing steps are completed before the final product is trafficked by cartels across the border.
The rapid rise of these precursor substitutes owes to the fact that China is the world’s pharmacy. It boasts the world’s largest pharmaceutical and chemical industries and consequently exerts near-hegemonic control over the world’s supply of basic chemical ingredients, pharmaceutical precursors and active pharmaceutical ingredients (API) This enables Chinese manufacturers the ability to shift from illegal to legal chemical production very quickly in order to circumvent legal roadblocks.
The US sources a majority of its generic drug supply from overseas, mostly from China. Thus, it is our dependence on Chinese manufactured pharmaceutical supply chains that drives the production of illicit chemicals, which are then concealed and trafficked using pre-existing trade conduits that transport prescription pharmaceuticals and their starting materials. Fentanyl precursors are the proverbial “needle in the haystack” of our gargantuan pharmaceutical imports.
The Fentanyl drug overdose crisis is inextricably linked to the ceding of our manufacturing sovereignty in favor of profits over national security. It’s also how we got the worsening prescription drug shortage crisis imperiling the health of our citizenry. Our self-inflicted pharmaceutical dependence has given us not one but two addictions.
Reshoring our manufacturing sovereignty and facilitating a manufacturing renaissance is vital not only from an economic and health perspective but would significantly reduce the supply of chemicals required for the manufacture and trafficking of Fentanyl. If we can’t get clean and sober from our twin fatal addictions, we’re consigned to the eternal doom of pawning our freedom, liberty, and the future of our children in exchange for our drug fixes.
Suggested Additional Reading:
The Fentanyl Overdose Epidemic: How a Hydra of Multinational Drug Cartels Has Orchestrated a Symphony of Destruction on America: A Comprehensive in-depth analysis of the breadth and scope of the problem
End China’s Chokehold on Pharmaceuticals: In-depth reporting on outsourced pharmaceutical supply chains and their dastardly consequences.
Outsourcing The Cure: How Our Dependence On Foreign Manufactured Pharmaceuticals Is Making Us Sick: My recent substack on the how and why of the catastrophe of the prescription drug crisis.