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Billions are being spent to keep fentanyl out of the U.S. Is it working?

LEILA FADEL, HOST:

Criminal gangs from China and Mexico are flooding the U.S. with fentanyl and other deadly drugs at an unprecedented rate.

MICHEL MARTIN, HOST:

Yes, that's according to two new studies that show fentanyl smuggling has increased dramatically despite efforts to target cartels and tighten border security.

FADEL: NPR addiction correspondent Brian Mann joins us. Good morning.

BRIAN MANN, BYLINE: Hi, Leila.

FADEL: The U.S. is spending billions of dollars to keep fentanyl out of American communities. Have efforts to stop the flow of the drug been effective?

MANN: Well, the results have really been mixed. As you mentioned, the U.S. has worked to tighten border security. It's targeting Mexican cartels here inside the U.S. and around the world. And the good news really is that police are seizing a lot more fentanyl in the form of these counterfeit pills. They're shaped to look like the pain pills you might buy at the pharmacy. In 2017, there were 50,000 of these pills seized. By last year that had surged to 115 million pills. Dr. Nora Volkow is head of the National Institute on Drug Abuse. She says these counterfeit pills are flooding the whole country, but the supply is especially heavy in Western states, including Arizona and California.

NORA VOLKOW: It surprised me because I did not expect the greatest entry of these pills was in the West. And this new data shows the magnitude, the number of pills was greater in the West than in the East. So it's shifting.

MANN: So a lot more pills being seized, Leila. The bad news here is experts, including Volkow, thinks this is just the tip of the iceberg. For every counterfeit fentanyl pill they're seizing, they believe a lot more of this deadly drug is getting through.

FADEL: The U.S. Drug Enforcement Administration released a new report on efforts to stop fentanyl smuggling. What did they find?

MANN: Well, it's not good news. The DEA says the Mexican cartels and Chinese criminal gangs are more powerful, more sophisticated than ever. According to this report, the Mexican cartels now control whole shipping ports in Mexico to maintain their fentanyl supply chains. Chinese gangs have also gotten better at using cryptocurrencies to move drug profits around and hide them from authorities. Again, there are some successes, more of these fentanyl pills being seized. But fentanyl is so cheap, so easy to make, the gangs are just churning out more. The DEA report found that all of these efforts failed to make fentanyl harder to find or more expensive to buy in any part of the U.S.

FADEL: Brian, with so much fentanyl available, what does this mean for communities?

MANN: Yeah, so there are signs, Leila, that overdose deaths are leveling off, maybe even declining a bit. In part, that's because the public health response is getting better. More people, for example, are carrying the naloxone. That's this easy-to-use drug that can reverse opioid overdoses. That appears to be helping. But overdoses are still running well above 100,000 deaths a year. Fentanyl is a leading cause of death for Americans under the age of 50. So this is still a really deadly public health crisis. And there's one other concern I'm hearing about from addiction experts. This pipeline of synthetic drugs described in these two new studies - it's not just getting bigger. It's also increasingly unpredictable and dangerous.

Fentanyl is the big threat right now, but gangs are pushing lots of other toxic substances and drug cocktails. They're making drug use more and more perilous. No one's really sure what's coming next. And so far, no one's found a way to shut down or even slow this drug pipeline.

FADEL: NPR's addiction correspondent, Brian Mann. Thank you, Brian.

MANN: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.