Drug dealers and drug users are keenly adept at changing their modus operandi when it comes to manufacturing, transporting, distributing, and obtaining their drug of choice. The current opioid crisis is a clear example of this reality.

The origins of this crisis lie in prescription drugs that were in many cases overprescribed by physicians or actively sought out by “doctor shoppers.” In response, both national & local officials drafted sweeping legislation in conjunction with pharmaceutical companies, health networks, doctors, and pharmacies to create the Prescription Drug Monitoring Program (PDMP). This database transcends state lines and became paramount in curtailing doctor shopping by monitoring both who distributed and who received prescriptions for opioid-based medication. In addition to education provided to the supplier, prescriber, and end user to limit unnecessary prescriptions, the PDMP’s tracking system successfully leveled off abuse in 2010.

Our successes in the war on prescription opioids can be attributed to disrupting their distribution methods. Once real restrictions, accountability, and tracking were applied via legislation, it became harder to prescribe/obtain these drugs without medical necessity. But what many consider a legislative success story in curtailing prescription opioid abuse actually spurred greater use of illicit opioid drugs. Since 2010, heroin usage nationally has steadily increased and a rash of overdose deaths have been spurred by fentanyl, a new deadly drug.

Fentanyl is a non-plant based, synthetic opioid 50 times more potent than heroin. It is less labor intensive to create, less vulnerable to environmental factors, and harder to detect than more commonly known street drugs, due to its ever-changing formulas. The bulk of synthetic fentanyl is sourced from China and criminal organizations in Mexico, which later acts as both a distribution thoroughfare for China and also uses the drug to increase their own profitability. 

In 2013 the National Forensic Laboratory Information System recorded 934 reports of synthetic fentanyl seizures. The next year it had almost 5,000, and in 2017 it recorded over 56,000 reports of FRS seizures. During this same time period, fentanyl related overdose deaths increased more than nine-fold.

In order to understand the rapid growth of synthetic opioids it is important to refer back to distribution, the key to any drug operation. Due to long-standing agreements with the Universal Postal Union (UPU), which sets shipping rates for 192 member countries made by the US Postal Regulatory Commission, China reaps the benefits of greatly reduced shipping rates. The ePacket program which allows China to ship any package 4.4lbs or less for a fraction of what it would cost a U.S. based shipper to ship to Asia or even domestically, has allowed China to send these drugs into the United States at a reduced rate subsidized by the American taxpayer. In effect, via its very own policy action America created a perfect storm to facilitate the spread of fentanyl related substances (FRSs).

Thankfully, President Trump sent a memorandum in August of 2018, mandating that the U.S. Postal Regulatory commission revisit and adjust a more equitable agreement with the UPU. In addition a recently passed law called the STOP Act mandates better screening at our international mail facilities to detect and interdict illegal drugs and requires additional tracking data of senders.

Couple the China direct mail campaign with our porous southern border and one can see why the epidemic has grown exponentially.

Illegal immigration is only a fraction of the crisis at our southern border. A common and often repeated misnomer is that “the majority of drugs come through our ports of entry.”This rhetoric does nothing to solve a very real, life and death crisis, only pandering to a political stance in what should be a frank public safety and health discussion. The fact remains the majority of drugs “interdicted” are seized at our ports of entry, but there is simply no way to quantify drugs that make it through the gaps in our southern border. The rise in deaths nationwide clearly indicates that these drugs are in fact making it through.

When one maps the data of the highest drug overdose deaths by state, the picture becomes clear that border states, ports of entry, major mail distribution centers, and the Interstate 95, 81, 80 corridors are vastly over represented, echoing again the importance of distribution. Interrupting the methods of delivery with enforcement, screening and education, along with stricter transnational shipping regulations and greater border security are paramount legislative priorities.

In addition, we need to be better prepared on the ground. First responders are ill equipped to handle an opioid mass casualty incident, prison staff have little to no access to opioid reversing drugs such as Narcan (Naloxone), and schools only stockpile a few on hand doses of the lifesaving drug, if any at all. There are detailed reports of Russian forces weaponizing fentanyl, using it to incapacitate armed rebels in a Moscow theater but also killing dozens of hostages. Considering the fact that it only takes the equivalent to 3 grains of salt worth of fentanyl to kill a person and it would only take 118 pounds to kill 25 million people this is a very real threat as a weapon of mass destruction.

Greg Giuntini works for DetectaChem. His crew is responsible for the development of new technology for narcotics field testing that keeps officers safe from fentanyl exposure. The tests require just a small sample, so a quick swipe of a bag can help detect fentanyl or other dangerous substances. 

Giuntini says that weaponized fentanyl has the potential for causing serious harm to the public.

“The biggest danger is when that substance becomes used as a weapon. A simple kilo of powder with holes poked through attached to a drone in public would be enough to kill hundreds, if not more. The same goes for ventilation systems. There’s a huge risk there,” he said. 

Congress must focus on the fentanyl emergency with the same urgency and multifaceted approach in which they addressed the prescription opioid crisis. Disrupting distribution and targeted enforcement via federal and local law enforcement, education and treatment via federal/local healthcare organizations, and domestic preparedness for a FRSs mass casualty event via the Department of Homeland Security and the Federal Emergency Management Agency are all key issues that our elected officials should hold oversight hearings to investigate.

The synthetic opioid threat is not a left or right issue. Between primary and secondary exposure this crisis is affecting all demographics and no person will be left untouched by these drugs. Government agencies, at every level need to have an action plan if we are to address the rapid growth of synthetic opioids.

Rob O’Donnell, NYPD Detective, Retired, is a 27 year Public Safety Professional. During his career he worked for the Department’s Organized Crime Control Bureau Narcotics division, is certified by NY/NJ HIDTA in Intelligence and link analysis, responded and worked recovery for both the 93 WTC bombing and September 11th, retiring out of the Homicide task force. After relocating to Pennsylvania, he became involved with the Fort Dix terror plot in his capacity as a community safety director and is currently a certified Emergency Medical technician for the Commonwealth as well as certified by FEMA in the National Incident Management System.