Why is fentanyl use becoming widespread now?

Mark Kleiman responds to the question, why is fentanyl use becoming widespread now?

He describes the increase in availability of prescription opioids and the role of price in leading users to transition to heroin. Then, he describes the expansion of fentanyl.

At the same time, people in the U.S. were learning how to buy chemicals unavailable here – banned drugs, cheap unbranded pharmaceuticals, Human Growth Hormone, you name it – by mail-order from illicit or quasi-licit outfits in China, ordering over the Internet (and, when law enforcement made that dangerous, over the “Dark Web”) often paying in cryptocurrencies. Instead of using complicated smuggling schemes, sellers simply put these products in the mail; for about $20, you can get a package of up to four pounds mailed from China to New York.

It didn’t take long for some of those Chinese outfits to start making fentanyl; unlike heroin dealers, they didn’t need a source of opium. The chemistry involved isn’t especially challenging (not, for example, like making LSD). Fifty grams of fentanyl – an ounce and a half – has the potency of a kilogram of heroin, and it’s way, way cheaper.

He also describes how technology has affected dealing illegal drugs, producing significant gains in efficiency and reductions in risk.

But with mobile phones, texting, and social media, transactions can now be arranged electronically and completed by home delivery, reducing the buyer’s risk and travel time to near zero and even his waiting time to minimal levels. In the recent Global Survey on Drugs, cocaine users around the world reported, that their most recent cocaine order was delivered in less time, on average, than their most recent pizza order.

These efficiency gains and risk reduction provide even more downward pressure on prices. They also create new difficulties for enforcement and supply reduction.

Unfortunately, Kleiman paints a very grim picture, suggesting that we’ll have to wait for the crisis to burn itself out.

It’s worth keeping in mind that Kleiman’s expertise is in criminal justice policy, not treatment and recovery.