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The Fight Against the Fentanyl Crisis in America

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Oct 3, 2023 • 9 cited sources

Fentanyl has played a significant role in the skyrocketing rates of opioid overdose deaths in the U.S. It is a major contributor to both fatal and nonfatal overdoses.[1] 

Fentanyl’s incredible potency has caused a huge loss of life and put a strain on healthcare systems and communities. The drug has remained a constant focus among medical, government and community officials who are dedicated to increasing public awareness of the problem, increasing access to treatment and preventing further loss of life.

The fight against the fentanyl crisis in America requires raising awareness about its dangers, improving access to addiction treatment and support, strengthening law enforcement efforts to curb its illicit production and distribution, and implementing harm reduction strategies to save lives.

What Is Fentanyl?

Fentanyl, a synthetic opioid, provides a critical service in pain management, particularly in cases of severe pain or surgical intervention. Its exceptional potency compared to opioids such as morphine or heroin makes it invaluable in situations that demand robust pain relief. However, this powerful strength is also why the drug can be deadly when misused.

Very minor doses of fentanyl can have a profound effect. For patients who are living with cancer or another terminal illness, the drug offers relief when other treatments prove inadequate.[2]

Drug dealers take advantage of this potency by adding fentanyl to other substances in an attempt to boost the intensity of their product while keeping costs low. A very small amount of fentanyl goes a long way. Unsuspecting users can suffer from extreme respiratory depression and die within minutes of taking fentanyl if they overdose. 

The Rise of Illicitly Manufactured Fentanyl

Though it is possible for fentanyl to be diverted from legitimate medical sources and sold on the street, most of the time, the black market version of the drug is synthesized in illicit labs. These labs don’t adhere to any of the rigorous safety standards that are applied to medication production in the U.S. 

In those labs, some dealers will mold the powdered form of fentanyl into the shape of well-known and expensive medications that are commonly requested on the street, drugs like oxycodone and Xanax. Drug makers even mimic the markings of the drug they are impersonating, as well as the color, shape, and size, to fool buyers with the cheaper (and often far stronger) product. 

The result has been an increasingly rising number of fatal overdoses related to synthetic opioid use.[2]  

The Dangers of Fake Pills Mixed With Other Drugs

Some of the reasons why fake pills and illicitly manufactured fentanyl are so problematic include the following:[1-3] 

Slight Miscalculations Can Be Deadly

Just a few grains of fentanyl can be overwhelming to some users, and no drug dealer or batch or pill sold on the street is made to any standard specifications. This means that the potency fluctuates greatly from batch to batch. Consumers can never be sure how much fentanyl they are taking, which means they cannot moderate their use.

Fakes Look Exactly Like the Real Thing

Illicit fentanyl in the form of prescription pills is often indistinguishable from the real thing, making it impossible for users to protect themselves.

Fentanyl Isn’t Just in Opioids Sold on the Street

Fentanyl and its analogs are often put into non-opioid products that are sold on the street, including pills sold as benzodiazepines and even drugs like cocaine. This significantly heightens the risks for users who might not anticipate encountering fentanyl in their substance of choice.

Fentanyl Stays in the Body After the Effects Wear Off

Fentanyl’s effects manifest rapidly but also dissipate more quickly than some other opioids. This could prompt people who buy the drug on the street to follow up with a second dose too quickly, triggering an overdose.

Where Is Fentanyl Coming From? 

The majority of fentanyl entering the United States comes from two sources: Mexico and China.[4,5]


Mexican drug cartels are the primary distributors of fentanyl in the United States. They import chemicals from China before producing pills and powder in clandestine labs. They then smuggle the drugs across the U.S.-Mexico border. 


China is the primary source of the chemicals used to manufacture fentanyl. Once exported to Mexico or other countries, these chemicals are then used to create fentanyl. In some cases, fentanyl is produced in China and then smuggled directly into the United States.

How Does Fentanyl Enter the Country? 

Fentanyl can enter the U.S. through various avenues, including these:[4,6]

Land Ports of Entry

Fentanyl is often brought into the country illegally through official ports of entry and concealed within vehicles and luggage. It is also sometimes mixed in with other products on shipping containers.

Mail & Shipments

The drug may be shipped into the country by mail and other shipments.

Virtual Currency

Fentanyl is increasingly sold and purchased online using virtual currencies, making it hard for law enforcement agencies to track down buyers and sellers.

What Is the US Doing to Combat the Production & Distribution of Fentanyl?

The U.S. has taken an integrated approach to combating the production and distribution of fentanyl. This includes the following:[7,8]

Increased Law Enforcement

The Biden administration has augmented funding for law enforcement efforts aimed at intercepting fentanyl both at the U.S. border and within the country.

International Cooperation

The U.S. is part of an international campaign organized in conjunction with global partners to combat the illegal synthetic drug trade. The U.S. and other nations are also working together to prohibit the export of chemicals used to make fentanyl.

Public Awareness

The government is taking measures to raise awareness about the dangers associated with fentanyl use through public service announcements, educational campaigns and training sessions for first responders.

Treatment for Fentanyl Misuse & OUD 

The government offers treatment to individuals who have OUD related to fentanyl misuse. This includes increased access to harm reduction measures, Medication for Addiction Treatment (MAT) and counseling services.

How to Help Spread Awareness of the Fentanyl Crisis 

Spreading awareness about the fentanyl crisis is an important way to let people know the problem exists and encourage those in crisis to seek the help they need to avoid overdose. There are a number of ways you can help, such as these:

  • Learn as much as you can about fentanyl as well as possible prevention and treatment options, so you can act as an effective advocate.
  • Use social media platforms to spread information, news and stories related to fentanyl as well as harm reduction methods. Sharing ways that people in crisis can lower their risk of overdose may help to save a life. 
  • Work with local schools to share information about fentanyl. Young people may think it is safe to experiment with the drug, so they need to hear the truth about how easily overdose can occur.
  • Write to your elected officials, urging them to take action to combat the fentanyl crisis in your area.

How to Help Someone With a Fentanyl Addiction

If you or someone you know is struggling with fentanyl misuse, treatment is needed. This substance is highly addictive and can easily lead to fatal overdose. The sooner treatment begins, the better.

MAT with Suboxone can play a key role in the recovery process.[9] Since Suboxone lessens withdrawal symptoms and cravings for fentanyl and other opioids, you can focus on the work you are doing in therapy to build a gratifying and successful life without opioid misuse.

If you’d like to learn more about how MAT can benefit you or your loved one, contact Bicycle Health today. We’re ready to help you take the first step toward a better future.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Fentanyl facts. Centers for Disease Control and Prevention. Published June 27, 2023. Accessed August 24, 2023.
  2. Fentanyl DrugFacts. National Institute on Drug Abuse. Published June 1, 2021. Accessed August 24, 2023.
  3. Pardo B, Reuter P. Enforcement strategies for fentanyl and other synthetic opioids. Brookings. Published June 2020. Accessed August 24, 2023.
  4. Felbab-Brown V. Addressing Mexico’s role in the US fentanyl epidemic. Brookings. Published July 19, 2023. Accessed August 24, 2023.
  5. Fentanyl flow to the United States. Drug Enforcement Administration. Published January 2020. Accessed August 24, 2023.
  6. Greenwood L, Fashola K. Illicit fentanyl from China: An evolving global operation. U.S.-China Economic and Security Review Commission. Published August 24, 2021. Accessed August 24, 2023.
  7. Fact sheet: Biden-⁠Harris administration announces strengthened approach to crack down on illicit fentanyl supply chains. The White House. Published April 11, 2023. Accessed August 24, 2023.
  8. Canada-U.S. Joint white paper: Substance use and harms during COVID-19 pandemic and approaches to federal surveillance and response. U.S. Department of Health and Human Services. Published 2022. Accessed August 24, 2023.
  9. Treating opiate addiction, Part I: Detoxification and maintenance. Harvard Medical School. Published June 27, 2019. Accessed August 24, 2023.

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