This morning, we help explain why the drug problem in the U.S. has gotten so much worse in recent years. — David Leonhardt
For much of human history, people got their drugs from nature. Marijuana comes from the cannabis plant, cocaine from coca leaves, heroin from poppies and magic mushrooms really do come from mushrooms. Even legal drugs, like alcohol, tobacco and coffee, come from plants. Their highs were often discovered by chance, when someone consumed them in just the right way.
But in today’s overdose crisis, the most damaging drugs do not come from plants. They are synthetic — manufactured in a lab, usually requiring no plants at all.
Last year, fentanyl — a synthetic opioid — caused more overdose deaths than any other drug has in a single year. The second-deadliest drug was meth, which is also produced in labs (the kind you might have seen in “Breaking Bad”).
Together, fentanyl and meth helped make 2021 the worst year for drug overdoses in U.S. history: The full-year death toll topped 100,000 for the first time, the C.D.C. reported last week.
Both drugs have proliferated so quickly because they are synthetic.
Traffickers prefer synthetics because they can make and ship the drugs around the world more quickly and discreetly. Cartels no longer need a large, exposed field with dozens of workers to mass-produce drugs; they can just start a lab in a tucked-away warehouse or apartment building with a handful of chemists. And these technicians can make more powerful drugs, which lets traffickers smuggle smaller amounts for the same high.
Drug users often prefer synthetics, too: The drugs are typically cheaper, even though they are more potent.
So fentanyl and meth have spread seemingly everywhere, pushing overdose deaths to record highs year after year.
Counterfeit oxycodone tablets, which were found to contain fentanyl.Kholood Eid for The New York Times
A synthetic takeover
America’s antidrug efforts have struggled to keep up with the rise in synthetics, letting the overdose crisis worsen.
In some ways, the drugs’ rise is the latest turn in an escalating competition between law enforcement and traffickers. Smugglers hid drugs in cargo in cars, boats and planes, so the authorities deployed drug-sniffing dogs and conducted more thorough stops and searches. Traffickers flew drugs across the border with drones, so law enforcement launched blimps with low-altitude radar to detect them.
But synthetic drugs are a major shift in that battle. Regina LaBelle, the former acting drug czar for President Biden, told me their rise was her office’s “worst nightmare.” The traditional war on drugs largely focused on stopping the flow of drugs grown on farms. It did not work perfectly, but it had a significant effect: One expert estimated that prohibition increased the price of heroin and cocaine by 10 to 20 times, so users were less likely, or able, to buy them.
The impact is likely smaller for synthetic drugs because they are easier to make and smuggle.
With synthetics, the authorities may not even know what to look for. New synthetic drugs regularly pop up — often with impossible-sounding names, like “isotonitazene” — making it hard for officials to keep up with the latest threat.
Many experts now argue that the U.S. needs to fight the addiction crisis by investing in alternative strategies that focus more on expanding treatment and on harm reduction than on reducing the supply of drugs. At the rate that overdose deaths are increasing, the alternatives may be the only option.
For more: Drug users are mixing opioids and stimulants in more dangerous combinations known as “speedballs” and “goofballs.”