Did the illicit fentanyl trade experience a supply shock?

POLICY ARTICLE

DRUG POLICY

Did the illicit fentanyl trade experience a supply shock?

A synthesis of government and social media data suggests a disruption, possibly tied to events in China.

Fatal overdoses from synthetic opioids, most notably fentanyl, steadily increased more than twenty-five-fold in the United States over fifteen years, peaking at seventy-six thousand in twenty twenty-three. This trend began to sharply reverse in mid-twenty twenty-three, dropping the annual rate of fentanyl overdose deaths by over a third by the end of twenty twenty-four. Explaining this unexpected drop is of major scientific and policy interest. Whether a supply shock could account for a substantial part of the decline is challenging to determine because drug trafficking organizations operate in secret. Synthesizing data from the US and Canadian governments and from discussions on the social media platform Reddit, we suggest there was a major disruption in the illicit fentanyl trade, possibly tied to Chinese government actions, that translated into sharp reductions in overdose mortality beginning in mid- or late-twenty twenty-three and continued into twenty twenty-four across both the US and Canada.

Supply shocks sometimes produce large and rapid changes in the severity of drug problems. The early proliferation and overprescribing of prescription opioid pain medications beginning in the late nineteen nineties and traffickers' introduction of fentanyl into the North American illicit drug supply around twenty fourteen are two prominent examples of supply changes that sharply increased drug-related morbidity and mortality. In the opposite direction, the pronounced drought in Australia's heroin supply in early two thousand one (the causes of which are still debated) was followed by a sixty percent decline in opioid overdose mortality. The Chinese government's scheduling of the potent synthetic opioid carfentanil in twenty seventeen, legally designating the drug as potentially dangerous and tightening regulatory controls on it accordingly, immediately preceded a sharp drop in both seizures of and deaths from this fentanyl analog in the Midwest US region where it was prevalent. Controls on precursor chemicals used in the manufacture of drugs can sometimes shock markets; increased controls on pseudoephedrine, required to make methamphetamine, reduced availability and harm from that drug for at least some months.