Fentanyl: Global Challenges and Solutions

Context

A list presented to the US Congress identified 23 countries as sources or routes of illegal drugs (especially fentanyl). These include India, Pakistan, China, and Afghanistan. The US's concern about fentanyl stems from its potential for high lethality and widespread distribution.

About Fentanyl

• Fentanyl is a synthetic opioid.
• Chemical formula: C₂₂H₂₈N₂O
• It was developed for medical use in the 1960s.
• It is used to relieve pain in controlled doses.
• In illicit use, it is approximately 50 times more potent than heroin.
• Even a mere 2 mg can be fatal.

Uses

• Medical: For patients with severe pain
• Illicit: Mixed with heroin or other drugs on the illicit market

Difficulty in regulation

• Fentanyl is produced from precursors, not from plants.
• Main precursors: N-phenethyl-4-piperidone (NPP) and 4-anilino-N-phenethylpiperidine (4-ANPP)
• These chemicals are legal in industrial and pharmaceutical manufacturing but can also be used illegally.
• Making large quantities of fentanyl from small amounts of precursor is easy and discreetly transportable.

US Concerns

• More than 57,000 U.S. opioid overdose deaths were expected in the U.S. in 2023–24.
• US security agencies seized 50.6 million fentanyl-laced pills and a significant amount of powder in 2022.
• China and India are major contributors to the international supply chain, and processing is carried out by Mexican cartels.
• The US has imposed legal action, trade sanctions, and diplomatic pressure on companies and officials.

Challenges

• Difficulty distinguishing between legitimate and illicit industrial use of chemicals used in production
• International supply chains are complex and involve multiple countries
• Rapid spread of fentanyl to illegal users and markets
• Small volumes of shipments and shipments make monitoring difficult

Way Forward

• Increased international cooperation and monitoring
• Stricter controls and export regulations on chemical precursors
• Overdose prevention through naloxone and treatment programs
• Awareness campaigns warning consumers that counterfeit pills may contain fentanyl
• Expansion of alternative treatment and de-addiction programmes