To fight against the scourge of fentanyl, the American executive tries to organize itself

A powder that has panicked American power for several years. Fentanyl is said to be fifty times more potent than heroin and a hundred times more powerful than morphine. In the United States, this synthetic opioid has supplanted in a few years all the other drugs produced by drug traffickers, becoming the leading cause of death for 18-49 year olds. This product was linked to more than two-thirds of the 110,000 overdose deaths in the federal state in 2022. In the same year, authorities seized enough fentanyl to kill the entire American population.

Faced with this alarming observation, the American government, through its Secretary of State Antony Blinken, announced that it wanted to lead a global “coalition” to fight against this scourge. To do this, the Secretary of State is bringing together his international counterparts this Friday, July 7, for an inaugural session to which nearly 90 countries around the world have been invited.

In its pure state, however, fentanyl is not considered a drug but an overpowering analgesic, used with great care in the medical community. Its “use is normally reserved for severe pain”, specifies in Figaro the professor at the CHU of Lyon Benjamin Rolland.

But in the United States, its use has been diverted for several years. This massive consumption of opioids can be explained, among other things, by the widening of the prescription of very powerful painkillers from 1996 and by the launch of insistent commercial campaigns by the pharmaceutical industries. From then on, some patients became dependent and diversified their consumption by turning to stronger products. Including synthetic ones like fentanyl, creating a real black market. The latter can indeed be consumed in the form of medicine or manufactured counterfeits. Its effects are many and varied if it is not used wisely: euphoria, drowsiness, relaxation, slowing of breathing, etc... until overdose.

Fentanyl can be "swallowed, smoked, snorted or injected", details the Canadian Center for Addiction and Mental Health (CAMH), which brings together a set of psychiatric hospitals and centers specializing in the treatment of addictions in this country also undermined by this drug. It can be sold in the form of "powder" or "tablets", but also be mixed with other products such as heroin or cocaine. In this form, it sometimes goes unnoticed. “Many cases of overdoses come from the fact that people do not know that what they consume contains fentanyl”, also assures the CAMH.

In addition to being very powerful, “fentanyl is also more “refined” for the opioid receptors in the brain”, explains Professor Benjamin Rolland. Concretely, the product “detaches less easily from the receptor”, even “when an antidote, such as naloxone, is administered [a drug that can temporarily neutralize the effects of an opioid overdose and give paramedics time to intervene , editor’s note]”. The risk of death by overdose is therefore “significantly increased”.

The young age of the victims is of particular concern to the public authorities. Of the 70,000 people who died in 2021, 1,146 were teenagers. The dramatic examples saturate the American press: last May, three teenage girls were found "in a car in the parking lot of a rural Tennessee high school", a few hours before their graduation ceremony, reports The New York Times. Two were already dead while the third, aged 17, was rushed to hospital.

Each state thus tries to legislate on the problem. “In the 2023 legislative session alone, hundreds of fentanyl-related crime bills were introduced in at least 46 states, according to the National Conference on State Legislatures,” reports the US daily. In Virginia, for example, the drug has been codified as a “weapon of terrorism”.

And the fight against this scourge has been going on for several years. In 2017, US President Donald Trump already referred to “the worst drug crisis in US history” and declared a state of health emergency. The funds, however, were slow in coming. The same year, a Commission to combat the opiate crisis was created to establish guidelines: improving access to substitution treatments or even making naloxone available. This can be provided to police or firefighters or directly distributed to drug users.

Finally, there is the question of traffickers, concerning counterfeit fentanyl. "Unlike 'opiates', there is no need for poppy to produce the basic molecules (morphine, codeine, etc.)," ​​also emphasizes Benjamin Rolland. “It can therefore be produced directly with fairly simple processes,” he continues. This specificity therefore facilitates its production. The main ones implicated by the American power are the clandestine Chinese laboratories and the Mexican cartels.

On June 7, the American ambassador to Beijing urged China to invest more in the fight against this scourge. “We strongly urge the Chinese government to use its considerable power to prevent Chinese black market companies from selling fentanyl,” said Nicholas Burns. In 2019, Beijing had however banned exports of this product to the United States. But since then, according to many experts, the country continues to deliver chemical compounds necessary for the manufacture of fentanyl, especially to Mexico and Central America, reports AFP.

Last April, the United States therefore announced sanctions against fentanyl trafficking networks, involving China and Mexico. Washington notably sanctioned the four sons of the famous Mexican trafficker "El Chapo", members of the Sinaloa cartel, Joaquin. American justice thus intended to attack "the largest, violent and prolific operations of fentanyl trafficking, managed by the Sinaloa cartel and fueled by chemical compounds from Chinese pharmaceutical companies", according to the words of the Minister of Justice. , Merrick Garland. More recently, on June 23, the United States also indicted Chinese companies accused of being involved in trafficking fentanyl, a first. One was accused of having enough fentanyl to kill 25 million Americans.