The pipeline of deadly fentanyl to the US could dry up, experts say

This summer, Dan Ciccarone, a doctor and street drug researcher at the University of California, San Francisco, sent a team to collect data on city streets in areas where illegal fentanyl has been deadly for years. They found something unexpected.

“The fentanyl supply is running low for some reason,” Ciccarone said. “Hanging out on the streets, talking to people – the drugs are hard to find and more expensive.”

When street fentanyl began to proliferate in the American street drug trade beginning in 2012, most experts believed that the deadly synthetic opioid was unstoppable. Fentanyl is cheap, easy to produce, and extremely profitable. The black market supply chain that feeds U.S. demand for the drug is operated by some of the most sophisticated and ruthless criminal gangs in the world.

But Ciccarone said that over the past six months he has heard from street drug experts across the U.S. who have also seen significantly less fentanyl and fewer overdoses.

“I'm from Ohio, I've heard from West Virginia, and I've heard from Maryland and Arizona, and they're all telling me the same thing: some kind of supply shortage on the road,” he said.

There are skeptics and people who question this trend, but some of the top drug policy analysts in the U.S., as well as experts with close ties to the fentanyl street markets, believe the data points to a significant disruption in the deadly fentanyl supply chain.

“It's a development that many drug policy experts could not have imagined,” said Vanda Felbab-Brown of the Brookings Institution, who studies international criminal organizations that produce and smuggle fentanyl.

She said drug gangs appear to be smuggling less fentanyl and are also “adulterating” or diluting the potency of the fentanyl they sell. “Everyone was surprised by the extent of the adulteration of fentanyl,” Felbab-Brown said. “And even more significantly, allegations in certain locations in the U.S. that there is not enough fentanyl available.”

Researchers generally agree that there has been an “unprecedented” decline in fentanyl purity in some parts of the United States. Labs that test street fentanyl find that it is reduced or diluted far more aggressively, often with an industrial chemical called BTMPS.

An industrial chemical mixed with fentanyl

“We had samples that only contained BTMPS and no fentanyl,” said Nabarun Dasgupta, a North Carolina-based addiction researcher who tests fentanyl samples collected from illicit drug markets across the country.

US Drug Enforcement Administration / US Drug Enforcement Administration

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US Drug Enforcement Administration

Edward Sisco, a research chemist at the National Institute of Standards and Technology who helped analyze fentanyl samples, said it's a mystery why drug gangs would use BTMPS in fentanyl mixtures. There is no evidence that the substance makes users high.

“It is commonly used to prevent UV degradation of plastics, and there are some other industrial uses as well,” Sisco said, adding that the chemical appears to be intentionally added to fentanyl powders early in the supply chain, possibly in drug labs in Mexico .

“When something new comes into the drug market, it usually happens in one geographical location. It’s very atypical for (BTMPS) to pop up all over the country at the same time,” he said.

Although BTMPS is considered toxic to humans, it does not cause overdose or immediate death.

Some drug policy experts believe these shifts in fentanyl supply are factors in the sudden nationwide decline in fentanyl-related deaths, which fell about 20% last year, according to the U.S. Drug Enforcement Administration.

Dennis Cauchon, a harm reduction activist in Ohio, believes this pattern is evident in his state, where the number of fatal overdoses fell even faster in 2024, by about a third. “If you look at the share of fentanyl in the drug supply in Ohio, you can predict how many deaths there will be,” Cauchon said. “So the real question is: Why has fentanyl declined?”

This question is being hotly debated by drug policy and addiction experts.

Are Mexican drug cartels and their Chinese partners finally feeling the pressure?

Ng Han Guan/Pool/AFP via Getty Images / AFP

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AFP

Some analysts believe international pressure on Chinese companies that make fentanyl precursor chemicals could be a factor. Others believe a global crackdown on Mexican drug cartels smuggling fentanyl into the U.S. is finally affecting the black market supply chain.

“In the 24 months ending August 2024, nearly 70,000 pounds of fentanyl were seized along the Southwest (U.S.) border,” said Jen Daskal, a deputy assistant to President Biden on the National Security Council who focuses on fentanyl policy. “That’s more fentanyl seized in the last two fiscal years than in the previous five years combined.”

Seizures are part of the strategy. The U.S. has also steadily increased direct pressure on the Mexican cartels, attempting to seize fentanyl profits, arresting top Sinaloa leaders and obtaining more cooperation from the Chinese and Mexican governments.

Daskal acknowledged that the number of drug deaths in the U.S. remains unacceptably high, but said the Biden administration's fentanyl strategy is showing progress: “We are seeing the impact in terms of lives saved.”

Last year the cartels seemed to have recognized the pressure. They made public promises to curb the production and smuggling of fentanyl into the United States. The U.S. Drug Enforcement Agency expressed skepticism about the gesture, calling it “a public relations stunt.”

But Brookings' Felbab-Brown now believes there may have been significant “disruptions to U.S. supplies” in Mexico. She says the cartels may also be hoping to reduce law enforcement's focus on their activities by intentionally weakening the effectiveness of street fentanyl.

“It could be their decision at the wholesale level to adulterate fentanyl to reduce mortality. If that is the case, it is still a significant achievement by U.S. law enforcement that influences markets and behavior,” she said.

“We have to be really careful not to be too optimistic”

Not everyone is convinced that reducing the supply of fentanyl on America's streets makes sense. Dan Salter leads a federal task force targeting drug traffickers in Georgia, North Carolina and South Carolina.

Salter told NPR that in 2024, there was a sharp decline in the amount of fentanyl in drug seizures in his part of the United States. “We have seized almost 75 kilograms of fentanyl so far this year,” he said. “In 2023 we seized 216 kilograms.”

However, according to Salter, this is likely a temporary and minor supply disruption that is unlikely to last: “I think we have to be really careful not to be too optimistic.”

Rachel Winograd, a drug policy researcher at the University of Missouri-St. Louis is also skeptical that fentanyl pipeline disruptions are causing the drop in drug deaths, which have fallen 34% in Missouri.

“Drug seizures at the border and elsewhere have really increased in 2023,” she said. “But I don’t think that has anything to do with the decline, at least not here in Missouri.”

Winograd believes other factors, including better addiction treatment and the spread of the overdose-reversal drug naloxone, are bigger factors in saving lives.

Experts agree that the street drug supply in the United States remains extremely toxic and dangerous. Substances used to adulterate fentanyl, including BTMPS and xylazine, a horse tranquilizer also known as “Tranq,” appear to cause less fatal overdoses but are still harmful to humans. Frontline harm reduction workers also worry that increasing variability in fentanyl purity could endanger some users as they try to control their doses.

Haven Wheelock, who works on the streets for an organization called Outside In in Portland, Oregon, said the sudden shift in fentanyl supply is causing some addicts to seek help. “Could it be a motivating factor for people to do something different when seeking treatment? Absolutely. It could also lead to riskier behaviors,” she added.

Wheelock warned that some severely addicted people may also inject fentanyl instead of smoking it, a practice considered more dangerous.

Ciccarone, the street drug researcher in San Francisco, believes an overall decline in the availability and purity of fentanyl has significantly slowed overdoses, contributing to a 15% drop in drug deaths in his city this year.

“The only thing that could really explain this is a supply shock,” he said. “The fentanyl is drying.”

Most experts interviewed by NPR agreed that the decline in fentanyl supply is significant and widespread, but said it will take months of research and more data to confirm whether the change will have a lasting impact.

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