The surge is now being driven by an especially deadly synthetic opioid called fentanyl. As much as 80 times more powerful than heroin, only a few grains of this chemical compound are enough to cause a fatal overdose.
Unfortunately, the legal prohibitions on the various forms of fentanyl expire next month unless Congress reauthorizes them. If Congress fails to act, illegal labs in Mexico and China stand ready to flood the United States with what would be a legalized poison. There is broad bipartisan support for reauthorizing the fentanyl ban, but House leadership, despite the looming deadline, is blocking the measure.
A Post editorial on Monday, urging Congress to act, suggested that the delay may be because of congressional consternation over related sentencing guidelines. That may be true, but the House has yet to make public any rationale for the delay.
Fentanyl has been predominantly produced in China, and increasingly in Mexico. Before 2018, drug traffickers were able to stay one step ahead of U.S. law by making slight modifications to fentanyl compounds, adjusting, for example, a single molecule. These so-called fentanyl analogues had the same narcotic properties as fentanyl but, because of their minuscule molecular variations, technically skirted the existing ban on fentanyl.
Through hard diplomacy, we persuaded the Chinese government to prohibit fentanyl analogues. Here at home, the Drug Enforcement Administration in February 2018 used its emergency regulatory powers to ban all fentanyl substances, but, by law, this ban can only last two years.
It is easy to understand why fentanyl is so deadly. Only a tiny amount is enough to trigger an overdose, and because the quality and precision of compounding done in the illicit labs vary, users cannot be sure of the amount of active ingredients they are ingesting.
That is bad enough when the user intends to take fentanyl by itself, but drug traffickers increasingly are mixing fentanyl with a wide range of other drugs, including cocaine, heroin and methamphetamine. Drug users thus may have no idea whether they are ingesting fentanyl and, if so, how much they are taking.
These risks are even higher with fentanyl analogues, which usually are more potent than “classic” fentanyl. Trafficking fentanyl amounts to outright murder.
There is no question that overdose deaths are being turbocharged by fentanyl. In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in overdose deaths in the United States. In that year, 42,249 drug overdose deaths involved opioids, and of those deaths, 45.9 percent involved synthetic opioids.
By attacking the overdose crisis on a broad front, the Trump administration in 2018 was able to stop the increase in overdose deaths, and even slightly reduce them, for the first time in several decades. Much of that success stemmed from substantial progress in controlling the abuse of legal opioids. But the progress will be reversed if the country is hit by a tsunami of newly legalized fentanyl analogues. Without congressional action, the Justice Department would not have the legal tools to prevent this onslaught.
The proposed Stopping Overdoses of Fentanyl Analogues legislation is broadly supported — attorneys general in all 50 states signed a letter urging its passage — and is essential to addressing the drug overdose crisis. It is unthinkable that at the very time China has been willing, at our urging, to restrict fentanyl analogues, Congress would be willing to open the floodgates to this poison. The Senate is poised to act, and the House should follow suit. Thousands of American lives are in the balance.