Here's a chart from the CDC showing the biggest sources of drug overdoses:
Here's what I don't understand. The first (known) case of a China White overdose happened here in Orange County in the late 1970s. Since then, various analogs of fentanyl have been available on the street now and again, but it was never all that popular. Then, suddenly, after more than 30 years, it took off like a rocket.
It's no surprise that this happened. Fentanyl is cheap, fairly easy to make, and a smuggler's dream since you don't need very much of it. So the question is not why it became popular, but why it took so long to become popular.
Does anyone know? I've been unable to come up with an answer on my own.
UPDATE: Answer here!
Because other opioids became harder to get? https://www.nature.com/articles/d41586-019-02686-2
Hillbilly heroin from the late 90’s (oxycontin, ground up the extended-release Perdue pills, etc.) had a population fiending once the mills and entreprizing pharmacists were cracked down upon. I read scripts for opiates increased like 100x nationwide over the 90’s.
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I've wondered about this too, and also haven't found an answer.
My best guess is that criminals are conservative. If you get yourself wedged in to that market, radically overhauling the business model is risky, and like a lot of businesses, they don't change unless they have to. And "worse is better" startups face much worse fates than being bought out by Google, so they don't try.
But that's just a guess.
A smuggler's dream, but not a dealer's dream - too likely to kill off your customers?
If you are right that means drug dealers are smarter than Republican leaders who are killing off their voters with their anti-vax lies.
Being able to ramp up production: make it easier to produce so you don't need a formally trained chemist, produce it at scale, and be able to produce it without killing off the cook, organize feedstock supply chain, etc.
It may be easy to make, if you have the right precursors. Bulk purchases have gotten easier over the years, and there's a cat and mouse game of what's being regulated and what is now being used to avoid regulations.
read empire of pain!
basically, purdue created a market is pain management that they claimed was non addictive, but in reality for a ton of people addicted to opioids. Then they changed their pill so it was harder to abuse, the gov cracked down on over-prescription, it became clear that oxy was dangerous and doctors stopped prescribing it. And a gazillion of hooked people had to look for illegal alternatives.
read empire of pain!
basically, purdue created a market of pain management that they claimed was non addictive, but in reality got a ton of people addicted to opioids. Then they changed their pill so it was harder to abuse, the gov cracked down on over-prescription, it became clear that oxy was dangerous and doctors stopped prescribing it. And a gazillion of hooked people had to look for illegal alternatives.
There are a bunch of moving parts here, some of which have been listed above. Another is that fentanyl isn't popular with the customers. Most of them don't want to be taking something that deadly. As long as someone was supplying them with heroin, they weren't particularly interested in synthetics.
Something similar has happened with meth. Most of the meth available is much more dangerous than it used to be. The restrictions on pseudoephedrine that were intended to reduce the supply of meth accomplished no such thing. It just meant that the manufacturers switched to other methods, which led to far more toxic meth on the streets. The users didn't want this change, but it's what they're getting.
From what I've read, black tar heroin was preferred on the West Coast for a long time, which limited the expansion of fentanyl. Even after the prescription pill market dried up, fentanyl was largely an East Coast thing for years.
There are probably supply chain factors as well. It's got to be a bit harder to mail it here from China than to smuggle it in cars from Mexico. Shipping the chemical components to Mexico from China is likely easier now. Plus, there is a learning curve for drug cartels. They had to figure out getting supplies and cooking it up.
Sometimes things like this just happen. Asking why fentanyl suddenly got hot is a bit like asking why Beanie Babies suddenly becanpme a thing in the 90s. Small stuffed animals had existed for many decades before that, after all!
From the above linked NATURE article:
>>>"... Purdue Pharma reformulated OxyContin to make it more difficult to crush and inhale. This did discourage abuse. But at the same time, for unclear reasons, the supply of heroin increased, and its price dropped sharply.
...
Around 2013, the contours of the epidemic shifted for a third time. Heroin dealers who wanted to increase profits began to mix their products with fillers and fentanyl."
It order to understand the rise of fentanyl it would really help if we first understood why heroin suddenly became abundant & cheap circa 2010 and how long that lasted.
Wondering how long it will take to get the vaccine that was just recently reported to market, how it will be made available, its cost, & how much of an impact that will have - comparable to Naloxone?
Pingback: Here’s why fentanyl took until 2013 to become popular – Kevin Drum
I was going to write a long response here, but I vaguely remembered reading an explanation back in 2018. Basically, it got cheaper, easier to synthesize and many alternatives vanished. The article is here:
https://www.samefacts.com/a-primer-on-fentanyls/
Amusingly, it cites a certain far sighted Kevin Drum as inspiring that essay in a Mother Jones article, "Fentanyl Could Produce Big Changes in the Illicit Drug Trade". Well, he was right.
https://www.motherjones.com/kevin-drum/2018/05/fentanyl-could-produce-big-changes-in-the-illicit-drug-trade/