Fentanyl in the US: A visual guide

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Nearly 22,000 pounds of fentanyl were seized at US borders during the 2024 fiscal year, according to data from the US Customs and Border Protection. Nearly all of it – about 97% – was confiscated along the southwest border, with seizures in Tucson, Arizona, accounting for more than half and another 30% in San Diego. Just a couple dozen pounds of fentanyl were seized along the northern US border with Canada last year, CBP data shows, and experts say that the illicit networks in Canada are almost entirely separate from those in the US. “We don’t get any significant amount of fentanyl from Canada,” Felbab-Brown said. “The small seizures that have been conducted at the northern border have mostly to do with US citizens buying fentanyl in Canada for personal consumption and then smuggling it themselves.”

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According to the CDC, the first wave of the opioid overdose epidemic started in the 1990s with the abuse of prescription opioids. Purdue Pharma and its owners, members of the Sackler family, reached a multibillion-dollar settlement this year to resolve thousands of lawsuits alleging that the pain medication OxyContin caused a widespread opioid addiction crisis in the US. There were rapid increases in overdoses involving heroin starting in 2010, which the CDC considers the second wave, but synthetic opioids – primarily fentanyl – took over around 2013. Overdoses surged during the Covid-19 pandemic, reaching a peak between the fall of 2022 and the summer of 2023, when the CDC estimates that there were nearly 115,000 overdose deaths in one year. Synthetic opioids, primarily fentanyl, were involved in about two-thirds of those deaths. But overdose deaths started a rapid decline at the start of last year. Fentanyl is still involved in most cases, but the latest data shows that annual deaths are down 22% compared with a year earlier. There were about 58,000 deaths involving synthetic opioids in the 12-month period ending in August. Some experts suggest that a “fourth wave” of the opioid epidemic is underway, in which illicit fentanyl is more frequently mixed with other drugs, and the combination of fentanyl and stimulants can be particularly dangerous. During the time that overdose deaths involving opioids declined, those involving cocaine and psychostimulants such as methamphetamine increased, according to the preliminary data from the CDC.

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