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66 Dep't of Just. J. Fed. L. & Prac. 55 (2018)
Fentanyl Trafficking Trends in the United States

handle is hein.journals/usab66 and id is 582 raw text is: Fentanyl Trafficking Trends in the United States Kirsten Walters Supervisory Intelligence Research Specialist Drug Enforcement Administration, Intelligence Division Fentanyl is a Controlled Substances Act (CSA) Schedule II synthetic opioid. It is used as an anesthetic, and is also prescribed as a pain reliever to manage breakthrough pain in cancer patients. Its strong opioid properties have made it an attractive drug of abuse for opioid users. Pharmaceutical fentanyl, available in tablets, liquids, patches, and lozenges is diverted from healthcare facilities, although usually on a small scale. This diversion is typically carried out by individuals with access to the drug who steal it to satisfy a personal addiction or for street level sales. Users can extract the fentanyl gel solution in transdermal patches to smoke or ingest the fentanyl, and intravenous fentanyl solution can be injected directly into the bloodstream. Fentanyl is also illicitly manufactured in clandestine laboratories in China and, likely, Mexico before being smuggled into the United States and distributed in opioid markets. Illicitly produced fentanyl is typically distributed in a white powder form to be mixed into heroin or other illicit drugs, or pressed into counterfeit opioid prescription pills. Illicitly produced fentanyl is the most common type of fentanyl abused in the United States and is primarily responsible for the current fentanyl crisis. The threat posed by illicitly produced fentanyl is multifaceted. It originally entered illicit drug markets through heroin; fentanyl in powder form is used as an adulterant and mixed into heroin, oftentimes without heroin users knowing it. It is increasingly more common for fentanyl to be mixed with adulterants and diluents and sold as heroin, with no heroin present in the product. Fentanyl in this form looks just like heroin, is packaged in the same manner as heroin-in baggies or wax envelopes-and displays similar stamps or brands as heroin. Many heroin users have no desire to use fentanyl, although some heroin users will seek it out because of its potency. Fentanyl was introduced into the prescription pill abuser market when traffickers began taking white powder fentanyl and common diluents and using pill press machines to press it into counterfeit prescription pills that are commonly abused. Often, these pills closely resemble the authentic product they are being sold as, and the users have no idea they are laced with fentanyl. July 2018 United States Attorneys' Bulletin 55 Figure 1. Counterfeit Oxycodone Tablets Containing Fentanyl July 2018 United States Attorneys' Bulletin 55

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