By Bryce Pardo and Peter Reuter

  The synthetic opioid crisis in North America has increased fatal overdose rates to unprecedented levels within a matter of a few years. It involves new technologies, a new source of supply (the chemical industry in China), and new forms of distribution (the internet and mail). These elements are perhaps even more difficult to suppress than other supply sources from foreign countries. This has led to an assumption that nothing can be learned from prior experience in trying to control drug markets. In this paper, we first explore what might be learned from some notable past successes. We begin by examining a set of episodes in which enforcement against a specific illegal drug market had more than a brief impact on supply, though the enforcement may have caused other harms. Examples include the near-elimination of the quaaludes market in the 1980s and the “heroin drought” in Australia in the early 2000s. Exploring common features of these past successes reveals insights that may reduce the risk of fatal overdose. We then examine the characteristics of fentanyl distribution in detail, noting that taken individually, the

Washington, DC: Brookings Institution, 2020. 21p.