By Jonathan P. Caulkins and Keith Humphreys

If, in 2015, someone had told you that the number of overdose deaths caused solely by the two most historically lethal drugs—heroin and cocaine—would drop by more than half by 2021, you would likely have assumed that the overdose crisis in the U.S. was finally coming to an end. Instead, drug overdose deaths soared to more than 100,000 per year due to the rise of synthetic drugs, a truly disruptive innovation with which U.S. drug policy is only beginning to grapple.

To clarify the key term: synthetic drugs are substances that can be produced in a lab and are not from plant-derived components. In Canadian and U.S. illegal opioid markets, synthetic fentanyl and its analogues are outcompeting heroin, which is made from the poppy plant. These synthetics claimed the lives of more than 70,000 Americans in 2021 (out of 106,699 total drug-involved overdose deaths, or 66%), either by themselves or in combination with other drugs.[1] Methamphetamine, another synthetic, has attained a larger share of the stimulant market than cocaine, which is made from coca leaves.[2] The rapid expansion of synthetic tranquilizers—such as xylazine and benzodiazepines—has spread addiction and death, particularly when these drugs are used in combination with opioids. The U.S. is also facing a bevy of so-called new psychoactive substances (NPS), such as MDMA and mephedrone, that collectively attract more users than do older, “minor” drugs such as LSD, GHB, and PCP.

Drug policy analysts, including the authors of this brief, are swamped with requests from desperate policymakers, clinicians, parents, and activists to find solutions to the problem of synthetic drugs. This brief comprises our answer. Unfortunately, it is not particularly upbeat. All four traditional pillars of drug policy—enforcement, treatment, harm reduction, and prevention—have limits, and there is no simple solution for the synthetic drug market. Nonetheless, the nation can do some things better and should stop doing other things that are harmful. Policymakers must:

• Maintain prohibition of the production and sale of synthetic drugs

• Expect law enforcement to shrink market-related harms, such as violence, but not necessarily to shrink the supply of the drugs themselves

• Keep expanding medication-assisted treatment and access to naloxone

• Embrace the shunning of illegal drugs as a cultural norm

• Be generous toward those who are struggling, including those suffering from drug addiction

Unfortunately, the widespread availability of potentially lethal temptations in the U.S. may be the new normal, and overdose deaths will continue to remain higher than historical norms. Such realism is depressing but honest, and honesty is the best foundation for policy.

New York: Manhattan Institute, 2023. 13p.

By European Monitoring Centre for Drugs and Drug Addiction and Europol

EU Drug Market: Amphetamine describes the European amphetamine market from production and trafficking, to distribution and use. It details the processes, materials and actors involved at different stages and levels of the market. Taking a threat assessment approach, the module identifies key issues and makes recommendations for action at EU and Member State level.

Amphetamine is the most common synthetic stimulant drug available on the European drug market and it competes with cocaine and a range of new psychoactive substances for a share of the profitable European Union (EU) stimulant drug market. The prevalence of amphetamine use is higher than methamphetamine in most EU Member States, with notable exceptions, such as Czechia and Slovakia. Illicit amphetamine products mostly consist of powders or pastes, usually mixed with other ingredients, such as lactose, dextrose or caffeine, but tablets containing amphetamine are also available. The estimated annual value of the retail market for amphetamine in the EU is at least EUR 1.1 billion, with a range of EUR 0.9 billion to EUR 1.4 billion.

The demand for amphetamine in the EU is met by European production concentrated largely in the Netherlands and Belgium, where production is complex, large-scale and based on the drug precursor BMK. BMK has some limited use in industry and can be diverted from legitimate sources or smuggled into the EU, but more frequently it is made from chemicals known as designer precursors imported from China. Some of the amphetamine produced in the EU is used to produce captagon tablets, which are mainly trafficked to consumer markets in the Middle East

Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction and Europol, 2023. 8p.

By Vanda Felbab-Brown

Synthetic opioids remain the source of the deadliest U.S. drug epidemic ever. Since 1999, drug overdoses have killed approximately 1 million Americans,[1] an overdose lethality that has increased significantly since 2012 when synthetic opioids from China began supplying the U.S. demand for illicit opioids. Even though China placed the entire class of fentanyl-type drugs and two key fentanyl precursors under a controlled regulatory regime in May 2019, it remains the principal (if indirect) source of U.S. fentanyl. Fentanyl scheduling and China’s adoption of stricter mail monitoring has created some deterrence effects. Instead of finished fentanyl being shipped directly to the United States, most smuggling now takes place via Mexico. Mexican criminal groups source fentanyl precursors — and increasingly pre-precursors — from China, and then traffic finished fentanyl from Mexico to the United States. Scheduling of fentanyl and its precursors in China is not sufficient to stem flows to the United States.

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  There is little visibility into China’s enforcement of its fentanyl regulations, but it clearly remains limited. U.S.-China counternarcotics cooperation remains fraught, and from the U.S. perspective inadequate. Rejecting U.S. blame of China for the opioid epidemic and emphasizing U.S. responsibilities for that calamity, Beijing points to its benevolence in anti-drug cooperation. But China’s cooperation with the U.S. in the global counternarcotics campaign has been subordinated to the overall deteriorated geostrategic relationship between the two superpowers. There is little prospect that in the absence of significant warming of the overall U.S.-China bilateral relationship, China would significantly intensify its anti-drug cooperation with the United States. U.S. punitive measures, such as sanctions and drug indictments, are unlikely to change that. Structural characteristics of synthetic drugs, including the ease of developing similar, but not scheduled synthetic drugs and their new precursors — increasingly a wide array of dual-use chemicals — pose immense structural obstacles to controlling supply, irrespective of political will to prohibit and regulate their use and enforce the regulations.

New York: Brennan Center for Justice, 2022. 84p.

By Jason Eligh

The purpose of this report is to examine the existing retail markets for meth across several countries in eastern and southern Africa. This will be achieved through an analysis of meth availability, retail meth prices, distribution systems and domestic marketplaces. The report provides an analytical summary of meth markets that is grounded in data collected in 10 countries across the region with details of specific retail price points, commentary on domestic meth distribution systems and structures, and discussion of common structural characteristics across the region that enable and sustain these markets. Furthermore, the data generated from research undertaken for this report is intended to contribute to the broader regional objective of constructing an open-source database of time-series, country-specific illicit commodity price data, where applicable and practicable.

Geneva: Global Initiative Against Transnational Organized Crime, 2020. 104p.