Fentanyl Fallacies

By Kevin D. Williamson

Friday, April 18, 2025

 

Fentanyl is a wonder drug.

Not only is it useful for managing severe pain (e.g., for cancer patients and burn victims) but it also provides policy cover for … whatever.

 

Donald Trump’s senior economic adviser, Kevin Hassett, knows that Trump’s tariff policy is dumb and destructive, and it is very difficult to make an economic case for it, so he insists that the tariffs are really part of a fentanyl interdiction policy. Trump would like to blame illegal immigrants for everything from heartbreak to psoriasis, and he reliably invokes fentanyl trafficking in his litany of immigration denunciations.

 

The problem is that—as so often is the case with Trump and his sycophants—the facts do not quite line up with the story he would like to tell.

 

It is the case that most of the fentanyl that enters the United States illegally is brought across the southern border. It is not the case that illegal immigrants are the ones doing the trafficking or that harsher anti-immigration measures in general would help to control the flow of the synthetic opioid. According to government data, the great majority—some 86.2 percent—of fentanyl offenders were U.S. citizens, at least as of 2021. Mostly they were on the younger side (average age 34), they were overwhelmingly (82.8 percent) male, mostly (78.4 percent) Hispanic or black (41 percent and 37.4 percent, respectively), most had criminal histories though a sizable minority (43.1 percent) had no serious records, and only 6.7 percent were career criminals.

 

Which is to say: Fentanyl smugglers look, on paper, a lot like other kinds of serious criminals, from muggers to murderers. They’re young men, disproportionately nonwhite, and in most cases already possessed of a less-serious criminal history.

 

Fentanyl is legally manufactured in the United States for medical purposes, and at least some of that product, though apparently not a great deal, ends up sold on the street for recreational purposes. Fentanyl has a global supply chain, with manufacturers in Latin America dependent on precursor chemicals largely manufactured in Asia, where production has shifted in part from China to India in response to Beijing’s (supposedly) taking a stronger hand on the issue. Some of those precursors come from diverting legally manufactured chemicals onto the black market, and some come from off-the-books pirate operations.

 

There does not seem to be very much illicit fentanyl manufacturing in the United States, but U.S.-based criminal organizations have shown themselves quite capable at manufacturing other synthetic drugs, notably methamphetamine, which do not require the kind of space and exposure involved in growing poppies for heroin or coca for cocaine. It would not be surprising if more effective intervention at the borders resulted in a shift to domestic manufacturing as a replacement for smuggling. Likewise, the diversion of legally produced marijuana into the black market is suggestive of what could happen in the case of fentanyl if foreign supplies are effectively reduced.

 

Americans did not start getting high on fentanyl because they were looking to get high on fentanyl—Americans started getting high on fentanyl because they were looking to get high on heroin. The pattern is familiar and predictable: Successful heroin interdiction encouraged prescription opioid abuse, successful prescription opioid interdiction helped launch the market for fentanyl-fortified heroin. When people couldn’t get heroin, the market supplied pills, and when people couldn’t get pills, the market found new ways to move heroin and heroin substitutes.

 

You won’t hear the current administration mention the fact, but overdose deaths in the United States (the majority of which still involve fentanyl) declined significantly during the Joe Biden administration, having spiked dramatically during the first Trump administration. I do not think that either presidency had much to do with the spike, which probably was driven by COVID policy. (Boredom and isolation are very hard on addicts.) Trump is a predictable man, and it is likely that if overdoses continue to decline, he will insist that his border policies deserve the credit for … things continuing to move in the direction they already were moving.

 

Every generation has its nightmare intoxicant: Gin was “mother’s ruin” and the stuff in piña coladas was “demon rum,” and there was Reefer Madness, then LSD, and then the first go-’round with heroin, and then crack, and so on. As generations of social critics have noted, the fixation on particular recreational drugs often is a way of fixating on other things: It was the tiniest bit of economic independence for women in the case of gin, racial fears in the cases of marijuana (which was vilified as a Mexican thing and a Native American thing before it was a black jazz-fan thing) and crack, the general awfulness of the 1960s counterculture in the case of LSD, and a bit of Vietnam War anxiety in the case of heroin. Americans took a relatively liberal view of the drugs typically enjoyed by reasonably well-off white people until the dramatic rising enthusiasm for opiates and opioids, which have killed a lot of reasonably well-off white people.

 

I do not know what will happen with fentanyl use in particular; I suspect that, if we think of the broader class of opiate/opioid drugs, consumption will wax and wane, as it has for well more than a century—it was old news back when Bayer trademarked the brand name “Heroin” back in 1898. Washington will act at the margins of the market, but not much will change as a result of policy, because the fundamental driver is on the demand side.

 

What to do?

 

Only the obvious.

 

I know that my particular brand of libertarianism is far out of fashion at the moment, but I suspect that we would be, on balance, better off if our junkies still were getting their goods from Bayer rather than from off-the-grid factories in the Mexican jungle. If that sounds like waving the white flag to you, then consider that there were about 87,000 overdose deaths in the United States in the 12 months ending in September 2024—and that was a marked improvement over the prior year. And then there is all of the collateral damage—and expense—of the so-called war on drugs.

 

If that’s winning, I’ll take surrender.