Fentanyl in America: Geography of a Crisis
There are no quick and easy solutions to America’s illegal fentanyl problem.
Kodiak Island is one of America’s most remote places. Located off the southwest coast of Alaska, it has only 12,500 residents but receives over 60,000 tourists per year. They come for the scenic green coastlines, which have given Kodiak the nickname the “Emerald Isle,” as well as activities like coho salmon fishing, watching Kodiak bears and whales, and kayaking. But in this outdoorsman’s paradise, in February, a Kodiak man was sentenced to seventeen years in prison for intent to distribute 1.5 kilogrammes of fentanyl, along with other drugs. In June, police seized nearly 900 illegal fentanyl pills from another Kodiak drug dealer.
Fentanyl often reaches Alaska by mail, or it is smuggled in by airline passengers. In June, for example, an Arizona man named Odarius Shaw was sentenced to ten years in prison for sending 50,000 fentanyl pills to Alaska twice a week for over six months. The pills had been stuffed into the checked luggage of passengers on commercial flights. “[T]he amount of fentanyl Mr. Shaw supplied to Alaska could destroy entire communities,” said US Attorney for the district of Alaska S. Lane Tucker. In May, Alaska announced a “One Pill Can Kill” campaign, noting that a fentanyl pill worth US$10 on the street in Arizona can sell for US$250 in rural Alaska.
Alaska’s illegal fentanyl crisis illustrates how the drug is ravaging the farthest corners of America’s landscapes. KFF Health News says that fentanyl is “ubiquitous” in Cabell County, WV, which is eighty percent rural and has the highest opioid overdose death-rate in the US. Cabell County is home to Marshall University, which received a US$3.3 million grant from the National Institute on Drug Abuse in July to study the genetic mechanisms underlying fentanyl addiction. And in South Dakota, the last members of one of the largest drug-trafficking conspiracies in state history were sentenced to prison in November. From a California jail cell, where he was serving time for murder, ringleader Terry Morris, Jr. had used a contraband cell phone to orchestrate the trafficking of 80,000 fentanyl pills from Mexican cartels to Sioux Falls.
Fentanyl is an addictive synthetic opioid, up to fifty times stronger than heroin. Illegal fentanyl is now the leading cause of death for Americans aged 18–45. From Hawaii to California to Louisiana, governments are seeking solutions to the worst drug crisis in American history. Arizona is a pivotal state in the fight against illegal fentanyl. “The Grand Canyon state has become the fentanyl state,” said Kari Lake, a 2024 US Senate candidate and former news anchor from Arizona. Indeed, half of all US fentanyl seizures have occurred in Arizona, which has a 372-mile border with Mexico. In April, amid escalating fentanyl deaths, Arizona Governor Katie Hobbs signed a new law stiffening the penalty for trafficking over 200 grammes of fentanyl to a mandatory minimum five- to ten-year prison term, or ten to twenty years for repeat offenders. The law is known as the Ashley Dunn Act, in memory of a 26-year-old woman from Prescott, Arizona, who died in 2021 after taking just half a counterfeit pill laced with fentanyl.
A common myth holds that most illegal fentanyl is smuggled into America through Arizona’s remote desert and mountainous border regions. In fact, most illegal fentanyl arrives through official ports of entry. In August, at Arizona’s Lukeville Port of Entry, the US Customs and Border Patrol (CBP) made its largest ever fentanyl seizure. Four million blue pills containing over a thousand pounds of fentanyl were found stuffed into 234 packages concealed within the frame of a trailer. It was enough to kill over half the population of Arizona. CBP Commissioner Troy Miller said in October that the agency has seized over 50,000 pounds of fentanyl along the US border over the last two years, more than ever before in history and enough to kill the entire American population many times over.
Most illegal fentanyl is produced by Mexico’s Sinaloa Cartel, the most powerful cartel in the world, and Jalisco New Generation Cartel (CJNG). The DEA has tracked the activities of these two cartels in nearly fifty countries, from money laundering in China to making fentanyl precursors in India. Incoming Trump “border czar” Tom Holman told Fox News that the White House will label the cartels “terrorist organizations” and “use the full might of the United States Special Operations to take them out.”
The fentanyl issue will be a major point of contention in relations between the Trump administration and Mexico, since the Mexican government plays an essential role in preventing fentanyl from reaching the US border. On 26 November, Trump threatened to put 25 percent tariffs on Mexico and Canada unless they secure their borders—as well as “an additional ten percent tariff” on China, “above any additional tariffs,” unless China cracks down on fentanyl smuggling. Perhaps not coincidentally, on 5 December, two weeks after Trump’s remarks, Mexico announced its biggest fentanyl seizure in history, over one tonne of fentanyl pills confiscated by Mexican soldiers and marines.
Mexico’s new president, Claudia Sheinbaum, took office in October. But Rice University border expert Tony Payan says Sheinbaum has viewed fentanyl as primarily a US problem rather than a Mexican problem. This is likely to change in a hurry. Payan told Florida news station WSLR that:
If [Trump] sees that fentanyl begins to also go down, and deaths by fentanyl overdoses go down … then they can sit down and renegotiate the [US-Mexico-Canada Agreement] with a lot more freedom. So you’ll see Mexico is more collaborative. I don’t think Mexico has a choice, by the way. I think Mexico is stuck in a corner. … [It] doesn’t really have a whole lot of leverage. … And so I think at the end, Mexico is going to have to fold and follow US designs. It’s going to be a very aggressive policy towards Mexico in particular. I mean, Mexico has been at the center of Mr. Trump’s rhetoric. ... So I think Mexico will just have to make some concessions, really important concessions if it wants to continue to have access to the American market.
The cartels produce fentanyl in Mexico from chemical precursors imported mostly from China. The precursors are “cooked” by chemists in cartel labs, and the fentanyl is sent across the border into the US. In December, an article in the New York Times reported that Sinaloa Cartel members are now showing up on university campuses in Mexico, some disguised as janitors, to recruit chemistry students to become fentanyl cooks:
Times reporters spoke to a chemistry professor, who said the recruitment of his students was common. The students [who worked as fentanyl cooks] said they had different jobs within the criminal group. Sometimes, they said, they run experiments to strengthen the drug or to create precursors. Other times, they say, they supervise or work alongside the cooks and assistants who produce fentanyl in bulk.
The cartels are aiming to be able to produce their own fentanyl precursors soon, rather than having to import them from China.
The global epicentre of illegal fentanyl trafficking is “Ambos Nogales,” or “Both Nogales,” the twin cities that straddle the Arizona–Mexico border. Nogales in Mexico is a bustling industrial city of 260,000 and a gateway for factory products from the northern states of Mexico coming into the US. Each year, some 380,000 trucks, 3.7 million cars, 889 trains, three million pedestrians, and ten million people enter the US through the ports of entry in Nogales, AZ. This immense volume of traffic makes it challenging for the CBP to spot fentanyl smugglers.
Aaron Sarin
Nonetheless, the CBP seized over 45 million fentanyl pills in Nogales alone in the fiscal year 2023. The CBP interrogates drivers with trained detectives, and it searches vehicles using drug-sniffing dogs, handheld chemical analysers, and immunoassay strips that can detect fentanyl in other drugs. Border agents keep Naloxone available, a drug that rapidly counteracts the effects of opioid overdoses in both humans and dogs. It was a CBP dog that, in August, sniffed out nearly 100 pounds (45 kg) of fentanyl inside the centre hump of a Dodge Ram pickup driven by a 22-year-old woman attempting to drive through the Nogales port of entry.
To transport fentanyl from state to state, the cartels employ thousands living in the US, especially trucking companies. In California, the US Department of Justice (DOJ) in February completed Operation Smoke Jumpers, a two-year investigation that led to the indictment of San Diego-based Carin Trucking and others. Carin had been using its fleet to traffic some 680,000 fentanyl pills, many hidden inside fire extinguishers in scrap metal trucks.
Meanwhile, Hector Alejandro Apodaca-Alvarez was one of seven traffickers working for the Sinaloa Cartel who were sentenced to prison in a Miami court in May. From the border town of Somerton, Arizona, Apodaca-Alvarez had used his trucking company to send tens of thousands of fentanyl pills, as well as cocaine and methamphetamines, to an undercover DEA agent in South Florida. The traffickers had coordinated fentanyl shipments throughout the US, including Arizona, California, Florida, Kentucky, Massachusetts, Rhode Island, Texas, and Virginia. Roque Bustamonte of Yuma, Arizona, was Apodaca-Alvarez’s main fentanyl supplier and received life in prison. Bustamonte’s nickname is the “Skittles Man,” as in recent years, the Sinaloa Cartel has been producing and trafficking fentanyl pills in rainbow colours resembling Skittles candy. These are just a few of many trucking companies, drivers, and dealers inside the US who have been convicted for working with Mexican cartels.
Many users take illegal fentanyl unknowingly. Every sort of illegal drug is now potentially laced with fentanyl by dealers to give it a kick or make it more addictive (fentanyl is extremely addictive), especially cocaine, methamphetamines, and marijuana. But measuring doses minute enough to be safe requires hospital-grade technology, which most users and dealers do not have. Moreover, counterfeit pills resembling other drugs but containing fentanyl are also extremely common.
Illegal fentanyl is sold in many forms, from pills and powder to bars that resemble street chalk. The pills are typically blue and stamped “M30” to look like oxycodone (Oxycontin or Percocet). In June, a nineteen-year-old college freshman in New York took just one pill of what she thought was the pain medication Percocet. It had been purchased by a friend on social media. It turned out to be pure fentanyl, and she was dead within hours. Similar stories have played out in record numbers across the US. Illegal fentanyl is now killing 200 Americans a day, 70,000 each year.
The casualties come from all walks of life, from babies and toddlers exposed to their parents’ illegal drugs to high-school cheerleaders and football players and inmates in prison. CalMatters.org even reports that California has seen a dramatic rise in workplace deaths since the early 2010s due to the ingestion of fentanyl on the job and during breaks. Just two milligrammes of fentanyl can kill a person. Seven out of ten fentanyl pills seized by the US Drug Enforcement Agency (DEA) contain a lethal dose.
Throughout 2024, Washington and Beijing sparred over who is to blame for America’s fentanyl problem. In April, the House of Representatives Select Committee on the Strategic Competition Between the United States and the Chinese Communist Party (CCP) revealed its findings that the CCP “directly subsidizes the manufacturing and export of illicit fentanyl materials and other synthetic narcotics through tax rebates.” The committee found that the CCP provides grants and awards to “companies openly trafficking illicit fentanyl materials.”
In January, the US and China held “frank and honest discussions” about combatting the flow of fentanyl precursors into the US. Both sides expressed hope for expanded cooperation, but Yu Haibin, the deputy director of China’s National Narcotics Control Commission Office, argued that “the fentanyl problem in the US is not manufactured in China; its roots lie within the country itself.” Illegal fentanyl trafficking networks combine Mexican drug cartels, Chinese chemical manufacturers and banks, and American drug dealers, all facilitated by the internet.
In October, the US Attorney’s Office indicted eight Chinese chemical manufacturing companies and eight employees for attempted distribution of synthetic opioids and precursor chemicals used in the production of fentanyl, as well as money laundering. The DOJ accused companies in Wuhan, Guangzhou, Hubei, Tianjin, and Jiangsu of distributing fentanyl precursors, and specific Chinese business leaders were indicted for using their Bitcoin wallets to launder fentanyl-related payments.
However, the DOJ also credited the Chinese government’s Ministry of Public Security with shutting down five companies that the US had indicted for fentanyl-related charges in recent years. In addition, it commended China for recently designating fentanyl precursors piperidone and 1-BOC-4-AP, as well as the drug protonitazene, as controlled substances. Protonitazene is a new deadly synthetic opioid up to three times more potent than fentanyl. It has been increasing in prevalence since 2021.
Before 2019, fentanyl was widely available for sale on over 100 websites in China. It was often simply mailed from China to Mexico or the US. But in 2019, President Xi Xinping made fentanyl a controlled substance and banned the export of many types of fentanyl to the US. This led to the rise in exports of fentanyl precursor chemicals from China. The precursors are sent either directly to Mexico or first to the US, then across the border to Mexico to be cooked into fentanyl.
The DOJ arrested several top leaders of the Sinaloa Cartel in 2024, including cartel co-founder Ismael “El Mayo” Zambada Garcia, 76, in New Mexico in July. He is now awaiting trial in New York. The DOJ also arrested Joaquín “El Güero Moreno” Guzmán, the son of the infamous former head of the Sinaloa Cartel, Joaquín “El Chapo” Guzmán Loera, who has been serving a life sentence in a federal super-maximum security prison in Colorado since 2019.
These 2024 arrests built on the momentum from the 2023 arrest of another son of El Chapo, Ovidio “The Mouse” Guzmán. The Mouse was the first to push the Sinaloas to begin producing and dealing illegal fentanyl. The story of his apprehension is a good example of the damage fentanyl trafficking is doing in Mexico. The Mouse was captured in the state of Sinaloa by the Mexican army on 5 January 2023, in the tiny town of Jesús María, population 5,000. In a 4 am raid, the army shot through the front door of a hilltop mansion and captured The Mouse in ten minutes.
But for the next ten hours, the town became a war zone. The army closed all streets out of the city and cut all water, electricity, and telecommunications. They battled Sinaloa Cartel members, who sprayed bullets from mounted machine guns and lit dozens of cars and military vehicles on fire. Residents hid in their homes in the dark. The Mexican army deployed Black Hawk helicopters, airplanes, armoured vehicles, and hundreds of soldiers. By evening, the army had claimed one of its biggest victories ever over the cartels. The casualties numbered 29 dead, including ten soldiers, and 35 wounded. The Mouse was extradited to the US, where he now awaits trial.
In 2023, fentanyl trafficking brought the Sinaloa Cartel intense pressure from the Mexican government, supported by the DEA. As a result, in mid-2023, the Sinaloas decided to stop fentanyl production by all but a select few cooks. An order went out from Los Chapitos, the faction of the Sinaloas run by El Chapo’s sons, to find anyone still producing fentanyl and kill them. Cartel hit men assassinated scores of fentanyl cooks in late 2023, but fentanyl production was too lucrative to stop entirely. In 2024, Sinaloa-controlled fentanyl labs continued to migrate northward, out of Sinaloa into states closer to the US border, especially Baja California and Sonora. Meanwhile, amid the power vacuum following the capture of the Sinaloa Cartel’s leaders, a bloody civil war broke out in September between rival Sinaloa factions. In Culiacán, the capital of Sinaloa state and headquarters of the Sinaloa Cartel, the intra-cartel war has left over 500 dead and over 600 missing since 9 September.
There are no quick and easy solutions to America’s illegal fentanyl problem. The US Department of Homeland Security’s Homeland Threat Assessment for 2025 projected that fentanyl smuggling and seizures will “remain high into 2025,” in part because cartels are finding new ways to evade US customs regulations. In addition, the report says that Chinese suppliers of fentanyl precursor chemicals have figured out new ways of doctoring the customs labelling on packages to avoid detection. And Chinese collaborators have started shipping pill press equipment to Mexico and the US from South Korea to conceal its origins.
In a CBP interview, Commissioner Miller said the fentanyl crisis is the biggest challenge he has faced in his thirty-year career with the agency. “We cannot seize our way out” of it, said Miller. “[I]t is so multi-dimensional, right? We’re talking about precursors in China. We’re talking about Mexico, where the drugs are being manufactured. We’re talking about pill presses, dyes, and other equipment. … We’re talking about a demand on a scale that we’ve really never experienced before. … 100,000-plus overdoses, 70 percent of those being from opioids.” Miller says that lowering demand for fentanyl through education campaigns is essential. We need to “get in schools,” he says, “and hammer home the message that ‘one pill kills.’”
