Fentanyl: the Opioid that Takes Away from Breathing

By Yeonjae Shin ‘26 ARTLESS STUDENT WRITER

Do you know the first reason for the death of young people in the United States in 2020? It is fentanyl.

Fentanyl killed more than 60,000 people in a single year in 2020. Not suicide, not infectious disease, not car accidents, Fentanyl. Then, what is Fentanyl?

What is Fentanyl?

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It should only be used for patients with intolerable pain, but it is abused recently by many people as a recreational drug. It is a bigger problem than you think,linked to the global community due to its widespread use.

What is the tendency of the spread of fentanyl?

Death caused by Fentanyl has proliferated since 2014 in the United States. It kills 175 people per day. Not only in the United States, the spread in Korea has al-

Restraining the spread of fentanyl is also related to political problems in USA, and also between various countries.

The country which produces the most illegal fentanyl is China. Since 2012, Chinese companies have started to provide illegal fentanyl to various countries in the world. In China, there is the biggest pharmaceutical industry in the world including more than 5000 pharmaceutical companies and 160,000 chemistry distribution companies. Since the competition between the countries was extreme, they started to sell and distribute illegal medicines including fentanyl. Drug gangs in China can get fentanyl easily at a cheap price, and they started to sell around the world, especially to the United States. Then, the number of reported law enforcement encounters testing positive for Fentanyl in the United States increased highly from 2014 to

2015.

The reason why the countries failed to control the spread is a new way to smuggle fentanyl. They sell the legal materials used to synthesise Fentanyl to countries with less strict laws such as Mexico. Mexico cartels buy these materials, and produce fentanyl themselves. Today, Mexican transnational criminal organisations (TCOs) are largely responsible for the production of U.S.-consumed illicit fentanyl. Then, they sell to other countries including the United States. Since Fentanyl is made of acetone and chlorine which are usually used for legal purposes, it is impossible to restrict every element which makes fentanyl. The complex relationship between the USA, China, and Mexico and sneaky ways to distribute fentanyl make it difficult to restrain the spread.

As the situation became really serious, Donald Trump, the USA president at that time requested Xi Jinping to restrict producing fentanyl in China in 2018. Then, China promised that they will strengthen the punishment of illegal production of fentanyl in 2019. In 2022, they shared about precursor trafficking incidents from China or India to the USA as a measurable objective of them. However, even though two countries tried to reduce the spread of fentanyl, it is becoming worse and worse by the year.

This problem is also linked to domestic political problems in the USA. As the fentanyl is smuggled through the border between USA and Mexico, it implies that the border is not was not secure. Republicans use the spread of fentanyl as an evidence of criticising Biden; using the fact that fentanyl can hook the children and make them addicted.

Why is it so addictive? Why is it dangerous?

Fentanyl passes through the protection of our bodies easily. Also, it binds strongly to receptors that attach to the narcotic. The bond is so strong that there are no other substances in our body stronger than the level of bonding. Since the receptor is destroyed, you cannot feel joyful anymore without fentanyl. Furthermore, you feel severe pain when the effect of fentanyl decreases. These reasons make you have no choice but to look for fentanyl. However, normal people do not know about the suitable amount, and how to administer it. Unprofessional and illegal uses of patches cause overdose and side effects.

The side effects are severe constipation, nausea, vomiting and stiffening the muscles. The most dangerous thing about fentanyl is about making you not feel pain. A basic reason for breathing for humans is releasing carbon dioxide from the body. It is very painful when we hold the breath and the body is filled with carbon dioxide because the body becomes acidified. Shockingly, fentanyl makes it not painful even if the person doesn’t breathe. It makes the brain unable to detect carbon dioxide in order to release it. The addict is exposed repeatedly to hypoxia and gets permanent damage. The only reason for life becomes fentanyl. At the end, the addict dies because you don’t breathe due to hypoxia.

Why is it legal in most countries? What is the original purpose of it?

Aren’t you curious about why, despite these dangers, fentanyl is used in legal ways? It is really essential for the patients who need it. It is used as analgesic often in the hospitals especially for terminally ill cancer patients. Patients suffering from extreme pain are less likely to get addicted to narcotic pain medications compared to people who have no need for medication. The medication is designed to be absorbed through the skin. The amount of the medication applied is also constant and designed to raise the concentration really slowly, which is 12 micrograms per hour. With one patch, a patient can use it for 3 days. Even in the hospital, there is a warning message on the screen when a doctor tries to prescribe the fentanyl patch. However, some doctors prescribe fentanyl easily which might cause a serious addiction.Terrible chronic pain can be an enormous threat to life and medications like fentanyl are necessary to treat these conditions. Continuous severe pain breaks the life rhythm and disrupts the autonomic nerves. As a result, it causes extreme fear, depression, and shorter lifespan. Just by controlling the pain, it can increase the quality of life and also extend life.

What should governments do to stop the spread of fentanyl?

Until now, you read about fentanyl, how dangerous it is and how difficult it is to restrain it for various reasons. It is obvious that not only individuals, governments should work to stop the spread of it. There are a few possible solutions. First is education. Do you know the phrase “Prevention is better than cure.”? Education should include danger and the appropriate uses of fentanyl. Also, it should be for not only students, for all nations and especially doctors, which can prevent abuse and overdose of it. Secondly, trace the production and distribution of fentanyl. For example, a foreign government informed a U.S. agency about an inbound fentanyl shipment in 2017. It allowed the agency to seize the shipment before it reached the United States.

Fentanyl is not a problem between one or two countries. More than three countries are involved in the process of production, distribution, selling and purchase. To trace fentanyl and restrain the spread, cooperation between countries around the world is necessary.