49% of illicit fentanyl seizures are in pill form

An article published in the International Journal of Drug Policy on May 13, 2024, highlighted national and regional trends in fentanyl seizures across the United States between 2017 and 2023. The study was funded by the National Institute on Drug Abuse (NIDA), a subset of the NIH. According to the study, 49.0% of all fentanyl seizures in the US in 2023 were in pill form, including over 115 million pills with illicit fentanyl.

Researchers in the International Journal of Drug Policy evaluated annual trends in fentanyl seizures by examining data from High-Intensity Drug Trafficking Areas across the US between 2017 and 2023. The data revealed significant increases in fentanyl pill seizures across the country.

For example, in 2017, pills comprised 10.3% of fentanyl seizures, while by 2023, 49.0% of seizures were in pill forms. Additionally, the pill weight related to total seizure weight increased significantly in that period, rising from 0.4% in 2017 to 54.4% in 2023.

Additionally, the study explored the geographical distribution of the seizures. Researchers reported that the “plurality” of seizures were in the Western US. Overall, the West has the greatest number of law enforcement seizures of fentanyl, and the greatest weight of fentanyl seized. Approximately 77.8% of seizures in the West were also in pill form.

In addition to high rates in the West, the Midwest also saw a significant increase in pill seizures, with an adjusted annual percentage change (AAPC) of 142.2. Furthermore, the number of pills seized had an increased AAPC of 421.0.

The Drug Enforcement Administration (DEA) notes that fentanyl is a potent synthetic opioid that is FDA-approved as a pain management drug and anesthetic. The drug can be legally prescribed to treat severe pain, commonly in cancer patients.

However, with its potency being 100 times greater than morphine and 50 times greater than heroin, fentanyl has a high potential for abuse.

“Fentanyl has continued to infiltrate the drug supply in communities across the United States, and it is a very dangerous time to use drugs, even just occasionally,” said NIDA Director Nora D. Volkow, MD, in the NIH press release. “Illicit pills are made to look identical to real prescription pills but can actually contain fentanyl. It is urgently important that people know that any pills given to someone by a friend, purchased on social media, or received from any source other than a pharmacy could be potentially deadly – even after a single ingestion.”

The fentanyl crisis is part of the ongoing opioid epidemic that has plagued the US since false claims were made by pharmaceutical companies manufacturing similar drugs. A 2023 CDC report notes that drug overdose deaths, including overdoses involving fentanyl, have increased significantly. For example, the number of overdose deaths involving fentanyl in the US increased by 55% from 2019 to 2020.

The authors of the study noted that the national fentanyl supply and illicit use must be monitored, with a focus on regional shifts. Understanding these changes can guide targeted prevention and public health efforts.

“Availability of illicit fentanyl is continuing to skyrocket in the U.S., and the influx of fentanyl-containing pills is particularly alarming,” added Joseph J. Palamar, PhD, MPH, associate professor in the Department of Population Health at NYU Grossman School of Medicine, New York City, and lead author on the paper. “Public health efforts are needed to help prevent these pills from falling into the hands of young people and to help prevent overdose among people taking pills that unsuspectingly contain fentanyl.”