America’s Opioid Crisis: Introduction

Contributors: Mallory Bowling, Madison Clore, Abbie Edwards, Andy Hamer,

Patrick Hemmig, Jason Huffman, Declan LeWarn, Jack Micucci, Lucius Overby,

Trevor Tiemeyer, Luke Uhlman, Kennedy Weigel, Seth Workman

Over the last two decades, America’s opioid crisis has created grave social and economic problems that threaten the country. As examined in this article, it began with prescription opioids (first wave) in the 2000s, followed by heroin around 2015 (second wave), then fentanyl and super meth starting around 2020 (third wave), and now fentanyl-laced meth, heroin, and other opioids (fourth wave). Today, fentanyl and super meth are inexpensive to produce, easy to make, hide, and smuggle, and so highly addictive they create a captive market. Moreover, it seems that the war is being lost in spite of extensive efforts by law enforcement to apprehend cartels, producers, and dealers, the judicial system to convict, and social workers to rehabilitate. This Special Edition of Publius examines the causes, the criminal network, social consequences, enforcement efforts, and possible solutions to America’s opioid crisis.

Part I - The Four Waves, 1995-Present examines the four waves of the Opioid crisis, beginning with the first wave of prescription drugs, the second wave of heroin, the third of fentanyl, and finally the fourth wave of meth laced with fentanyl.

Part II - Smuggling, Gangs, Weapon Trafficking, Money Laundering, and Enforcement details the other dimensions of the opioid crisis.

Part III - The Human Cost describes the social consequences of America's Drug Crisis.

Part IV - Conclusions: Looking for Solutions explores what can be done at a global, national, and regional level to address this crisis.

The articles draw from the following sources: the seminal work of Sam Quinones, who in his two award-winning books Dreamland and The Least of Us, chronicles the history of America’s two-decade opioid crisis; the recent book by Peter Schweizer, Blood Money, which details the myriad of international drug enterprises, many in China, that manufactured fentanyl, its analogues, and other synthetic drugs; Luke Smith’s 2021 Publius article, “Examining the Roots of a Crisis: The Creation of an Opiate Market that Continues to Evolve,” that examines the first wave of the opioid crisis. This article also draws from numerous reports from the Drug Enforcement Administration, Center for Disease Control and Prevention, United Nations Office on Drugs and Crime, and the US Department of Justice, as well as US News and World Report, The New York Times, and other periodicals.