Fentanyl pill seizures are skyrocketing, 115 million pills seized in 2023: Study

The number of fentanyl seizures by law enforcement more than quadrupled between 2017 and 2023, with researchers finding the drug has continued entrench itself in the country's illicit drug supply.

Seizures of fentanyl in the U.S. have followed an exponential upward trend since 2017, according to data from the federal High Intensity Drug Trafficking Areas (HIDTA) program. Researchers on the study, funded by the National Institute on Drug Abuse (NIDA), sourced data from the HIDTA.

About 50,000 pills containing fentanyl were seized in 2017, but the figure shot up to more than 115 million pills in 2023.

Fentanyl in pill form is becoming increasingly common, with pills accounting for roughly half illicit fentanyl seizures last year, compared to 10 percent in 2017.

"The main finding is how strikingly fast fentanyl is entering into the country disguised as imitator pills," NIDA Director Nora Volkow told The Hill. "I must also state that the total number of deals is just gigantic, which is very concerning."

The driver behind the dramatic increase of fentanyl pill seizures over the years is a combination of authorities becoming more aware of the drug entering the country in pill form and an overall increase in total fentanyl being trafficked in, mainly through the borders with Mexico and Canada.

The Drug Enforcement Administration cites China as the primary source of the fentanyl that is ultimately smuggled into the U.S.

Earlier this month, the House Select Committee on Strategic Competition between the United States and the Chinese Communist Party put out a report stating the Chinese government directly subsidizes the manufacturing and exporting of illicit fentanyl.

"While the PRC government publicly acknowledged in November 2023 that the trafficking of fentanyl precursors and other illicit narcotics materials in the manner described above is illegal under Chinese law, the Select Committee found thousands of PRC companies openly selling these illicit materials on the Chinese internet—the most heavily surveilled country-wide network in the world," the committee said.

A common way fentanyl-containing pills reach U.S. residents is via online shopping, according to Volkow. Patients in pain whose doctors will not prescribe them opioids, turn to the internet, where pills are more accessible and cost less.

These buyers don't seek out fentanyl and most likely don't know that the drug they bought online has been cut with the highly potent opioid. Volkow noted a worrying trend when it came to the demographic of buyers.

"We're seeing people that are older — there is a significant rise in people that are 65 to 74 that are dying from from overdose fatalities. And 65 to 74 are not people that go in and seek heroin," said Volkow. "We saw an increase in between 15 and 19 years old. And those kids are not seeking out the heroin or fentanyl."

Florida saw the largest number of fentanyl seizures in 2023, followed by Arizona and California. California was found to have the highest number of total pills with illicit fentanyl, with more than 38 million pills seized last year.

Regionally, the West accounted for the majority of pills seized in the U.S., and the Northeast reported the fewest.

"A major finding was the growth of fentanyl seizures in the West compared with the other US regions. In 2023, the West had the plurality or majority with respect to all measures other than number of powder seizures which were highest in the South. Although, while the South had more powder seizures, greater powder weight (and overall weight) was seized in the West," the report stated.

"Indeed, fentanyl seizures were initially less common in the West, but the West now largely dominates regarding the number and size of seizures, especially with respect to pills."

Volkow said the main reason drug dealers are pumping more fentanyl into the U.S. is "greed."

"You make much more money with fentanyl than you do with heroin, at least 50 times more," she said. "The other aspect about it is that it is relatively easy to synthesize and manufacture. And because it's so potent, which is the third thing, you can bring a small volume and in the small volume ... basically you can extract multiples thousands of doses."

The NIDA director cited fentanyl test strips as a "powerful tool" for combatting the harm caused by the opioid, along with the drug naloxone, which can counteract the effects of an opioid overdose. Both options are relatively inexpensive.