The future of fentanyl and other synthetic opioids / Bryce Pardo, Jirka Taylor, Jonathan P. Caulkins, Beau Kilmer, Peter Reuter, Bradley D. Stein.

Format:

Book

Author/Creator:

Pardo, Bryce, author.

Taylor, Jirka, author.

Caulkins, Jonathan P. (Jonathan Paul), 1965- author.

Kilmer, Beau, author.

Reuter, Peter, 1944- author.

Stein, Bradley D., author.

Contributor:

Rand Corporation.

Series:

Research report (Rand Corporation) ; RR-3117-RC.

[Research report] ; RR-3117-RC

Language:

English

Subjects (All):

Drug abuse--United States--Forecasting.

Drug abuse.

Opioid abuse--Government policy--United States.

Opioid abuse.

Fentanyl.

Opioids.

Drug abuse--Forecasting.

Government policy.

Forecasting.

United States.

Physical Description:

xxxii, 232 pages : color illustrations, color maps ; 23 cm.

Place of Publication:

Santa Monica, Calif. : RAND Corporation, [2019]

Summary:

Deaths involving synthetic opioids in the United States increased from roughly 3,000 in 2013 to more than 30,000 in 2018. In fact, synthetic opioids like fentanyl are now involved in twice as many deaths as heroin. This book offers a systematic assessment of the past, present, and possible futures of synthetic opioids in the United States. It is rooted in secondary data analysis, literature reviews, international case studies, and key informant interviews. The goal is to provide decisionmakers, researchers, media outlets, and the public with insights intended to improve their understanding of the synthetic opioid problem and how to respond to it. The authors conclude that (1) fentanyl and other synthetic opioids are becoming dominant in some parts of the United States and Canada, but remain less common in other parts of these countries; (2) a confluence of factors, including the dissemination of simplified and novel synthesis methods and increasing e-commerce, helps explain the surge in synthetic opioids; (3) much can be learned from other countries' experiences with synthetic opioids; (4) supplier decisions, not user demand, drive the transition to fentanyl; (5) fentanyl's spread is episodically fast and has ratchet-like persistence; (6) synthetic opioids drive up deaths rather than the number of users; (7) problems with synthetic opioids are likely to worsen before they improve, and states west of the Mississippi River must remain vigilant; (8) improving surveillance and monitoring is crucial; and (9) limiting policy responses to existing approaches seems unlikely to reverse this tide.

Contents:

CHAPTER ONE: Introduction

CHAPTER TWO: Insights From Mortality and Seizure Data in the United States

CHAPTER THREE: Assessing Explanations for the Recent Rise in Synthetic Opioids

CHAPTER FOUR: International Experiences with Synthetic Opioids

CHAPTER FIVE: Some Possible Futures for Fentanyl and Other Synthetic Opioids

CHAPTER SIX: Concluding Thoughts

APPENDIX A: Background Information on Synthetic Opioids

APPENDIX B: The Economics of Mexican Heroin and Fentanyl

APPENDIX C: Opportunities for Better Surveillance and Monitoring

APPENDIX D: Supplemental Information on Data and Methods

APPENDIX E: Details on Key Informant Interviews.

Notes:

Includes bibliographical references (pages 195-229).

ISBN:

1977403387

9781977403384

OCLC:

1120576051