United States Drug Enforcement Administration

Fentanyl is the most prevalent and the most significant synthetic opioida threat to the United States and will very likely remain the most prevalent synthetic opioid threat in the near term. The fentanyl threat remains most severe in the white powder heroin user market in the Midwest and Northeast United States, and fentanyl availability continues to be primarily by itself or with heroin. Fentanyl mixtures with non-opioid substances are a cause for public health concern due to the high potential for large numbers of fatal overdoses in short periods of time; however, there is no evidence that transnational criminal organizations (TCO) are trafficking strategic quantities of fentanyl already mixed with non-opioid drugs. Fentanyl’s popularity is unlikely to be challenged in the near term, but traffickers will likely continue to produce new fentanyl-related substances and other novel opioids.