Research Seminar Series: Is the Fentanyl Crisis Finally Easing? The Short-term Case for Optimism vs. the Long-term Case for Pessimism

Abstract: The sudden and substantial decline in the number of fatal overdoses involving the synthetic opioid fentanyl in the US, in the 12 months July 2023 to June 2024, has generated many hypotheses about its causes. Some possible causal factors include 1) a diminution in the pool of susceptibles as a result of high fatality rates amongst regular opioid users, (2) the effects of expanding treatment availability for opioid use disorder, 3) increased focus on harm reduction efforts, including the distribution of Narcan and fentanyl test strips, and (4) interruptions to the supply, e.g., as the result of aggressive law enforcement against producers and traffickers. Against this short-term optimism is the compelling but little examined steady 45 year increase in fatal drug overdoses. An alternative interpretation of recent trends is that after a spike above the curve during Covid, the US is simply returning to the underlying curve, a “regression to the dynamic mean”. This seminar will have two components. In the absence of regular and reliable measures of the state of the market, we look for evidence that supply has been reduced by examination of comments on Reddit. Threads on three subreddits r/fentanyl, r/heroin, r/opiates) were examined for the frequency with which comments suggested shortages in the periods January 2020 to June 2023 and July 2023 to October 2024. For example, in r/fentanyl the term “drought” was hardly used at all in the first period (appearing in 18 of 13,682 threads, 0.1%) but it appeared in 143 out of 3,993 threads (3.6%) in the second period. Analysis of terms indicating higher price and lower quality were broadly consistent with this finding. The analysis provides support for the claim that market conditions have tightened in the period July 2023 to late 2024, perhaps contributing to the decline in fatal overdoses. (Kasey Vangelov) The long-term analysis considers what might be the drivers of the 45 year rise. Are there changes, for example in perceptions about the dangers of drug use, that might lead to a plateauing or decline in fatal overdoses. (Peter Reuter)