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Americans may remember 2022 for events like Hurricane Ian, Uvalde's mass shooting and the Supreme Court's abortion ruling. But beneath the headlines, a poorly understood drug stealthily spread its dark shadow across the country.

Fentanyl, a powerful synthetic opioid, emerged as the silent killer driving a 44 percent rise in overdose deaths, which reached 107,000 in the 12 months to January 2022 _ more than gun and motor vehicle deaths combined.

The Centers for Disease Control and Prevention (CDC) says fentanyl and its chemical copycats caused about two thirds of those deaths _ often young people who thought they were taking something less powerful.

Drug enforcement efforts had started to tame America's opioid epidemic by cracking down on the so-called 'pill mills' that doled out prescription painkillers like OxyContin and Percocet and kickstarted the crisis in the early 2000s.

But this latest phase of addiction involving fentanyl has been more deadly and difficult to control, due in large part to the potency of the drug, which packs down small and is easy to mail or smuggle across borders. 




The drug was initially produced in India and China and mailed to recipients across North America. Makeshift labs have since sprung up in Mexico to receive the precursor chemicals from Asia, mix them or press them into pills, and smuggle them into the US





This image from Mexico's national defense forces shows a makeshift drugs lab in northwest Mexico, where officers discovered precursor chemicals, fentanyl paste, weapons and drug making gear, from November 2021  

Fentanyl is 50-100 times stronger than morphine. By one estimate, a year's supply of pure fentanyl powder for America's market would fit in the beds of two pickup trucks.

The US opioid crisis has been surging for decades but intensified in the pandemic, when lockdowns and hospital closures left people particularly bored and vulnerable to addiction.

The drug was first developed in 1959 for use as a painkiller for cancer patients, often injected or as a patch. In the 2010s, it increasingly turned up in pills and other forms in the US opioid epidemic, according to the Drug Enforcement Agency (DEA). 




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Initially, the drug was produced in India and China and mailed to recipients across North America, says a RAND Corporation study from February. 

Makeshift labs have since sprung up in Mexico to receive the precursor chemicals from Asia, mix them or press them into pills, and smuggle them into the US. 

One kilo of fentanyl purchased for a few thousand dollars can yield hundreds of thousands of pills worth millions.

Organized criminals from the Sinaloa Cartel and the Jalisco New Generation Cartel have started producing fentanyl themselves. Its precursor chemicals are cheap and hard to trace, as they are often used to make such basic goods as soap, medicines and pesticides. 




Drugs and paraphernalia recovered from a bust in New York in September 2016, in which officers made a record seizure of 33 kilograms of heroin and 2 kilograms of fentanyl from a drug ring encompassing New York, Massachusetts, Pennsylvania, Arizona and New Jersey





DEA officers seized a million fake pills containing fentanyl at a home in Inglewood, California, in July. The drug is so potent that users can easily take a lethal dose  





Immigrants seeking asylum in the US are processed by border agents after crossing into Arizona from Mexico. Guards told DailyMail.com that cartels get drugs across the border by using migrants as decoys 





The Centers for Disease Control and Prevention (CDC) estimates there were 109,673 overdose deaths in the year to April _ a new record. Many were due to fentanyl, pictured





The above CDC graph shows estimated (dotted line) and confirmed (black line) drug overdose deaths in the US since 2015. There has been a small downturn, which may just be fatalities returning to pre-pandemic levels





This map shows the change in overdose deaths over the 12 months to June 2022 compared to the 12 months to June 2021

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