Editing Drug Enforcement Administration (section)

===Fentanyl overdose crisis===
In 2019 and 2020, record overdoses from illicit [[fentanyl]] tablets or as a deadly [[adulterant]] in [[heroin]] have ravaged North America. An estimated 19,416 individuals died of a drug overdose in the United States in the first 3 months of 2020 compared with 16,682 in the same 3-month period in 2019; this trend was fueled by synthetic opioids (especially illicitly manufactured fentanyl and analogs). Furthermore, between May 2020 and April 2021, the estimated number of drug overdose deaths in the United States exceeded 100,000 over this time period, with 64.0% of deaths involving synthetic opioids other than methadone (the same illicitly manufactured fentanyls and analogs).<ref name=jo>{{Cite journal |last1=O’Donnell |first1=Julie |last2=Tanz |first2=Lauren J. |last3=Gladden |first3=R. Matt |last4=Davis |first4=Nicole L. |last5=Bitting |first5=Jessica |date=2021-12-17 |title=Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020 |url=http://www.cdc.gov/mmwr/volumes/70/wr/mm7050e3.htm?s_cid=mm7050e3_w |journal=MMWR. Morbidity and Mortality Weekly Report |volume=70 |issue=50 |pages=1740–1746 |doi=10.15585/mmwr.mm7050e3 |issn=0149-2195 |pmc=8675656 |pmid=34914673}}</ref>  In contrast, Europe has seen a decrease from heroin overdoses, and a practical absence of illicit, synthetic opioids.

Fentanyl, originally developed in the 1970s by [[Janssen Pharmaceutica]], is a potent anesthetic primarily used in hospital or hospice settings. In Europe, heroin is mainly supplied from [[Western Asia]] (from [[Afghanistan]] and neighboring countries), and less likely to be contaminated with fentanyl. In North America, there are now fewer deaths involving heroin than either meth or cocaine, a striking change that has taken place over the last two years as heroin has all but disappeared from some regions. Due to the absence of heroin from Asian sources, fentanyl-laced heroin powder or tablets have filled that void.<ref>Leana S Wen, Nakisa B Sadeghi (October 06, 2020). [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32113-9/fulltext The opioid crisis and the 2020 US election: crossroads for a national epidemic] {{Webarchive|url=https://web.archive.org/web/20201216185314/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32113-9/fulltext |date=December 16, 2020 }} ''The Lancet''. VOLUME 396, ISSUE 10259, P1316-1318. DOI:https://doi.org/10.1016/S0140-6736(20)32113-9 {{Webarchive|url=https://web.archive.org/web/20220713040735/https://www.thelancet.com/retrieve/pii/S0140673620321139 |date=July 13, 2022 }}. Retrieved 18 December 2020.</ref>

In October 2021, the US reported another record in fentanyl deaths, as federal agencies were unable to stem the tide of illicit, synthetic drugs entering the US. Originally, introduced to replace much of the white powder heroin in the Eastern United States, the drug continues to move further west. Between July 2019–December 2020, illicitly manufactured fentanyl involved deaths increased sharply in midwestern (33.1%), southern (64.7%), and western (93.9%) jurisdictions.