Experts: Obama administration didn't do enough to curb fentanyl epidemic, now leading cause of opioid deaths

Opioid deaths in the U.S. (Washington Post chart)

Deaths from the powerful synthetic opioid fentanyl have been skyrocketing since 2013, but experts say the Obama administration did not take the threat seriously despite warnings and a mounting death toll.

Eleven national health experts wrote a private letter to high-ranking Obama administration officials in May 2016, begging them to declare fentanyl a national public health emergency. That would have given the administration more funding, resources and flexibility in targeting the problem, but it didn't act, Scott Higham, Sari Horwitz and Katie Zezima report for The Washington Post.

"The decision was one in a series of missed opportunities, oversights and half-measures by federal officials who failed to grasp how quickly fentanyl was creating another — and far more fatal — wave of the opioid epidemic," the Post reports. "Fentanyl has played a key role in reducing the overall life expectancy for Americans. If current trends continue, the annual death toll from fentanyl will soon approach those from guns or traffic accidents."

The numbers are sobering: more than 67,000 people died of synthetic opioid-related overdoses between 2013 and 2017, most related to fentanyl. "In 2017, synthetic opioids were to blame for 28,869 out of the overall 47,600 opioid overdoses, a 46.4 percent increase over the previous year, when fentanyl became the leading cause of overdose deaths in America for the first time," the Post reports.

Part of the problem was that federal officials didn't realize fentanyl needed different strategies to fight it, rather than being lumped in with all anti-opioid efforts. It was also difficult to understand the current scope of the epidemic since Centers for Disease Control and Prevention data collection lags at least a year. Also, it was relatively easy for foreign countries like Mexico and China to sneak fentanyl into the country: U.S. Customs and Border Protection didn't have enough staff or equipment to catch fentanyl shipments, and until 2018, the U.S. Postal Service didn't require monitoring of international packages, the Post reports.

"This is a massive institutional failure, and I don’t think people have come to grips with it,” John P. Walters, chief of the White House Office of National Drug Control Policy between 2001 and 2009, told the Post. "This is like an absurd bad dream and we don’t know how to intervene or how to save lives." The Post package provides a comprehensive history of the issue and includes excellent multimedia features.