Importing the Opioid Crisis? International Trade and Fentanyl Overdoses
Working Paper 31885
DOI 10.3386/w31885
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The U.S. opioid crisis is now driven by fentanyl, a powerful synthetic opioid that currently accounts for 90% of all opioid deaths. Fentanyl is smuggled from abroad, with little evidence of how this happens. We find a positive relationship between state-level imports and drug overdoses, which is consistent with fentanyl smuggling occurring via legal trade flows. This relationship accounts for 14,000-20,000 deaths per year, and is not explained by geographic differences in “deaths of despair,” general demand for opioids, or import competition. Our results suggest that fentanyl smuggling via imports is pervasive and a key determinant of recent opioid problems.