Cumulatively, since 1999, drug overdoses have killed approximately 1 million Americans.1 That number exceeds the number of U.S. service members who have died in battle in all wars fought by the United States.* Even worse is that the United States has never experienced the level of drug overdose fatalities seen right now. In just the 12 months between June 2020 and May 2021, more than 100,000 Americans died from drug overdose—more than twice the number of U.S. traffic fatalities or gun-violence deaths during that
period. Some two-thirds of these deaths—about 170 fatalities each day, primarily among those ages 18 to 45— involved synthetic opioids. The primary driver of the opioid epidemic today is illicit fentanyl, a synthetic opioid that is up to 50 times more potent than heroin.2
Drug overdose deaths do more than cause tragic and unnecessary deaths. They also harm the national economy. In 2018, according to the White House Council of Economic Advisers, the cost of overdose fatalities was $696 billion, despite being roughly two-thirds of annual overdose deaths today. It is therefore reasonable to estimate that drug overdoses are now costing the United States approximately $1 trillion annually.
These alarming statistics are more than just numbers on a page; they represent devastating losses to families and communities, including personal losses to members of this very Commission. Whether measured in lives or in dollars, the United States’ drug overdose epidemic should shock everyone. It is unacceptable.
Given these fatalities, the Commission finds the trafficking of synthetic drugs into the United States to be not just a public health emergency but a national emergency that threatens both the national security and economic wellbeing of the country. The President declared the illicit drug trade a national emergency in a December 15, 2021, executive order,† extending his predecessor’s declaration that the opioid crisis is a public health emergency. In
terms of loss of life and damage to the economy, illicit synthetic opioids have the effect of a slow-motion weapon of mass destruction in pill form.

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