The Killing Drugs: Synthetic Opioids around the World

In the final episode of The Killing Drugs, host Vanda Felbab-Brown speaks with Dr. Lisa Durette and Dr. Alexis Kennedy of the University of Nevada, Las Vegas, about the impact of the fentanyl and opioid epidemics on young people. They explore risk factors leading to substance use disorders among the young, including developmental vulnerabilities, the social environment, and trauma and abuse. They discuss the challenges in identifying opioid use in adolescents, how to have conversations with young people about drugs, and the importance of community and family involvement in prevention. Finally, they explore treatment and other drug support services available to young people or their lack of, including in the juvenile justice system.  Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode, Vanda Felbab-Brown discusses the fentanyl and opioid crisis in Nevada with Dr. Anne Weisman and Dr. Sara Hunt of the University of Nevada, Las Vegas (UNLV). They analyze the high rates of opioid misuse in the state and the resulting strain on health systems and behavioral health workers as well as coroners, a professional group essential in responding to drug use, but often neglected in policy focus. Their conversation explores the significant innovations that the state of Nevada adopted as a result of UNLV research and policy work and ways in which it can serve as an exemplar to other U.S. localities struggling with inadequate resources to deal with fentanyl. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode of The Killing Drugs, Vanda Felbab-Brown discusses the emerging smuggling and retail of illicit fentanyl in South America with guests Daniel Mejía of Universidad de los Andes and Sara García of InSight Crime. They explore the sources and networks behind this threat, as well as the factors that mitigate or could amplify it. They also analyze South America’s preparedness to respond to fentanyl trafficking and use. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode, host Vanda Felbab-Brown speaks with Dr. Alex Stevens, criminology professor at the University of Sheffield, about the emerging threat of synthetic opioids in Europe, particularly fentanyl and nitazenes. Stevens argues that the greater availability of treatment access and harm reduction programs in Europe than in the United States could reduce the severity of a growing flow of synthetic opioids into Europe. Felbab-Brown and Stevens also discuss the challenges of controlling synthetic drug supply chains and various law enforcement actions taken in Europe as well as the role of Afghanistan’s opium poppy ban. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode of The Killing Drugs, Vanda Felbab-Brown talks with Fred Dews about the role of Mexican criminal groups in the U.S. opioid crisis and U.S-Mexico anti-crime cooperation. She explains how, in addition to dominating fentanyl and methamphetamine production and supply to the United States, the Sinaloa cartel and cartel Jalisco Nueva Generación have expanded their role in other illegal as well as legal economies in Mexico and are building up political and institutional influence. Felbab-Brown also discusses the state of the U.S.-Mexico counternarcotics and law enforcement cooperation as well as the role of Chinese money laundering networks in the fentanyl trade. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode, the podcast roles are reversed as show host Vanda Felbab-Brown is interviewed by Fred Dews, show producer and multimedia project manager at Brookings, about her research on the evolution of illicit networks and supply chains in China that fuel the U.S. fentanyl and opioid crises. They also discuss the evolution and complexities U.S.-China counter-narcotics cooperation and its prospects. Felbab-Brown also assesses some of the accomplishments of the restarted bilateral cooperation. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode, host Vanda Felbab-Brown speaks with Philomena Kebec, economic development coordinator for the Bad River tribe, about the particularly devastating impact of the fentanyl epidemic on American Indian and Alaska Native communities. In the United States, Native communities experience the highest drug overdose mortality rates among racial groups, with fatalities far surpassing national averages. But the sheer numbers do not capture the totality of the devastation, such as the cultural losses and community grief. Yet federal and state responses to the fentanyl crisis among Native communities have been profoundly inadequate. Kebec emphasizes the urgent need for greater resources, culturally tailored and evidence-based care, and greater decision-making authority for Native communities. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

Host Vanda Felbab-Brown interviews Stanford professor Keith Humphreys about drug decriminalization in San Francisco, Oregon, and British Columbia. They discuss the origins and motivations for the dramatic policy change in 2020; the design of the policies, including the similarities with and differences from the decriminalization policies in Portugal; and the outcomes in the Northwest, including in terms of drug use, dealing, arrests, and property crime. Humphreys also explains what caused backlash against such policies and, ultimately, policy reversals. Humphreys emphasizes balanced policies, strong community engagement, and evidence-based public health service provision as the way forward. Keith Humphreys holds the Esther Ting Memorial Professorship at Stanford University, receives research funding from the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the Veterans Health Administration, and is a non-executive director of Indivior PLC. His views do not necessarily represent official policy positions of any of these organizations. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

Host Vanda Felbab-Brown talks with RAND researchers Beau Kilmer and Roland Neil about U.S. domestic law enforcement responses to the fentanyl crisis. Kilmer and Neil highlight a decline in drug arrests, particularly for cannabis, in the United States, but note a surge in fentanyl-related seizures. They also discuss various alternatives to incarceration for specific drug-related crimes, including police-led deflection programs, and they cast skepticism on new punitive approaches, such as drug-induced homicide laws. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In this episode, host Vanda Felbab-Brown discusses the benefits and limitations of harm reduction approaches with experts Regina LaBelle and David Holtgrave, who discuss a wide scope of harm reduction measures, including naloxone provision, overdose prevention centers, and the importance and efficacy of client-centered and community-centered approaches. Felbab-Brown, LaBelle, and Holtgrave also explore the legal barriers and stigma that pose challenges to adopting these strategies in the United States. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

Host Vanda Felbab-Brown speaks with Dr. Nicole Gastala and Dr. Harold Pollack about the challenges in reducing opioid use disorder in the U.S. They discuss the effectiveness of medication-assisted treatment and explore barriers like stigma, socioeconomic disparities, rural access issues, and insufficient insurance coverage. The conversation emphasizes the need to expand Medicaid, build family support, and reduce stigma within the medical community. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In the show’s second episode, host Vanda Felbab-Brown talks with Dr. Peter Reuter and Dr. Greg Midgette, criminology professors at the University of Maryland, about the current state of the U.S. drug market, discussing changes to U.S. consumption patterns from cocaine to various opioids. The episode also explores the dramatic rise in lethality in the U.S. drug market, not just because of the widespread prevalence of fentanyl, but also because of the increasing potency of methamphetamine. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

In the show’s first episode, host Vanda Felbab-Brown speaks with Dr. Jonathan Caulkins, a professor at Carnegie Mellon University, about the unique challenges that synthetic drugs, and particularly synthetic opioids, pose for policy. After laying out the history of drug use in the United States and the origins of the fentanyl epidemic, they discuss the pros and cons of a wide range of policies—from various law enforcement approaches to prevention, treatment, harm reduction, and prescribed safer supply. Show notes and transcript. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs

Over 100,000 Americans are dying of drug overdoses annually. On The Killing Drugs: Synthetic Opioids around the World, host Vanda Felbab-Brown, a senior fellow in Foreign Policy at the Brookings Institution, interviews leading experts on the devastating synthetic opioid crisis to find policies that can save lives in the United States and around the world. Brought to you by the Brookings Podcast Network. Learn more at: Brookings.edu/KillingDrugs