Just as the Trump administration has seen initial success cracking down on fentanyl at the border after fentanyl-related deaths hit an all-time high under the Biden administration, Washington faces a new era in the opioid epidemic.

New drugs on the block

Fentanyl is a legitimate pharmaceutical drug reserved for rare medical situations, but it has been knocked off by Chinese chemical suppliers and Mexican cartel manufacturers in recent years in the latest iteration of the opioid epidemic.

Fentanyl can be made year-round and smuggled into the United States in small doses as opposed to marijuana or cocaine, which both come from plants that are harvested seasonally and must be smuggled in large quantities to be profitable. Fentanyl is also used as the main ingredient in counterfeit prescription pills produced in Mexico and moved into the U.S. The pills look identical to real prescription sedatives, including Xanax, Percocet, and oxycodone, and are readily available across social media sites.

The DEA explained this month that police and public health officials are seeing fentanyl combined with several new substances, particularly xylazine, nitazenes, cychlorphine, and medetomidine. 

“Many of these substances are not approved for human use and are often undetectable to the user,” the DEA stated in its May warning to the public.

Xylazine, known as “tranq” for its use in sedating horses, and medetomidine are legal drugs, but they are used by veterinarians to sedate animals. Nitazenes and cychlorphine are unregulated synthetic opioids, the latter of which is up to 10 times more potent than fentanyl. Fentanyl itself is up to 100 times more potent than morphine and 50 times stronger than heroin.

Naloxone, the ingredient in Narcan, is an antidote for opioid overdoses, but because xylazine is not an opioid, the emergency medicine only stops the effects of fentanyl, not the tranquilizer, making those who overdose more likely to have lethal repercussions. However, xylazine and medetomidine cannot be fully reversed.

Xylazine is often combined by cartel chemists with fentanyl in order to “amplify sedation and euphoria,” at the cost of causing respiratory suppression and a high lethal risk to the user.

A user who takes xylazine and fentanyl — either by injecting, snorting, swallowing, or inhaling it — can experience unique physical symptoms not seen among users of other types of drugs, prompting the “zombie” name.

Xylazine causes blood vessels to constrict, limiting blood flow. Without adequate blood supply, the skin takes on the appearance of lesions at the injection site and throughout the body. The skin stretches out and disintegrates, posing a risk of limb amputation.

Trump’s fentanyl crackdown

The latest Centers for Disease Control and Prevention data indicated that 109,000 people died from drug overdoses in 2022, with 70% of deaths tied to a synthetic opioid such as fentanyl. Deaths are increasingly referred to as poisonings rather than overdoses because users may be unaware that the substance they are using contains fentanyl.

The amount of fentanyl being seized by federal law enforcement at the nation’s border has decreased sharply over the past year since President Donald Trump commanded the government to shut down the border to the deadly drug. More than 6 billion potentially lethal doses of fentanyl were seized by federal law enforcement at the border in fiscal 2023. It was enough to kill all 330 million people 18 times — but plenty more has made it into the country undetected. 

U.S. Customs and Border Protection, the federal agency responsible for inspecting people, vehicles, and goods at the nation’s air, sea, and land borders, interdicted almost half as much fentanyl in fiscal 2025 as in 2023. Roughly 85% of all fentanyl was caught by CBP’s Office of Field Operations officers at the ports of entry as opposed to Border Patrol agents, federal data show.

Government officials and private sector experts suggested a variety of reasons for the decrease in seizures, including the drug being produced in a new, non-pill form, reduced demand in the U.S., problems with production in Mexico, and better evasion of U.S. federal police at the border.

CBP Commissioner Rodney Scott told the Washington Examiner in April that the drug being produced in powder form, as opposed to pills, has allowed smugglers to move it into the country more easily.

“Our intel sources basically revealed they were, cartels were having a harder and harder time recruiting drivers … smugglers to bring pill form fentanyl into the United States because our prosecutions and our deterrence messaging was so solid. They knew they were going to jail for quite a while,” Scott said in an April 27 interview in his Washington office. “In the powder form, the smuggler doesn’t … know necessarily what they’re bringing across. It could be meth, it could be cocaine, it could be fentanyl. So basically, they shifted back to that powder form so they could recruit people to bring it across to the lower overhead. We’re adjusting to that as well through increases in the nonintrusive inspection equipment.”

Last November, the U.S. and China reached an agreement that China would stop allowing exporters to send fentanyl ingredients, or precursors, to producers in Mexican drug labs, where the final product is made and then moved into the U.S. 

FENTANYL-LACED MARIJUANA, HORSE TRANQUILIZER, AND NITAZENES LISTED AS EMERGING DRUG THREATS IN U.S.

Following Trump’s two-day summit in China this past week, the White House issued a statement that both presidents “highlighted the need to build on progress in ending the flow of fentanyl precursors into the United States,” though the Chinese Foreign Ministry made no mention of a specific commitment.

Profits for human smugglers at the U.S.-Mexico border have dried up amid Trump’s illegal immigration crackdown over the past 16 months. The annual loss of billions of dollars in human smuggling fees has forced corporate-sized crime rings in Mexico, known as cartels, to pivot to other means of profit, including fentanyl and other drugs.