Welcome to the President's Inbox, a CFR podcast about the foreign policy challenges facing the United States.

I'm Jim Lindsay, Director of Studies at the Council on Foreign Relations.

This week's topic is the fentanyl epidemic.

With me to discuss why the United States is struggling to stop the flood of fentanyl from coming across the border is Vanda Felbaugh-Brown. Vanda is a senior fellow in the Strobe Talbot Center for Security, Strategy, and Technology in the Foreign Policy

Program at the Brookings Institution. There she directs the initiative on non-state

armed actors. She also co-directs the Africa Security Initiative and the Brookings series on

opioids, the opioid crisis in America, domestic and international

dimensions. She recently wrote a piece for foreign affairs titled, Why America is Struggling

to Stop the Fentanyl Epidemic. Vonda, thanks for joining me.

My pleasure. If we may, I'd like to begin by identifying the scope of the problem,

Vanda. Something on the order of 100,000 Americans died last year from preventable drug overdoses,

a number that is up nearly 60% in just the past four years, and up nearly 800% over 25 years.

The statistics show that the vast majority of those preventable overdoses involve fentanyl.

Indeed, the head of the Drug Enforcement Agency has called it the single deadliest drug

threat our nation has ever encountered.

What exactly is fentanyl?

Fentanyl is a synthetic opioid that has important legal medical uses.

It is an anesthetic that's used in surgeries, and Jim, you or your listeners really don't want to have a surgery without anesthetic that's used in surgeries and GMU or your listeners really don't want to have a

surgery without anesthetics. Fentanyl is also used when people have to be put on ventilators.

For example, during the most intense days of the COVID pandemic, people who had to be placed

on ventilators to keep them alive and breathing would be

given fentanyl. Nonetheless, fentanyl is also a drug that is being used in the illegal market

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