Opinion>Opinions - International

The views expressed by contributors are their own and not the view of The Hill

To stop the next drug crisis, the U.S. should look abroad

Comments:

by Jim Crotty, opinion contributor - 04/22/26 9:30 AM ET

Comments:

Link copied

by Jim Crotty, opinion contributor - 04/22/26 9:30 AM ET

Comments:

Link copied

Jaan Vaart, former drug user and nowadays coordinator of the harm reduction service, poses for a picture inside a van equipped with syringes and emergency equipment that he uses in his daily job, in Tallinn on November 18, 2019. – Of the more than 1,600 overdose deaths in Estonia since 2001, the vast majority were caused by fentanyl, according to the European Monitoring Centre for Drugs and Drug Addiction. (Photo by Alessandro RAMPAZZO / AFP) (Photo by ALESSANDRO RAMPAZZO/AFP via Getty Images)

The illicit drug trade is becoming more deadly — and more unpredictable. Although the dangers of fentanyl are now well known, traffickers continue to diversify, experimenting with an array of new synthetic substances, many of which have never been tested on humans.

The rise of these lab-made drugs has ushered in a new era, one in which illicit producers can rapidly develop highly potent substances using widely available chemical precursors. The scale of this shift is staggering: The United Nations has identified 1,446 new psychoactive substances worldwide, more than double the number reported a decade ago. By the time new synthetic drugs are identified in the U.S. it is often too late.

This rapidly evolving drug landscape underscores a critical vulnerability in the U.S. response: We currently lack sufficiently integrated real-time data to detect and respond to emerging threats before they are fully formed. Today, even our best data sets suffer from time lags and inaccuracies. Overdose death rates, for example, often aren’t validated until several months after they occur. In many ways, the U.S. is “flying blind.”

Significant gaps remain in how the U.S. collects and shares data. The first step, as they say, is admitting you have a problem. At the recent Rx and Illicit Drugs Summit in Nashville — widely considered the country’s leading forum for drug policy solutions — Sara Carter, director of the White House Office of National Drug Control Policy, acknowledged these shortcomings. She announced several new initiatives to help close the gaps.

These efforts are a step in the right direction. But improving domestic surveillance alone is not enough. To stay ahead of the next wave of synthetic drugs, the U.S. must also learn from countries that are often the first to encounter them.

After 30 years, the U.S. has learned valuable lessons about fentanyl and other synthetic drugs, but with an estimated 80,000 overdose deaths in 2024, it clearly still has a lot to learn from others. In trying to identify the next threat, the U.S. would be wise to consult with countries like Scotland and Estonia, that have firsthand experience confronting these threats.

Long derided as the “sick man of Europe” due to its high rates of substance use and addiction, Scotland is often among the first to encounter new illicit substances, especially opioids. During my time as a liaison officer at the U.S. Drug Enforcement Administration’s London Country Office, I worked closely with British, Scottish and Irish law enforcement to disrupt and dismantle transnational criminal organizations and develop strategies to combat the global drug trade.

In 2017, a senior member of Police Scotland contacted our office to inquire about two new, highly potent synthetic opioids that had infiltrated the heroin supply in Glasgow, resulting in the deaths of several longtime heroin users. He said the drugs were called “iso” and “eto” and asked whether the DEA had any information about them.

At the time, I had not heard of either, but I now know them to be isotonitazene and etonitazene — two members of the nitazene family of drugs, a class of synthetic opioids that can be over 40 times stronger than fentanyl. These substances are now emerging in the U.S., nearly a decade after first appearing in Scotland.

The small Baltic country of Estonia has also served as a proving ground for new synthetic drugs and was among the first to grapple with the challenges posed by fentanyl. In a preview of the U.S. opioid crisis, illicitly manufactured fentanyl and its analogues entered Estonia’s drug market around 2003 and rapidly replaced heroin, leading to a spike in overdose deaths. This influx marked the start of more than a decade of sustained fentanyl use, with Estonia recording the highest overdose death rates in Europe during the 2000s and early 2010s.

Existing intelligence-sharing mechanisms through international organizations like the United Nations Office on Drugs and Crime and the International Narcotics Control Board are essent