Every Drug Scourge Has Ended the Same Way. Will This One?

America has faced devastating drug epidemics before, and history shows they often ended for a similar reason: the drug became harder to get, more expensive, or more tightly controlled.

The nation’s first major opioid crisis unfolded in the late 1800s. According to the Smithsonian Institution, by 1895, about one in every 200 Americans was addicted to morphine or opium. Many of those affected were middle- and upper-class white women who had been prescribed the drugs by physicians or unknowingly consumed them in patent medicines that did not list their ingredients.

That epidemic eased over time, largely because medical practices changed. Doctors began prescribing opioids less frequently, aspirin and other treatments became available, and new laws increased oversight.

The Pure Food and Drug Act of 1906 required manufacturers to disclose what was in their products, while the Harrison Narcotics Tax Act of 1914 established federal controls over the production and distribution of opiates.

History offers other examples.

London’s infamous gin craze of the 1700s faded as poor harvests drove up grain prices and stricter licensing made alcohol harder to obtain. In China, widespread opium addiction was eventually curtailed through aggressive government action, though at an enormous human cost.

Despite the different approaches, the outcome was similar: the drug became more difficult to obtain.

Today’s fentanyl crisis presents a different challenge.

According to the U.S. Drug Enforcement Administration, fentanyl is about 50 times more potent than heroin. Because it is entirely synthetic, it does not depend on growing poppies or harvesting crops. It can be manufactured at relatively low cost, making it inexpensive to produce and distribute.

The DEA warns that as little as two milligrams—roughly the weight of a few grains of salt—can be fatal, depending on a person’s size, tolerance, and other factors. Fentanyl is also frequently mixed into other illegal drugs without the user’s knowledge, greatly increasing the risk of accidental overdose.

That combination of potency, low cost, and ease of production has made fentanyl especially difficult to combat.

Still, there may be signs that supply-side efforts can have an impact.

Researchers writing in the journal Science reported that after China strengthened controls on several chemicals used to manufacture fentanyl, street supplies appeared to become weaker and less available.

The findings are preliminary, but they suggest that reducing access to key ingredients could make illicit fentanyl harder to produce.

History does not guarantee that today’s crisis will follow the same path as those of the past. But previous drug epidemics have shown that when supply becomes constrained—whether through changes in medicine, regulation, economics, or enforcement—drug use and addiction can eventually decline.