Fentanyl markets, distribution, and consumption in South America

Executive summary

North America’s opioid epidemic, driven primarily by fentanyl consumption, has raised alarm bells around the world. Fentanyl, like other synthetic drugs, has revolutionized the traditional illicit drug market. Unlike plant-based drugs such as cocaine or heroin—which depend on geographical, environmental, and temporal conditions for harvesting and synthesis—synthetic drugs can be produced year-round in clandestine urban or rural laboratories using chemicals that are often easily and legally accessible. Additionally, synthetic drugs, especially fentanyl, pose significant health risks to users, making them a pressing issue for governments globally.

This paper addresses the current dynamics of fentanyl’s illicit production, distribution, and consumption in Colombia, Brazil, Chile, and Argentina and the actions that their governments are taking to prepare for and address this phenomenon.

As of mid-2024, illicit fentanyl distribution in South America has been very low, including in the four countries studied in this paper. However, aside from Argentina, the other three countries have experienced a significant increase in seizures of licit fentanyl—diverted from medical facilities—in the last few years of recorded data, albeit from a very low baseline. Even so, there is no evidence of fentanyl being illegally produced or extensively trafficked in the region. In very few cases, the seized illicit fentanyl had been trafficked from places like North America.

Similarly, law enforcement has identified only a few cases of fentanyl overdoses in the region, the vast majority of which involved fentanyl mixed into other illegal substances. However, many of the region’s countries, such as Argentina, lack adequate monitoring and the forensic capacities to test for the presence of fentanyl and mostly do not do so. Thus, the prevalence of its use could be significantly undercounted. There is no evidence so far that large, organized criminal groups are involved in the trafficking and distribution of fentanyl in Chile, Colombia, Argentina, or Brazil.

At this point, the biggest risk of an expanded illicit fentanyl supply in South America comes from local drug retail networks lacing other drugs with fentanyl to create demand without users’ knowledge. This practice, seen in the early stages of the North American fentanyl epidemic, where small distributors mixed fentanyl with drugs like heroin to increase their potency and profits, led to a surge in addiction and overdose deaths. Although only a few cases of this strategy have been detected in South America, authorities have seized fentanyl-adulterated drugs in cities like Bogotá and Medellín in Colombia and São Paulo in Brazil. These incidents have heightened fears about the potential spread of fentanyl-laced drugs in the region and the possibility of a similar crisis to that seen in North America.

To prevent a fentanyl epidemic in South America, different strategies must be factored in, drawing on the approaches of public health professionals, public-private partnerships, and law enforcement. Early warning systems should be established to detect the possibility of increased use, overdoses, or production of synthetic opioids. Health care systems must expand addiction treatment programs, train professionals in responsible opioid prescribing, and make naloxone, a medicine that reverses opioid overdose, widely accessible. Law enforcement should enhance border controls, use advanced technologies, and implement focused deterrence strategies targeting key traffickers. Regulatory authorities need to enforce strict controls on fentanyl precursors, including rigorous tracking, inspections, and collaboration across sectors to prevent diversion into illicit markets. Partnerships with the private sector can be instrumental in preventing the diversion of substances from legal to illegal uses.