Why Fentanyl Kills in the United States but Not in Mexico
What Mexico’s near-zero overdose rates reveal about the real causes of America’s opioid epidemic
The deadliest drug crisis in modern American history has a geographic cliff. Tens of thousands of people die each year from synthetic opioids in the United States, but once you cross the border into Mexico, the epidemic virtually disappears.
This is not a rhetorical flourish. It is one of the strangest and least examined asymmetries in global drug markets: Mexico is a central node in the fentanyl supply chain that feeds the United States, yet fentanyl consumption inside Mexico remains marginal. While more than 40,000 people in the U.S. die annually from overdoses linked to synthetic opioids, Mexico recorded just 113 overdose deaths from 2015 to 2024.
The question is why. What happens in Mexico that causes fentanyl overdoses to vanish, even though fentanyl is clearly trafficked throughout its territory?
