A Flood of New, Deadlier Drugs

What It Covers

NYT reporter Azam Ahmed examines how synthetic drugs — now numbering 1,450 distinct substances — are replacing plant-based narcotics. Fentanyl is already being superseded by nitazines, which are 20–40 times more potent. Ahmed's investigation into Cook County Jail reveals how drug-soaked paper has become a primary smuggling vector inside U.S. correctional facilities.

Key Questions Answered

• •Synthetic drug proliferation: The number of new psychoactive substances has tripled in the last decade, reaching 1,450 distinct compounds. Because all are lab-synthesized, chemists can alter a single molecule to produce an entirely new drug, making each regulatory crackdown on one substance a direct catalyst for the next generation of replacements.
• •Nitazines threat: Nitazines — a class of opioids developed by a Swiss pharmaceutical company in the 1950s but never commercialized — are now being manufactured illicitly in at least a dozen variants. They are 20–40 times more potent than fentanyl and are spreading across the U.S. and Europe, particularly where fentanyl supply has been tightly restricted by enforcement.
• •Drug-soaked paper as smuggling method: Traffickers dissolve synthetic drugs into liquid, saturate sheets of paper, and mail them into jails. Cook County investigators found a single sheet containing 10 overlapping synthetic substances. Smugglers later exploited Amazon's third-party seller system to ship drug-soaked books directly to inmates through trusted retail packaging, bypassing standard screening.
• •Enforcement paradox: Supply-side crackdowns consistently accelerate drug innovation rather than reduce availability. When authorities pressured Chinese manufacturers and Mexican cartels over fentanyl precursors, producers shifted to nitazines. After Cook County arrested its largest drug-soaked paper supplier, overdose rates remained unchanged within months, and a substance five times more potent appeared shortly after.
• •Harm reduction as viable framework: Scientists and public health experts increasingly favor harm reduction over criminalization or broad decriminalization, particularly given that 1,400-plus substances have no established medical safety profiles. Practical measures include widespread Narcan distribution, needle exchange programs, and legal immunity for bystanders who call emergency services during an overdose — all aimed at reducing deaths without requiring supply elimination.