What costs more lives than car accidents, gun violence, suicide COMBINED?

America’s deadliest threat isn’t a foreign army or terrorist cell – it’s a synthetic opioid devastating communities across the nation. Fentanyl is the leading cause of death for Americans aged 18-45, surpassing car accidents, gun violence, and suicide combined. But viewing this crisis solely through a public health lens masks its true horror – fentanyl represents a direct national security threat that demands an immediate, coordinated response.

The organizations controlling fentanyl production and distribution – primarily the  Sinaloa Cartel and Jalisco New Generation Cartel – are sophisticated and well-resourced, with funding, weapons supplies, and leadership across Mexico and the American southwest. Inside the United States, these two groups inflict gruesome violence to maintain territorial control, deploy military-grade weapons, and leverage corruption to expand their influence. Their operations drain our economic resources, destabilize our communities, and forge dangerous alliances with global criminal networks. Just as we mobilized comprehensive resources to combat terrorism after 9/11, we must now apply similar strategic tools to dismantle the fentanyl supply chain. To regain control of our cities, the U.S. must designate these cartels as Foreign Terrorist Organizations, exert pressure on China and Mexico to disrupt the flow of fentanyl, and mobilize public support against the flow of the drug.

The U.S. State Department has the authority to designate any group whose terrorism activities threaten the United States as an FTO. The Sinaloa Cartel and Jalisco New Generation Cartel operate with military precision and employ violence against American citizens to maintain power. An FTO designation would unlock critical legal and operational tools to target their networks, including enhanced authority to freeze assets, prosecute material supporters, and coordinate intelligence operations with international partners. This is exactly what the Drug Cartel Terrorist Designation Act, submitted to Congress on March 8, 2023 by Senator Roger Marshall, seeks to accomplish.

Second, our government must exert maximum diplomatic and economic pressure on China and Mexico to disrupt the supply chain. China remains the primary source of fentanyl precursor chemicals, while Mexican cartels handle processing and trafficking. Despite some regulatory gestures, neither country has demonstrated serious commitment to enforcement.

The U.S. must impose targeted sanctions on Chinese companies and individuals involved in precursor chemical trade. The imposition of sanctions against China, among other measures, is the aim of the Fentanyl Eradication and Narcotics Deterrence (FEND) Off Fentanyl Act, a legislative proposal submitted last year by the U.S. Senate Committee on Banking, Housing, and Urban Affairs. The FEND Off Fentanyl Act, if approved by Congress, would subject certain Chinese entities and government officials that fail to take steps to prevent the flow of fentanyl into the United States, potentially subjecting them to sanctions.

With Mexico, we must expand intelligence sharing and support trusted law enforcement units while increasing pressure for high-profile cartel extraditions. If such diplomatic efforts fail, the U.S. should consider unilateral actions to eliminate cartel production facilities and transportation networks. Such strikes must parallel the kind of limited, precision raids and drone strikes conducted in Pakistan from 2009 to 2012 to eliminate terrorist safe havens.

Third, we need a comprehensive national security campaign to mobilize public support. This isn’t just about drug awareness—it’s about helping Americans understand fentanyl’s broader threat to national stability.  The campaign should integrate prevention, enforcement, and treatment while empowering communities to identify A comprehensive national strategy to combat the fentanyl epidemic requires coordinated action from community leaders across multiple fronts. The approach begins with robust public awareness campaigns delivered through diverse media channels by trusted local voices, while simultaneously building partnerships between local governments, schools, religious institutions, and nonprofits to provide educational workshops and early intervention programs. This foundation of public education must be paired with concrete action: expanding access to addiction treatment services through targeted funding and regional cooperation, fostering compassionate law enforcement approaches that treat addiction as a health issue, and ensuring widespread availability of naloxone in public spaces alongside appropriate training for community members.

The effectiveness of this comprehensive approach is demonstrated by several successful community initiatives across the country. Dayton, Ohio achieved a remarkable 50% reduction in overdose deaths from 2017 to 2019 through a combination of extensive public awareness campaigns and a shift to health-focused addiction response. Beginning in 2020, Seattle implemented a citywide naloxone distribution program while fostering strong community partnerships, resulting in overdose rates significantly lower than comparable cities. Meanwhile, Gloucester, Massachussett’s innovative Angel Program, which prioritized treatment over arrests, led to a 30% decrease in opioid-related incidents within just one year, proving that when law enforcement and community organizations work together with a focus on compassion and recovery, meaningful change is possible.

The implications extend far beyond public health. Fentanyl trafficking profits fund arms dealing, human smuggling, and potentially terrorism. Cartel operations weaken governance across Latin America, destabilizing the Western Hemisphere and increasing migration pressures. Every day we delay comprehensive action, these organizations grow stronger and more deeply embedded in American communities.

Critics may question whether treating drug cartels like terrorist organizations is appropriate, or if unilateral action against production facilities risks international relationships. But with over 150 Americans dying daily from fentanyl overdoses, we’ve moved beyond the luxury of diplomatic hesitation.

The fentanyl crisis represents a clear and present danger to American security. By designating cartels as FTOs, applying sustained pressure on China and Mexico, and launching a national security campaign, we can begin to turn the tide. The infrastructure and legal frameworks exist—what’s needed now is the political will to deploy them.

The time for half-measures and jurisdictional debates has passed. America must act with the same resolve and comprehensive approach that defined our response to previous national security crises. Our communities, our stability, and our future depend on it.

Joseph Lestorti is a retired Supervisory Special Agent with the U.S. Department of State Diplomatic Security Service. Joe Buccino is a retired U.S. Army Colonel and the CEO of Vantage + Vox. David Kasten is a seasoned executive leader and Colonel in the U.S. Army Reserves who now leads Poolbeg Group LLC. 

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