,,iii #aaeth ,,congress #ast ,session ,s4 ,,res4 #hc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #h1 #bjag ,mr4 ,markey 7for himself and ,mr4 ,rubio7 submitted the following resolution2 which was referred to the ,committee on ,foreign ,relations ,,resolution ,expressing the sense of the ,senate regarding the trafficking of illicit fentanyl into the ,united ,states from ,mexico and ,china4 ,whereas the ,united ,states continues to experience a prescription opioid and heroin overdose epidemic that claimed more than #cc1jjj lives in #bjae2 ,whereas fentanyl is a synthetic opioid and the euphoric effects of fentanyl are sometimes indistinguishable from the euphoric effects of heroin or morphine2 ,whereas the effect of fentanyl can be up to #ej times stronger than heroin and #ajj times stronger than morphine2 ,whereas although pharmaceutical fentanyl can be diverted for misuse1 most fentanyl deaths are believed to be linked to illicitly manufactured fentanyl and illicit versions of chemically similar compounds known as fentanyl analogs 7collectively referred to in this preamble as illicit fentanyl72 ,whereas illicit fentanyl is potentially lethal even if only a very small quantity is ingested or inhaled2 ,whereas across the ,united ,states1 illicit fentanyl use and related deaths are rising at alarming rates2 ,whereas illicit fentanyl is cheaper to manufacture than heroin and the sale of illicit fentanyl is highly profitable for drug dealers2 ,whereas illicit fentanyl is sold for its heroin-like effects and illicit fentanyl is often mixed with heroin1 cocaine1 or methamphetamine as a combination product1 with or without the knowledge of the user2 ,whereas illicit fentanyl is often produced to physically resemble other opioid pain medicines1 such as oxycodone1 which sell for high amounts on the street2 ,whereas drug users often overdose on illicit fentanyl because users are unaware that they are ingesting illicit fentanyl and do not anticipate the toxicity and potential lethality of illicit fentanyl2 ,whereas1 according to the ,centers for ,disease ,control and ,prevention1 between #bjad and #bjae1 the death rate from overdoses caused by synthetic opioids1 including illicit fentanyl and synthetic opioid pain relievers other than methadone and heroin1 increased #gb percent2 ,whereas1 in #bjaf1 the ,drug ,enforcement ,administration 7referred to in this preamble as the ,,dea7 issued a ,national ,drug ,threat ,assessment ,summary1 which found that ,mexican transnational criminal organizations are-- 7#a7 the greatest criminal drug threat to the ,united ,states2 and 7#b7 poly-drug organizations that use established transportation routes and distribution networks to traffic heroin1 methamphetamine1 cocaine1 and marijuana throughout the ,united ,states2 ,whereas1 in #bjaf1 the ,,dea issued a ,national ,heroin ,threat ,assessment ,summary1 which found that starting in late #bjac1 several ,states reported spikes in overdose deaths due to fentanyl and its analog acetyl-fentanyl2 ,whereas the #bjaf ,national ,heroin ,threat ,assessment ,summary found that-- 7#a7 ,mexican drug traffickers are expanding their operations to gain a larger share of eastern ,united ,states heroin markets2 and 7#b7 the availability of heroin is increasing throughout the ,united ,states2 ,whereas in #bjae1 there were more than #i1ehj overdose deaths in the ,united ,states caused by synthetic opioids1 including-- 7#a7 illicit fentanyl2 and 7#b7 synthetic opioid pain relievers other than methadone and heroin2 ,whereas the number of deaths attributable to illicit fentanyl may be significantly underreported because-- 7#a7 coroners and medical examiners do not test1 or lack the resources to test1 routinely for fentanyl2 7#b7 crime laboratories lack the resources to test routinely for fentanyl2 and 7#c7 illicit fentanyl deaths may erroneously be attributed to heroin2 ,whereas1 in ,march #bjae1 the ,,dea issued a nationwide alert on illicit fentanyl as a threat to health and public safety2 ,whereas1 in ,october #bjae1 the ,centers for ,disease ,control and ,prevention issued a health advisory through its ,health ,alert ,network-- 7#a7 to make public health officials aware of the increase in fentanyl-related overdose fatalities2 7#b7 to provide recommendations for improving detection of fentanyl-related overdose outbreaks2 and 7#c7 to encourage ,states to expand access to1 and training on1 naloxone2 ,whereas1 in ,august #bjaf1 the ,centers for ,disease ,control and ,prevention updated the health advisory issued in ,october #bjae to make public health officials aware of the increasing-- 7#a7 availability of counterfeit pills containing various amounts of fentanyl and fentanyl-related compounds2 and 7#b7 frequency with which fentanyl-related compounds are mixed with1 or sold as1 heroin2 ,whereas illicit fentanyl has the potential to endanger public health workers1 first responders1 and law enforcement personnel who may unwittingly come into contact with illicit fentanyl by accidentally inhaling airborne powder2 ,whereas1 according to the ,,dea-- 7#a7 ,mexico is the primary source for illicit fentanyl trafficked into the ,united ,states2 and 7#b7 distributors in ,china are the source of the fentanyl analogs and the precursor chemicals to manufacture fentanyl analogs that are found in ,mexico and ,canada2 ,whereas fentanyl produced illicitly in ,mexico is-- 7#a7 smuggled across the southwest border of the ,united ,states1 or delivered through mail and express consignment couriers2 and 7#b7 often mixed with heroin or diluents in the ,united ,states and then distributed in the same ,united ,states markets in which white powder heroin is distributed2 and ,whereas ,united ,states law enforcement officials have recently seen-- 7#a7 an influx of illicit fentanyl into the ,united ,states directly from ,china2 7#b7 shipments of the equipment to manufacture illicit fentanyl1 such as pill presses2 and 7#c7 some illicit fentanyl products being smuggled into the ,united ,states across the northern border with ,canada3 ,now1 therefore1 be it ,that it is the sense of the ,senate that-- 7#a7 the use of illicit fentanyl in the ,united ,states and the resulting overdose deaths are a public health crisis2 7#b7 the trafficking of illicit fentanyl into the ,united ,states1 especially the trafficking of illicit fentanyl by transnational criminal organizations1 is a problem that requires close cooperation between the ,united ,states ,government and the ,governments of ,mexico and ,china2 7#c7 the ,united ,states ,government and the ,governments of ,mexico and ,china have a shared interest in1 and responsibility for1 stopping the production of illicit fentanyl and its trafficking into the ,united ,states2 7#d7 the ,united ,states should-- 7,a7 support efforts by the ,governments of ,mexico and ,china to stop the production of illicit fentanyl and its trafficking into the ,united ,states2 and 7,b7 take further measures to reduce and prevent heroin and fentanyl consumption through-- 7i7 enhanced enforcement to reduce the illegal supply2 and 7ii7 increased use of evidence-based prevention1 treatment1 and recovery services2 and 7#e7 the ,united ,states ,government1 including the ,secretary of ,state1 the ,attorney ,general1 the ,secretary of ,homeland ,security1 and the ,director of the ,office of ,national ,drug ,control ,policy1 should use the broad diplomatic and law enforcement resources of the ,united ,states1 in partnership with the ,governments of ,mexico and ,china1 to stop the production of illicit fentanyl and its trafficking into the ,united ,states4