Synthetic drug threats require a new international treaty

For more than a century, international drug control policy has relied on treaties designed primarily to regulate plant-based narcotics such as opium, coca, and cannabis. Today’s illicit drug market looks very different. Synthetic opioids, methamphetamine, and thousands of newly engineered psychoactive substances can now be produced almost anywhere using globally traded chemicals. Yet the international legal framework governing drug control has not kept pace with these changes.

This is not just a problem for the two most severely impacted countries—the United States and Canada—as other nations are also experiencing growing synthetic opioid problems. Addressing the volatile global market for synthetic opioids and other synthetic drugs will require intensified multilateral efforts, including new mechanisms for cooperation and more frequent opportunities to impose international controls on emerging drugs and precursor chemicals. The current system—under which governments meet once a year in Vienna at the Commission on Narcotic Drugs (CND) to consider new international controls—was designed for an earlier era and struggles to keep pace with today’s synthetic drug markets. During the CND’s regular session from March 9-13, two nitazenes and a synthetic cannabinoid were scheduled by the United Nations. Surely, before next year at this time, there will be new drug threats that deserve similar treatment.

The most recent international drug control treaty was adopted in 1988, well before the emergence of today’s synthetic substances and designer precursor chemicals. A newly negotiated global treaty focused squarely on synthetic drugs could provide modernized tools for more effective joint action. It would also send a clear signal to governments around the world about their responsibility to address the global illicit drug supply chain. As the global drug market evolves, the international legal framework governing it must evolve as well.

The scale and speed of change in the synthetic drug market raise an important question for policymakers: whether the existing international treaty framework can realistically keep pace with these developments. While the current conventions have long served as the backbone of international drug control, the rise of many new synthetic drugs and designer precursor chemicals suggests that new international mechanisms are necessary. This article examines recent synthetic drug trends, explains the limitations of the existing treaty system, and outlines several elements that could form the foundation of a new international agreement focused on synthetic drugs and their chemical inputs.

Synthetic drug trends

After years of truly stunning increases in fatal overdoses beginning around 2013 in the United States, it has been a relief to see large declines emerge over the past two years. Total drug overdose deaths, which peaked at 107,941 in 2022, have fallen to 68,408 over the most recent 12-month period, according to the Centers for Disease Control and Prevention (CDC). Although this decline is encouraging, overdose levels remain historically high, and addiction rates appear largely unchanged.

There has been considerable discussion about the causes of this decline. Some researchers attribute the decline to what they describe as a “fentanyl drought,” possibly linked to Chinese controls on precursor chemicals. Others point to additional factors, including expanded access to treatment, widespread naloxone distribution, the easing of social isolation during the COVID-19 pandemic, and possible strategic adjustments in fentanyl formulations by Mexican trafficking organizations.

If the reduction in fentanyl potency was driven primarily by Mexican cartel producers’ difficulty in obtaining sufficient high-quality precursor chemicals from China, the decline may prove temporary. Drug trafficking organizations are highly adaptive and continuously experiment with new production methods, chemical inputs, and drug formulations. Traffickers are already experimenting with alternative opioids, attempting to manufacture fentanyl precursors themselves, and seeking new sources of chemical inputs. Recent reporting indicates that Mexican criminal organizations have even begun recruiting chemistry students to assist in synthetic drug production.

Evidence also suggests that fentanyl potency may already be increasing again. Data indicate that concentrations of fentanyl detected in urinalysis samples of those with a substance use disorder reached a low point in late 2024 but returned to earlier levels by late 2025, with significant regional variation and continued volatility. The pace of overdose decline already appears to be slowing. Because multiple factors influence overdose trends, and CDC mortality reporting lags by six months, caution is warranted before drawing firm conclusions about long-term changes.

One clear trend, however, is that patterns of drug consumption are changing. Approximately 85% of fentanyl users tested positive for methamphetamine, cocaine, or both. Growing polydrug use of stimulants, opioids, and sedatives is particularly concerning.

One example of the evolving drug environment is xylazine, a veterinary sedative that prompted the Office of National Drug Control Policy (ONDCP) to invoke, for the first time, its authority under the 2018 SUPPORT Act to designate an emerging drug threat. In April 2023, ONDCP designated fentanyl adulterated with xylazine as an emerging threat and subsequently released a federal response plan outlining actions to be taken by multiple agencies. Congress previously used the same authority to designate methamphetamine in 2021.

This designation authority, together with the capabilities of other federal agencies, helps inform public health and law enforcement officials about emerging threats. However, even robust domestic response tools cannot fully address what is fundamentally a global supply chain problem. Synthetic drug production relies on chemical inputs from Asia, globally dispersed manufacturing networks, and trafficking organizations that operate across borders.

Why the existing treaties are inadequate

The number of synthetic drug threats has expanded rapidly. The United Nations Office on Drugs and Crime (UNODC) reported in 2024 that more than 1,200 individual new psychoactive substances have been identified worldwide. To track these developments, UNODC established the Global SMART Program in 2008 to work with governments to monitor emerging synthetic drug threats and provide early warnings of new substances appearing in illicit markets. Since then, the program has played an important role in identifying and sharing information about newly emerging synthetic drugs—an increasingly frequent occurrence in global illicit markets.

Global SMART is not the only important multilateral effort in this space. Central to managing the synthetic drug threat is controlling the precursor chemicals required for production. The International Narcotics Control Board (INCB) has developed several important programs to monitor shipments of precursor chemicals, including pre-export notification systems, diversion reporting, and targeted initiatives such as Project Prism and Project Cohesion. The organization monitored more than 34,000 shipments containing 90,000 tons and 8 billion liters of precursor chemicals, helping prevent the diversion of several tons of fentanyl precursor chemicals. This record is impressive, and compliance among major manufacturing countries is generally strong. However, the INCB can only require compliance for substances that have already been placed under international control. Traffickers, therefore, frequently shift to newly designed precursor chemicals that fall outside existing control lists.

Under the current international framework, governments work through the CND to place substances under international control pursuant to the 1961, 1971, and 1988 drug conventions. The scheduling process occurs annually and typically addresses substances individually. Given the speed at which new synthetic drugs and designer precursor chemicals now appear, the existing system struggles to keep pace.

In theory, the existing conventions can be amended. In practice, treaty amendments are complex and often take years to negotiate. Given the scale of the synthetic drug challenge, a new treaty focused specifically on synthetic drugs and precursor chemicals may offer a clearer path forward.

The growing geographic spread of synthetic opioids underscores the global nature of the challenge. Estonia experienced some of the highest overdose mortality rates in Europe for many years, driven largely by illicit fentanyl markets, while Scotland has recorded some of the highest drug-related death rates in the developed world. Synthetic opioids—including fentanyl analogues and nitazenes—have also appeared in illicit drug markets in a number of other European countries in recent years, including Latvia, Lithuania, Finland, and Sweden, according to monitoring by the European Union Drugs Agency. Beyond Europe, misuse of pharmaceutical opioids such as tramadol has become a serious concern in parts of West Africa, where illicit networks distribute high-dose tablets across the region and account for a significant share of global tramadol seizures.

Taken together, these developments illustrate how rapidly synthetic drug markets are spreading geographically and evolving chemically. In this context, the global community should not rely on a largely 20th-century legal framework to confront a 21st-century synthetic drug market.

Key elements of a new synthetic drugs treaty

Negotiating a new treaty would require sustained diplomatic engagement among producing, transit, and consumer countries. However, several reforms could form the foundation of an international agreement specifically focused on synthetic drugs and precursor chemicals. Such a treaty could complement the existing drug conventions while addressing gaps that have emerged in the synthetic drug era.

Six areas in particular merit consideration.

First, a provisional scheduling mechanism could allow the International Narcotics Control Board to issue temporary alerts requiring member states to implement provisional domestic controls on newly identified precursor chemicals or psychoactive substances within a specified period—perhaps 30 days—while a full scientific review is conducted.

Second, governments could adopt class-based precursor chemical controls regulating entire families of chemically related precursor compounds rather than controlling individual substances one at a time.

Third, governments could establish mandatory “Know Your Customer” requirements for chemical manufacturers and distributors handling dual-use precursor chemicals.

Fourth, international standards could be created for regulating pill presses, tablet molds, and specialized chemical reactors, including serial number registration and export certification requirements.

Fifth, the existing INCB pre-export notification system could be expanded into a mandatory real-time platform requiring governments to notify importing countries before shipping high-risk precursor chemicals.

Sixth, governments could strengthen maritime monitoring of precursor chemical shipments through improved data sharing, targeted inspections, and secure digital cargo tracking systems.

Taken together, these reforms could significantly strengthen international efforts to disrupt synthetic drug supply chains. Over the past decade, synthetic drug markets have proven highly adaptable, responding quickly to new enforcement and regulatory controls. The international policy framework designed to control them must adapt to these realities.

Conclusion: Challenges and opportunities for the Trump administration

In 2023, the Biden administration launched the Global Coalition Against the Threat of Synthetic Drugs, bringing together more than 160 countries and 15 international organizations to coordinate responses to synthetic drug trafficking. However, the Trump administration has not continued the coalition’s work or launched a comparable international initiative. That could change when the administration releases its forthcoming National Drug Control Strategy.

Administrations often seek to define new initiatives when confronting major international challenges. Modernizing the international drug control framework could provide an opportunity for renewed leadership on the synthetic drug crisis. The United States helped launch the modern international drug control system with the 1912 International Opium Convention. Yet the next stage of modernization does not necessarily need to originate in Washington. Countries such as Canada, Mexico, China, or members of the European Union could initiate discussions.

Nevertheless, the United States remains uniquely positioned to lead. Spearheading negotiations for a fourth global drug convention focused on synthetic drugs would demonstrate a clear commitment to working with like-minded countries to confront the fast-evolving synthetic drug market with tools equal to the challenge. The Trump administration has shown in the past that it is willing to reconsider previous approaches when circumstances demand it. It should do so again here by pursuing a multilateral strategy that advances both American and global interests. Otherwise, the United States risks ceding the mantle of global counternarcotics leadership at a moment when stronger international cooperation is urgently needed.