Fentanyl was originally synthesized in the 1960s as a medical opioid for severe pain and anesthesia, but today its illicit form dominates the U.S. opioid supply. Its extreme potency means that a lethal dose can be as little as two milligrams, making it highly dangerous. Because fentanyl is synthetically produced, there are no crop or seasonal limitations, allowing for year-round manufacture. The low cost of production means millions of doses can be created from just a few kilograms of precursor chemicals. Additionally, its easy distribution—tiny quantities can be shipped in envelopes, vehicles, or mail—makes it especially attractive to traffickers and difficult for authorities to intercept.

COVID-19 exposed a fragile pharmaceutical supply chain — hollowed out by decades of offshoring and rising costs. Today, the U.S. faces a choice: rebuild domestic drug manufacturing or remain dependent on foreign factories. A bold, practical solution is emerging — National Centers of Excellence for Pharmaceutical Manufacturing — shared regional hubs that provide GMP-certified facilities, workforce training, and surge capacity to ensure secure, affordable medicines made on American soil. Supported by President Trump’s recent Executive Order to restore domestic production, these centers could revive our industrial base, protect national security, and make drugs more accessible. The next crisis won’t wait — and neither should we.