The other fentanyl threat requires readiness

It’s the nightmare scenario few in Washington want to talk about – and even fewer are prepared to confront – and that is the use of illicit fentanyl as a weapon. Although medicinal fentanyl is used safely in anesthesia, illicit fentanyl is widely known as the deadly synthetic opioid driving America’s deadly overdose crisis. Fentanyl has been, and is now, further emerging as a credible chemical weapon in the hands of state and non-state actors. The question is not whether fentanyl can be used as a weapon. It already has. The question now is whether America is taking all the appropriate steps needed to prepare for the worst. In the 118th Congress, I had proposed that illicit fentanyl be classified as a weapon of mass destruction.

Over the last several years, illicit fentanyl has been inflicted upon us through deception in drugs – both prescription and recreational. Under the previous administration, overdose deaths reached over 100,000 every year. If that is not bad enough, it can be worse.

In 2002, Russian special forces deployed aerosolized fentanyl analogues during the Dubrovka Theater hostage crisis in Moscow. The gas incapacitated the Chechen terrorists holding over 900 hostages. The aerosolized fentanyl also killed 130 of those hostages—innocent civilians. The Russian government seemingly lacked either the means or the will to administer enough overdose reversal agents in time. That tragedy revealed a chilling truth: fentanyl can be weaponized, militarily and for terrorism, and when it is, the results can be deadly.

More than two decades later, the threat has only grown. Research conducted at Iranian military-affiliated universities shows clear interest in aerosolized synthetic opioids as incapacitating agents, possibly to be deployed via drones. The raw materials to manufacture illicit and weaponized fentanyl are inexpensive to produce, particularly in countries that turn a blind eye to its production. Illicit fentanyl’s reach into every American community is a proof point of how easy it has become for dangerous criminals to obtain and distribute the drug.

The Departments of Defense and Justice once explored fentanyl’s potential as a non-lethal incapacitating agent. Those efforts were shelved in the United States due to the inability to dose the drug effectively without risking death. Russia clearly did not share that hesitation. Knowing what we do about the current Iranian regime, the largest state sponsor of terror, it seems unlikely that they would hesitate to use this dangerous weapon.

Unlike other banned chemical agents such as tear gas, fentanyl and its analogues exist in a gray zone: common in hospital operating rooms and illicit drug markets alike, but just as lethal when aerosolized and released in a confined public space.

The U.S. Army’s Chemical, Biological, Radiological, and Nuclear (CBRN) program has confirmed that this threat is real.

Currently, most public spaces that stock naloxone—restaurants, transportation hubs, schools—carry only two to four doses. First responders are typically equipped for one or two overdoses at a time. This is a great effort to try to save everyday overdose victims, and has had success, along with the Trump administrations effort to reduce the illicit fentanyl supply. These stoic efforts, however, would not be nearly enough for a subway station full of poisoned commuters.

Having served as a Physician / Soldier engaged in the Intelligence Community, it has become intuitive to me to prepare for the worst and to be prepared to save lives.

There are steps America typically takes to fill any readiness gaps.

Our strategic national stockpile exists for public health threats and ensures ready access to sufficient volumes of countermeasures. Availability to life-saving countermeasures are scaled to include civilian emergency response systems and high-risk infrastructure.

A coordinated operational response plan for mass poisoning scenarios equips federal agencies to manage and mitigate such an unthinkable event. Enhanced training for first responders on chemical attack protocols, decontamination procedures, and rapid administration of readily available countermeasures saves lives.

For example, wherever the threat of a fentanyl attack might occur, naloxone should be required equipment for military personnel, intelligence assets and diplomatic staff. This would equip one with another level of self-defense and safety in the event of an attack, much like we do for other CBRN threats.

While widespread deployment used to seem unlikely, the threat of weaponized fentanyl is no longer theoretical. Small, targeted attacks could wreak unthinkable carnage if American communities are not prepared. Even more unthinkable would be looking back after an attack knowing that we had the antidote within our defense capabilities but didn’t take the steps necessary to have it in place to save lives. Let’s continue to work on this issue!

Fentanyl is more than a public health issue. With the weaponization capabilities of illicit fentanyl, naloxone is our best armor.

Once fentanyl is in the air, the clock is ticking.

Rep. Wenstrup represented Ohio’s 2nd Congressional district from 2013-2025 and served as co-chair of the GOP Doctor’s Caucus. He is a physician, Army Iraq War veteran and he served on the Ways and Means and House Intelligence Committees.