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For nearly a century heroin has dominated the illegal opioid trade. The global supply of heroin is estimated to generate tens of billions of dollars in revenues a year and its illegal use has long been the source of many societal harms. The arrival of inexpensive and mass-produced synthetic opioids, such as fentanyl, to parts of North America and Europe may signal the beginning of the end of heroin's dominance. Data from several places suggest that fentanyl and other synthetic opioids can quickly supplant heroin. Taking the extreme case, we calculate the estimated wholesale revenues of heroin currently and contrast that with fentanyl prospectively in the United States and in the rest of the world if fentanyl were to supplant heroin entirely. Heroin traffickers in the United States generate about $2.5 billion in revenues; the total import value of fentanyl, after replacing heroin, could be less than $100 million. For the rest of the world we project a reduction from $6.7 billion to less than $300 million. Retailer revenues on the other hand would probably rise because individuals may consume more frequently and with greater intensity due to fentanyl's shorter duration of action and so far there has been no indication of a notable reduction in retail prices. It is unlikely that heroin will entirely disappear, but very likely that globally heroin will account for a declining share of illegal opioids. Violence and corruption may decline but opioid related mortality and morbidity, as well as property crime, are likely to rise. Policy makers will face difficult challenges. Economics provides limited help in forecasting which opioid markets are likely to convert to synthetic opioids., Competing Interests: Declarations of Interest None., (Copyright © 2020. Published by Elsevier B.V.)

International commerce and travel have been restricted in order to limit the spread of COVID-19. The illegal trafficking in drugs, which is often concealed in other commercial activity, will be affected by these disruptions. This is particularly true for precursor chemicals, controlled substances of synthetic origin, and new psychoactive substances coming from Asia. China hosts large and under-regulated pharmaceutical and chemical sectors that provide many of the active ingredients used both in legitimate medicines and illicit fentanyl and methamphetamine. Unregulated producers and vendors in China have been supplying drug trafficking organizations in Mexico or using the internet and postal service to directly sell fentanyl to buyers in North America. The magnitude of supply shortages and interrupted trade of chemicals and synthetic drugs coming from China will depend on the breadth and depth of COVID-19's disruptions. In turn, this could impact vulnerable drug-using populations. Drawing on historical accounts of prior supply disruptions, this commentary offers some initial speculation as to the possible effects of COVID-19 on the supply of synthetic drugs like fentanyl and precursor chemicals supplied to North America from China, which may have important lessons for other parts of the globe. Prior supply disruptions coincided with elevated prices and reduced purities of street drugs as well as increases in the number of users entering treatment. However, it is challenging to predict how developments will unfold given the unprecedented nature of this pandemic. A short-term breakdown in supply chains, interrupted trade, or social distancing mandates may not have much of an effect on the availability of synthetic drugs. Yet, disruptions in trade for months or years could shape how drugs are supplied or used. Drug policy will need to evaluate market indicators as soon as they are available but responding now with expanded medication therapies, like methadone, may help save lives. The drug policy landscape could look different in a post-COVID world., Competing Interests: Declarations of Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)