Seizures of key pharmaceutical opioids show distinct regional patterns by substance.

• While fentanyl seizures remain overwhelmingly concentrated in North America (> 99 per cent), other pharmaceutical opioids dominate seizures in different regions: codeine in West and Central Africa and South Asia, tramadol in West and Central Africa, methadone in East Europe, buprenorphine in Europe and South Asia, and oxycodone in North America.
• Fentanyl, codeine and tramadol account for nearly 80 per cent of global seizures of pharmaceutical opioids over the 2020–2024 period, both in terms of volume and as a proportion of total seizures adjusted for purity and expressed in daily defined doses (S-DDD).
• Fentanyl seizures continue being heavily concentrated in North America (> 99 per cent of all fentanyl seizures in 2024 and previous years). Illicitly supplied fentanyl is mostly manufactured in North America, notably in Mexico, and consumed in North America. Following years of ongoing increases, fentanyl seizures declined strongly in 2024 – in line with reports of improved controls of precursor chemicals in East and South-East Asia and reports of falling opioid-related deaths in North America.
• Global tramadol seizures declined strongly in 2018 following the introduction of improved controls in India, but then increased again substantially between 2020 to 2024 (notably in West and Central Africa).