This presentation will review the history of US street drug markets since the early 1990s to explain the emergence of xylazine, fentanyl, and crystal methamphetamine in regional markets formerly dominated by heroin and cocaine. It will examine the relationship between each of these newly prevalent synthetic substances and describe what we know so far about their impact on related comorbidities. Finally, it will assess how the public health impact of recent transformations to the US narcotics supply relates to the experience of drug consumption and the actual way that people use drugs in their everyday lives. It will conclude with lessons learned to help determine what prevention strategies could be used to counteract the impact on communities.
Dr. Montero’s research draws together the methods of medical and economic anthropology to examine the racialized, gendered interface between the opioid overdose epidemic, mass incarceration, ongoing transformations in narcotics supply chains, and public assistance programs for psychiatric disability in the United States. His mixed-methods research studies the changes in the risk environment for HIV, HCV, mental health conditions, and fatal overdose among street-based drug users brought about by the emergence of synthetic sedatives (e.g. fentanyl and xylazine) and stimulants (e.g. methamphetamine) in the 2010s-2020s, and by the concomitant resurgence of punitive drug control targeting petty dealers throughout the US. One of the central questions of his current research is why the opioid overdose epidemic is becoming increasingly black following almost three decades in which it was predominantly white and working class. He is also conducting a long-term ethnographic study of the War on Drugs in the Afro-Indigenous region of Moskitia on the Caribbean Coast of Nicaragua and Honduras.