“Fentanyl Is the Name of the Game”: Narcopolitics and the Social Production of Drug Risk Among People Who Co-Use Opioids and Methamphetamine

Abstract

In Washington State, the dynamic drug policy around fentanyl has not only transformed policing but also the ways people who use drugs make sense of their own practices. Drawing on in-depth interviews with 20 people who use both opioids and methamphetamine, this article shows how legislative changes associated with the changing “moral panic” from methamphetamine to fentanyl have affected how people conceptualize the health and legal risks associated with each substance. We build on Garriott's concept of narcopolitics (the social regulation of behavior through drug policy) to show that policing plays a constitutive role in shaping how people who use drugs assess risk and experience addiction. Participants consistently associated opioids, especially fentanyl, with criminal activity, community danger, and heightened health risks, even when methamphetamine was also involved. Methamphetamine, by contrast, was frequently described as less dangerous, more functional, and even beneficial for productivity or safety. These distinctions were not reducible to intrinsic properties of the substances themselves, but mirrored policing priorities and widespread public health messaging. In this way, policing imparted moral valuations, risks, and use patterns onto individual substances, reshaping how participants interpreted their own experiences. We argue that narcopolitics offers a critical framework for understanding polysubstance use as a socially mediated practice contingent upon larger social and political structures. Policing does not just respond to, but helps actively construct, legal and health risks. In a political climate marked by dynamic drug policy and volatile politics, this study demonstrates how these shifts reflexively transform the lived realities of polysubstance use. These findings underscore the need for policy and treatment approaches that recognize the unequal regulation of different substances and its implications for harm reduction and care.