Synthetic drugs represent a grave and growing risk to the health and safety of people around the world. E.g. Illicit fentanyl and other synthetic opioids are involved in more deaths of American adults under 50 than any other cause. Other countries face challenges from dangerous synthetic drugs including tramadol, methamphetamine, captagon, MDMA, and ketamine. Recognizing the urgent need for collective action, the United States is rallying the international community to address this pressing challenge head-on. How did the United States and the world get here ?