Joy was seventeen when I met her. She had a smile that could light up a locked psych ward and a laugh too big for the walls around her. The first time we spoke, she burped right in my face, then broke into laughter. It was ridiculous, and it was hilarious. In that moment, I knew her. She was Joy—full of life, defiant in her humor, and absolutely unforgettable.
But Joy was already marked. Groomed online. Hooked by synthetics. Trapped in a system that would use her body night after night—sometimes seventy men in a single shift, a gun shoved into her mouth if she resisted, and more pills waiting to keep her tethered.
That is sex trafficking in America today. No chains in basements, nor whispers in alleys. It is industrial-scale captivity fueled by synthetic opioids, enforced with violence, and monetized through the bodies of American girls.
The New Doctrine of Captivity
Clandestine labs in China produce endless waves of synthetic opioids, including fentanyl, nitazenes, and compounds so novel they outpace our forensic libraries (UNODC, 2020). Transnational criminal organizations move them across the southern border. Trap houses weaponize them in American neighborhoods.
Synthetic opioids hijack the mu-opioid receptor with such potency that withdrawal becomes intolerable: bone pain, vomiting, dysphoria, autonomic chaos (Volkow, NEJM 2023). The body itself becomes the prison. Captivity no longer requires chains; it requires only supply.
And once the victim is hooked, the monetization begins. Fifty, sixty, seventy men in a night. Bodies industrialized for profit. According to the International Labor Organization, sexual exploitation generates $99 billion annually — two-thirds of global trafficking revenue (ILO, 2014).
This is not vice. This is asymmetric warfare.
The Battlespace
We found ourselves in a battle for which we were extremely unprepared. This new war is being waged in a new kind of battlespace with a tragically well-oiled machine made up of five distinct parts:
- Labs in China: weapons factories.
- Transnational criminal organizations: logistics and distribution lines.
- Trap houses: forward operating bases.
- Synthetic opioids: shackles.
- American girls: the commodity.
The result is a perfected economy of enslavement worth more than the GDP of many nations. And it is hidden in plain sight.
I am a physician, board-certified in psychiatry and addiction medicine. I can map the neurobiology of withdrawal receptor by receptor. But I am also trained to see the battlespace.
And this is what I see: a hostile network using chemistry as shackles, sex as currency, and violence as enforcement. This is not scattered crime. It is a coherent system of captivity.
Why We’re Losing
Our legal system is calibrated for slow-motion justice. Survivors are forced to testify for eighteen months or longer, seated across from the perpetrators who enslaved them. Associates sit in the gallery. The threat is implicit. Many victims refuse. Cases collapse. Predators walk.
The Department of State notes that trafficking convictions globally remain in the single digits per hundred thousand victims (TIP Report, 2024). That staggering gap between crime and consequence all but ensures impunity.
I saw it with Summer. She was twenty when I sat with her on the porch of a treatment facility in rural Mississippi. Her cravings were quiet for the first time. She told me about the years stolen and about the possibility of living again. For a moment, there was peace.
The very next day, she borrowed a phone, called her old trap house, and within hours a car pulled onto our land. She climbed in. Days later, she died of a synthetic overdose.
That is how strong the leash is, how brazen the system has become.
The Solution
We must fight trafficking the way we fight terror. I propose a plan that treats human trafficking and opioid smuggling as terrorism. Recently, the US Military blew up a boat of 11 traffickers (now called narco-terrorists) coming to the US from Venezuela. These were Tren de Aguas members known to be traffickers in Venezuela. We are escalating the fight to protect Americans from illicit synthetic opioid analogues, and protecting south/central American women from sex slavery by going on the offensive against these terrorists. The plan details:
- Intelligence mapping: Apply link-analysis tools used against insurgent networks. SIGINT, HUMINT, financial tracking. Map not just pimps, but suppliers, enforcers, and financiers. Trafficking behaves like a shadow economy (Cockayne, RAND 2016).
- Rapid prosecution: Build specialized trafficking tribunals. Shorten trial timelines. Protect survivor testimony through secure video or shielded formats. The drawn-out adversarial model retraumatizes survivors and undermines justice (Farrell & Dank, 2019).
- Offensive posture: Sixteen assets, dismantle trap houses, disrupt TCO pipelines with the urgency of counterterror operations. Waiting for local vice squads to “build a case” is equivalent to letting an IED factory run untouched.
- Medical integration: Addiction is not weakness; it is captivity. Survivors cannot be freed without medical detox, long-term recovery, and trauma-informed psychiatric care. The National Academies (2019) emphasize that treatment access is a public health necessitynot an accessory. We must nationally re-create the continuum of care network I built across the Southeast United States — integrating residential treatment, outpatient care, and acute psychiatric hospitalization — because that model is the gold standard. Neutralize withdrawal, and you cut the trafficker’s leash.
The Call
Joy is gone. Summer is gone. Both are casualties of a war America refuses to name.
Synthetic captivity is here. It is engineered; it is global; and it is winning.
If we are serious about ending it, we must stop fighting it as crime. We must fight it as the insurgency it is: with intelligence, speed, force, and law designed for war.
Until then, the machine keeps running, and the body count keeps rising.
About the Author: Lucas A. Trautman, MD, MPH is Medical Director of Oxford Treatment Center. He is board-certified in Psychiatry and Addiction Medicine. He earned his medical degree from the University of Tennessee Health Science Center and an MPH in International Health and Transnational Operations from Tulane University’s School of Public Health.
