Fenethylline is now illegal in most countries; it is produced primarily for illicit use, which takes place mainly in the Middle East, with some evidence that it is used by Islamist militants and terrorists, as stimulants for gunmen.

[8] Although there are no FDA-approved indications for fenethylline, it was used in the treatment of "hyperkinetic children", in what would now be called attention deficit hyperactivity disorder, and, less commonly, for narcolepsy and depression.

[citation needed] The Assad regime's annual fenethylline revenues were estimated to have been worth US$57 billion in 2022, about three times the total trade of the entire Mexican illicit drug market.

[24] Fenethylline is a popular drug in Western Asia, and American media outlet CNN reported in 2015 that it is allegedly used by militant groups in Syria.

[28][29] According to Abdelelah Mohammed Al-Sharif, secretary general of the National Committee for Narcotics Control and assistant director of Anti-Drug and Preventative Affairs, forty percent of users between the ages of twelve and twenty-two in Saudi Arabia are addicted to fenethylline.

[31][32][33] The following month, Agence France-Presse reported that Turkish authorities had seized two tonnes of fenethylline—about eleven million pills—during raids in the Hatay region on the Syrian border.

[34] In December 2015, the Lebanese Army announced that it had discovered two large-scale drug production workshops in the north of the country and seized large quantities of fenethylline pills.

[35][36] Traces of the drug were found on a mobile phone used by Mohamed Lahouaiej Bouhlel, a French-Tunisian who killed eighty-four civilians in Nice on Bastille Day 2016.

[38] In 2017, two other consignments of pills were found at Charles de Gaulle Airport: in January, heading for the Czech Republic, and in February, hidden in steel moulds.

[41] In December 2018, Greece intercepted a Syrian ship sailing for Libya, carrying six tonnes of processed cannabis and three million fenethylline pills.

[48][49] On 1 July 2020, an anti-drug operation coordinated in Italy by the Italian Guardia di Finanza and Customs and Monopolies Agency seized fourteen tonnes of amphetamines, labeled as Captagon, smuggled from Syria and initially thought by the Italian authorities to have been produced by ISIS,[50][51][52] which were found in three shipping containers filled with around 84 million pills, in the southern port of Salerno.

[55] In December 2020, Italian authorities seized about 14 tonnes of fenethylline arriving from Latakia, Syria, and heading towards Libya, consisting of about 85 million pills, worth around $1 billion.

[57] In February 2021, Lebanese customs seized at Beirut port a shipment of 5 million fenethylline pills hidden in a tile-making machine, intended for Greece and Saudi Arabia.

Drug money flowing into Syria is destabilizing legitimate businesses, positioning it as the global centre of fenethylline production, with increased industrialization, adaptation, and technical sophistication.

[64] In June 2021, Saudi authorities at Jeddah port seized 14 million fenethylline tablets hidden inside a shipment of iron plates coming from Lebanon.

[65] In the same month, Saudi authorities seized a shipment of 4.5 million fenethylline pills, smuggled inside several orange cartons, at Jeddah port.

[16] The division's security bureau, headed by Maj. Gen. Ghassan Bilal, provided protection for factories and along smuggling routes to the port city Latakia and to border crossings with Jordan and Lebanon.

[71][72] An illegal Syrian manufacturer told New York Magazine in 2015 of the effect the drug had on fighters: "[If] someone takes many pills, like 30 or so, they become violent and crazy, paranoid, unafraid of anything.

[25] A drug control officer in the central city of Homs told Reuters that protestors and fighters were able to resist painful interrogations better while on fenethylline.

[68][25] One 19-year-old fighter named Kareem, who said he fought alongside ISIS for more than a year, told CNN in 2014: "They gave us drugs, hallucinogenic pills that would make you go to battle not caring if you live or die.

"[25] In February 2023, Israel's Ministry of Defense claimed to have thwarted an attempt to smuggle thousands of fenethylline tablets from the West Bank into the Gaza Strip.

[74] Israel has publicly stated that fenethylline was used during the October 7 attacks, but this has been doubted by Caroline Rose, director of New Lines Institute’s Strategic Blind Spots Portfolio.