Heroin has always been the primary target in America’s efforts against opioid use and addiction. We now face another opioid that exceeds heroin in lethality – fentanyl, a powerfully addictive drug that accounted for nearly three of every five overdose deaths in Maine in 2017, even as the percentage from heroin declined.
Millions of Americans are addicted to drugs, and overdose deaths number over 50,000 annually, despite the use of the overdose-reversal medication naloxone. In Maine, we lose more than one a day – cutting short the lives of enough young adults to affect our demographic makeup in a state that is one of the oldest in the country. Blame for this intensified national emergency can be placed squarely on fentanyl, which is often mixed with heroin and is cheaper, stronger and more easily available than the plant-derived narcotic.
Thirty to 50 times more potent than heroin and 100 times as strong as morphine, fentanyl caused 58 percent of all drug fatalities in Maine in 2017, while the share of overdose deaths attributable to heroin that year was 21 percent. The man-made opioid has been used for legitimate medical purposes, including pain management and anesthesia, since the 1960s. Odorless and tasteless, it has been prescribed in spray, patch, tablet and other forms – even lollipops for pediatric use.
Fentanyl diverted from legitimate supplies or manufactured illicitly can be put into a press and turned into counterfeit oxycodone pills. A kilo of fentanyl worth a few thousand dollars can be cut to produce hundreds of thousands of pills and bring in millions on the street, according to the Drug Enforcement Administration. Illicit fentanyl started showing up on the streets in the U.S. in 2005, says the DEA, which traced a 2005-2007 spike in overdose deaths to a single laboratory in Mexico. After that lab was shut down, the fatality rate eased, only to climb again several years ago.
The culprit is China. The Chinese have mastered the production of fentanyl precursors in small laboratories that are difficult to expose and terminate. Precursor chemicals have been imported to Mexico and used to produce fentanyl, which enters the U.S. with ease through both our southern and our northern borders. What’s more, the Chinese have looked away as fentanyl has increasingly traveled to Canada and the United States directly by mail, transactions carried out on the internet with delivery guaranteed. Raids in China may find nobody home.
Volumes shipped are smaller than with heroin by comparison, and West Coast ports are wide open from Vancouver to California. Trained sniffer dogs can find fentanyl but risk overdoses themselves.
Fentanyl has entered the illegal drug trade at all levels, with trafficking rings, individuals and families involved in importing, transporting, mixing, packaging, distribution and selling fentanyl and laundering the proceeds from its sale. Drug wars are attracting the lowest levels of criminals. The vast intricate network of this underground economy results in unimaginable pyramids of tax-free money derived from preying upon the vulnerable. Gangs are selling at the street level of this chain, where extortion, violence and murder among competitors is commonplace.
Teamed with heroin, fentanyl is damaging and destroying lives everywhere, leaving a gallery of victims often avoided and neglected by their communities. They shrink from mainstream society, bearing stigma and shame atop layers of mental and physical disorders.
Despite sparks of hope – the growing acceptance of the fact that addiction is a disease; new medical management combating overprescribing of opioid painkillers; tremendous support for rehabilitation by police and other agencies of interdiction; intense and in-depth media coverage – victory is elusive in what has now officially become a declared war.
There seems to be no immunity from political wobbling in Washington. U.S. Rep. Tom Marino of Pennsylvania withdrew from consideration as drug czar after reports showed he made it harder for the DEA to act against giant drug companies. The person currently setting the White House opioid agenda is presidential aide Kellyanne Conway, whose bizarre advice to young people is “Eat the ice cream, have the french fry, don’t buy the street drug.”
China now has a pat hand. We need to address this peril unconditionally. Federal money is critically needed for education, health care and interdiction. Education needs the most. The decimal of expenditures needs to move to the right and fast. The peril is too great to wait.
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