How Fentanyl Changes the Opioid Equation

More than a decade into the opioid epidemic, illicit fentanyl and related synthetic drugs are now driving the nation’s spiraling overdose death toll. Involved in nearly half of the roughly 200 U.S. drug overdose deaths every day, fentanyl appears to be here to stay.

“Even if we do a really good job at the border and start making a serious dent in shipments from China and Mexico, we need to anticipate that people will simply start cooking it here. It’s already happening,” U.S. Customs and Border Protection operations manager Stephen McConachie said in an interview.

As governors in the hardest-hit New England, Mid-Atlantic and Midwestern states call for intensified law enforcement efforts and stiffer penalties for fentanyl dealers, public health officials are saying this latest drug scourge underscores the urgent need to get more people into treatment, particularly those who use heroin.

With lethal amounts of fentanyl showing up in heroin and other drug supplies throughout the country, active drug users are at a greater risk of dying than ever before, said Jay Butler, director of public health at the Alaska health department and past president of the Association of State and Territorial Health Officials.

Even as the number of new heroin users declined last year, according to a recent survey by the federal Substance Abuse and Mental Health Services Administration, the number of current drug users exposed to fentanyl appears to be growing, Butler said.

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