NPR News: Deaths Linked To Fentanyl Rise As Curbing Illicit Supply Proves Tough

Deaths Linked To Fentanyl Rise As Curbing Illicit Supply Proves Tough

In mid-August, an affable, 40-year-old man from Everett, Mass., overdosed at his mom's home after almost 25 years of heroin use. Joe Salemi had overdosed before, but this time couldn't be revived. Salemi's brother, Anthony, says he was pretty sure when his brother died that there must have been something besides heroin in the syringe. The medical examiner later confirmed it.

"I knew, deep in my mind, it was going to be the stuff that everyone's talking about now — fentanyl," Anthony says. "Because I never thought straight heroin would kill him."

Anthony Salemi was familiar with fentanyl. He'd been prescribed the powerful painkiller after surgery in 2006. Anthony had warned his younger brother about reports that dealers were adding an illicit version of the drug to heroin, sometimes promising a more intense high. Fentanyl is more than 50 times more potent than heroin, according the Centers for Disease Control and Prevention.

But people like Joe rarely know for sure if there is fentanyl in the tiny plastic bags of illegal powder they buy — or how much. Just a few grains of pure fentanyl, doctors say, is enough to kill most users. In Massachusetts, 75 percent of the people who overdosed this year tested positive for the drug.

"It just seems like the dealers and the drugs are ravaging the whole country, says Anthony Salemi. "The supply just keeps coming in, no matter how many cops you put at the border, it just keeps coming in. This is scary."

The Obama administration agrees that the increasing supply of fentanyl on the street is a major challenge and says agencies are doing a lot. But reducing the supply is complicated.

Fentanyl is a synthetic opioid, constructed with lab chemicals — unlike heroin or morphine, which start with the opium sap of a poppy plant. Drug enforcement agents say clandestine labs across China are the main source of the illegally sold fentanyl.

Producers then ship the drug to Mexico, where drug cartels mix it into heroin or press it into blue, pink or white tablets that look like prescription pills for anxiety or pain. The powder or pills are delivered to dealers, or directly to users, via the internet or darknet, an online area used for illegal purchases.

"Synthetic drugs are a real winner because they are easy to make, and they're cheap to produce," says Kara McDonald, director of policy, planning and coordination at the international narcotics and law enforcement bureau of the U.S. Department of State.