“Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain or to manage pain after surgery.”
So says the National Institute on Drug Abuse.
“I’m still dealing with it, working through it. My grief counselor says I’m supposed to talk about it.”
So says Don (not his real name), an Arkansas father whose son knew more about fentanyl than he did but not as much as he thought he did. He knew where to get it, and from whom. He knew, as the NIDA states, that the drug was known more familiarly among unauthorized users as “Jackpot,” or “China White,” or “Friend” or “Apache.” He knew that, at some point in the illicit distribution chain, wholesalers or retailers often spiced fentanyl with heroin, or cocaine, to give it a little extra zing. He knew these things because of his long battle with drug addiction, just as he had to have known that there are no guarantees on the street, that even the most “reliable” dealer often does not know with any certainty what is in those pills, or those packets of powder. Calculating that the rush is worth the risk — and the addict’s compulsion often does not permit calculation — the buyer does not always beware.
The son’s funeral was a few weeks ago.
“Who knows where he got it?” Don murmurs, not a question but a comment. Could have been from any of his son’s many “friends.” Perhaps even through the Internet, from an overseas distributor. One need only know which websites to visit; with a click and a credit card, fentanyl at your door (though the next person to ring the doorbell may be an agent of Drug Enforcement Administration). The purchaser presumes the seller, or the seller’s source, is a pharmaceutical facility that adheres to at least minimum standards of quality control.
Increasingly, that is a dangerous assumption.
Consider: The average NFL offensive lineman now weighs in excess of 300 pounds, as do 17 Razorbacks on this year’s roster. Three hundred pounds of fentanyl, either factory-produced or concocted in a clandestine lab, can produce one million doses. Thus can a “Breaking Bad” renegade chemist (certified, or amateur) with minimal experience and less regard for the customer’s heart rate than his own rate of return can, in fairly short order, produce enough of the substance to at least temporarily narcotize one-third of the population of Arkansas.
And, the experts note, it is far cheaper and easier to bring to the street than either heroin or cocaine: there’s no need of acres of opium poppies nor peasants to harvest the crop, ergo less fear of interdiction by police or the military (and, in some countries, the bribes needed to keep them away). Too, moving the product from point of manufacture to consumer is a breeze compared to trans-oceanic or cross-border transport, given the comparative difference in the drugs’ respective volume. (And before anyone can scream “Build that wall!” recognize that a fair amount of fentanyl arrives from China, which already has a wall; and not north from Mexico but south through Canada.)
To be certain, fentanyl has legitimate clinical value. In some patients suffering severe pain it can produce fewer adverse side effects than other palliatives. But it has to be carefully administered and monitored by trained clinicians, doctors or nurse practitioners, or by at- home caregivers instructed in dosage and application, coupled with warnings about its potential for abuse, and the need for securing it against theft or even curious children. The cops know not to handle powdered fentanyl without rubber gloves, nor risk inhaling it. It’s that powerful, that lethal.
Arkansas’s fight with fentanyl is of a piece with its under-staffed and under-funded campaign against all opioids, a struggle the substances are winning. In 2015 one in three bodies received at the State Crime Laboratory’s morgue tested positive for opioids, regardless of cause of death. Last year it was two of every four.
Don and his family had tried everything they knew to restore the lad to sanity. A guardianship petition was granted and the youth committed to a rehab center. Later, father as snitch: “I had him arrested!” Anything to break the cycle.
Don remembers his son as a person and not a statistic, but the young man will be recorded as an overdose in this year’s statistics, the tabulation far from complete.
“The funeral,” the father says, “was as much as we could do.”