One Pill Can Kill

Rolls of money, Us dollars and prescription drugs on dark surface.

By Bexar County Sheriff, Javier Salazar

Fentanyl is either the best kept secret of the drug world, or the worst kept secret. It’s the worst kept secret because anybody that wants to get their hands on it absolutely knows how to get it, to include our young people. It’s the best kept secret because many people, including parents and even law-enforcement officials, don’t truly understand it. In my opinion, as a law enforcement professional, most of us don’t understand the issue of fentanyl enough to be as afraid of it as we should be.

Thanks to information sourced from the Drug Enforcement Administration, known as the DEA, I will tell you what I know about fentanyl; to include what it is, who makes it, how it is made, how it gets here, who it’s killing, and how.

The information provided by the DEA came in the form of a presentation called, “One Pill Can Kill,” and is presented publicly by the Bexar County Sheriff‘s Office.

For starters, not all fentanyl is bad. There are two different types. Although both are considered synthetic opioids, that is where the similarities end.

Pharmaceutical/medical grade fentanyl is made in actual medical grade drug labs and is legitimately found in mainstream medications used to treat severe pain, such as that encountered after a major surgery.   Of most concern to the American public, and the topic of this article, is illicitly made fentanyl.

Illicit fentanyl is made in makeshift clandestine drug labs, some of which are huge in scale and which drug trafficking organizations, aka cartels, spend quite a bit of money to construct and maintain. It is not made to the exacting standards of the medical grade variety.  Measurements and quality control are only to maximize profits, certainly not for the safety of the consumer.

For the most part, fentanyl destined for the United States starts life in the form of precursor chemicals manufactured in China.

These precursor chemicals are sent to Mexico, where illicit drug labs crank out finished product for export to the U.S. It is then smuggled into the U.S. literally by the ton. By some figures, in excess of 90% of the fentanyl being brought into the United States is brought across the border in 18 wheelers driven by United States citizens.

There are several reasons the cartels have turned to fentanyl in favor of other drugs. For starters, by some estimates, it is 50 times more addictive than most mainstream drugs such as cocaine and heroin.

Unlike other drugs which rely on crops to grow, there is no growing cycle needed to manufacture fentanyl. Drug cartels are making it and distributing it as quickly as they can get their hands on the precursor chemicals from China.

Although, via media coverage, much attention has been given to “rainbow fentanyl” being made to look like candy and being marketed to kids, the truth is, that is not the way law-enforcement is most commonly encountering it.

The most common and arguably the most dangerous method, is in the form of counterfeit pills which look like legitimate prescription pills commonly used in the United States. If nothing else, cartels know their audience and what appeals to their target demographics.

They absolutely know without a doubt that there is a market in the United States for prescription medications. Being that the cartels are in this business to make money above anything else, it is cheaper and easier to make a fake pill which looks realistic than it is to actually get their hands on real medications. Not to mention, it’s much more addictive to the consumer. In most cases, the consumer has no idea the pill they are taking is counterfeit, leading to countless deaths in the United States.

 

Why would the cartels knowingly kill their customers? 

The cartels are providing a drug they know there is a certain clientele for.  They are making it stronger and stronger to remain competitive and to further drive addiction.  In their estimation, for every customer who dies, there are hundreds more to take their place. While they may not be deliberately trying to kill users, they are most certainly aware that it’s a distinct possibility, and just don’t care.

 

Why would people knowingly take a drug that can kill so easily?

If we think about it, most drugs have the potential to kill, to varying degrees.  However, many victims of fentanyl poisoning deaths do not know they are taking fentanyl.  Most believe they are ingesting a prescription type medication.  Although that doesn’t make it legal or ok, many are unsuspecting victims.  This is why many law enforcement agencies, the Bexar County Sheriff’s Office included, have taken to investigating these poisoning deaths-NOT “overdoses”-as potential murders.  The word “overdose” implies that the consumer/victim took too much of a drug they were intending to take.  “Poisoning” is the more correct term when someone is duped into taking something they have no clue will kill them.  There is a very real possibility that those who supply fentanyl laced counterfeit pills which lead to death will routinely face homicide charges.  (At least, that is the hope and intention of this author.)

 

How does it kill?

Fentanyl affects the brain’s ability to take in and process oxygen. As a result, death often comes in the form of hypoxia, or shortage of oxygen. In a sense, the victim suffocates.  Many survivors, or “angel parents” report that the victim died silently in their sleep after ingestion.  Drugs like Narcan can reverse the effects of the drug rather effectively, but the victim has to be found in time.  There are a variety of factors that can prevent the drug’s effectiveness, such as time since dose, amount of dosage, tolerance of the victim, etc.

 

How much fentanyl does it take to kill you?

The universally accepted lethal dosage is estimated to be around 2 mg. For some context, if you look at the year on a regular penny, 2 mg is smaller than the digits on that year.

More frequency and more strength: Counterfeit pills seized and tested by the DEA, have found that not only are fentanyl laced pills becoming more common, but also more potent. It used to be that 4 out of every 10 pills tested by the DEA tested positive for fentanyl. Now, that number has moved up to 6 in 10 pills. Additionally, the average concentration of fentanyl in each of those pills used to be around 1.8 mg, just under the universally recognized lethal dose. Now that average dose has gone up to 2.4 mg, just above the lethal dose.

 

Enough to kill every single American:

In 2021 alone, the DEA seized enough fentanyl to kill every living person in the United States. That’s just one law enforcement agency in one year. This does not include what was seized by state and local agencies for the same time period.

Faces of Fentanyl:  Normally, law enforcement agencies reserve things like memorial walls to commemorate fallen members of their particular agency.  However, the fentanyl crisis has reached such proportions that the DEA has erected a wall called, “Faces of Fentanyl,” which commemorates the lives lost to this horrible drug.  The memorial is located at DEA Headquarters in Virginia.

Among the thousands of victims on the wall are babies as young as 17 months, and seniors of 70 years of age.  This killer kills, regardless of age, location, or socioeconomic status.

We must act NOW to stop this drug from taking any more lives.  It is incumbent on us to educate everyone, young and old, on the dangers of accepting and taking pills from someone who is not a doctor, parent, or guardian.

For more information, check out www.DEA.Gov/OnePill, and/or email the Bexar County Sheriff’s Office to come make a presentation to your group regarding the dangers of fentanyl.  The presentation, which consists of a poignant PowerPoint and Q&A with actual “angel families” is called, “One Pill Can Kill.”  The email to schedule a presentation is OnePill@Bexar.org.

 

Sheriff Javier Salazar is a career law enforcement officer, husband, father, and son.