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Fentanyl, one of our Nation’s deadliest opioids
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By Ernest Gurulé

There is a shadow crossing the land, and it has come to Colorado. It has taken hold in the state’s population centers and found its way to some of the out of the way and often forgotten towns. But even there, it has inflicted the same pain and suffering as is found anywhere. As drugs go, it is as deadly as any drug law enforcement has come across in generations.

Fentanyl, a synthetic opioid, has gained a foothold in Colorado. “Over the last several years, the amount has increased,” said the Colorado Bureau of Investigation’s Shawn West. First spotted in Colorado in 2015 “it has increased every year,” West said from his Pueblo office.

Fentanyl is said to be 50 to 100 times more lethal than heroin. While it still has a way to go to equal the devastation in Colorado that it has caused in places like West Virginia and New Hampshire, the Colorado Department of Health has nonetheless recorded fatal fentanyl overdoses in 52 of the state’s 64 counties.

Fentanyl was first produced in 1959. It was used for pain relief for patients recovering from surgery or for those battling severe forms of cancer, often in hospice care. But its price and potency have just added to its popularity among people whose drug use has pushed the envelope. It’s easy to produce; it’s relatively cheap; it does the job users expect. It has replaced heroin as the leading cause of overdose deaths.

Simple math explains a lot about these two drugs. According to the Drug Enforcement Administration, a kilogram (2.2 pounds) of heroin---about $6,000-$7,000 wholesale---can be converted into approximately $80,000 in street sales. The same amount of fentanyl can be bought for $4,000-$5,000. But its potency allows it to be cut and repackaged into as much as 24 kilos with a street value of up to $2 million.

Its potency has dwarfed PCP, one of the drugs officers were warned to be extra cautious with in years past. Law enforcement agencies in Colorado and across the country are training officers to exercise utmost care in cases involving fentanyl. They are told to double up on latex gloves or to wear leather or kevlar over latex gloves and to wash them after a search. It is also suggested they wear eye protection and air filtering masks when fentanyl is suspected. Underscore the drug’s dangers, they are told to never field test for fentanyl. As little as two milligrams of fentanyl---equal to two grains of salt---can be fatal on the skin or if inhaled.

While Colorado has had its challenges with fentanyl, they pale in comparison to places where it has seized subsets of drug users. In August 2016, in Huntington, West Virginia, the U.S. Department of Health and Human Services recorded 26 overdoses. It identified the drug as heroin laced with fentanyl and carfentanyl, an analogue or designer drug.

New Hampshire, a relatively prosperous state economically, leads the nation in per capita overdose deaths. And in a recent poll, New Hampshire residents---for the first time---identified drugs as the state’s most pressing problem. Jobs and the economy trailed well behind.

In West Virginia, New Hampshire and other states, including Colorado, paramedics now include Narcan, the trade name of the opiate antidote naloxone, as part of their equipment. It is used as a partial reversal of an overdose. Some police departments also carry a supply with them.

“Prior to 2015, it’s been patches,” said West of fentanyl. Fentanyl patches, attached like a band-aid, were used for pain stabilization. “We now see it in solid dose form,” said West.

The largest quantities of the fentanyl coming into the country are manufactured in China and often street-labeled as “China Girl,” and “China White.” It is produced by outlaw companies known to U.S. authorities but out of reach of American law enforcement. “This is a real crisis,” said Deputy Attorney General Rod Rosenstein in a recent interview. “The Chinese government has the ability to stop this if they want to.”

The path fentanyl takes to reach the U.S. begins in both known and clandestine Chinese laboratories. Americans or others buy it or precursor ingredients through the dark web, the segment of the internet that is accessible only with special software. This method also allows users to remain invisible or anonymous.

The product or ingredients are packaged and shipped---often through the mails---to the U.S., Canada and Mexico. It is then processed and ultimately delivered to buyers in larger America cities where its domestic distribution chain begins.

At the recent G20 meeting in Argentina, Chinese President Xi Jinping vowed to crack down on his country’s rogue fentanyl operations and list it as a controlled substance meaning that those caught will be subject to maximum penalties, including death. With fentanyl and opioid deaths nearly doubling in the U.S.---from 9,580 in 2015 to 19, 413 in 2016 according to the CDC---U.S. officials can only hope the Chinese President keeps his word.

To date, China has stopped well short of classifying all fentanyl-related drugs differently and, as a result, any visible weakening in the delivery system has been negligible.





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