In 2021, more Americans were killed by fentanyl–laced pills and other addictive drugs than in all the wars the United States has fought since the end of World War II. In 2021, there were 108,000 fake–drug deaths, more than twice as many as automobile, gunshot, or suicide deaths. Ultra–lethal, easily formulated fentanyl accounted for 80% of the deaths. The remainder of these tragic demises came from abuse or misdirection of pharma/non–pharma products e.g., opioids, methamphetamines (meth), and cocaine. The year 2022 will assuredly surpass this grim harvest of death. There are no local, state, or national government strategies to abate the carnage. For the most part this federal governmental failure is ‘off message’ and ignored by the media.
Most poison pills are non–pharma produced but intentionally fabricated to look like the real thing. Most of these highly addicting faux medications are admixed with deadly fentanyl. Recently and terrifyingly, fentanyl pills are colored to appeal to younger users (Headline image). Children have been killed believing the fentanyl tablets were candy.
Other common addictives also include pharma/illegal drug lab–produced heroin, meth, cocaine, methadone, and others. These drugs are sold illicitly, but blatantly, on the streets and in ‘trap houses.’ Addicting drugs are readily available on the internet and dark web. Sometimes, the deadly product is conveniently delivered to the user’s residence. Much of so called ‘gun violence’ and most of homelessness is related to drug trafficking.
Three tsunamis of overdose deaths have swept across America. In the late 90s, the first opioid death wave was iatrogenic, perpetrated by segments of pharma and shilling by their highly remunerated ‘pain experts; foremost among many, Russell Portenoy, MD.5 A decade later, as deceived physicians belatedly stopped blithely prescribing opioids, their addicted patients frequently turned to illegal, but widely available, heroin. This was the second death wave.
Heroin production, transportation, and distribution of plant–based, mostly Afghan poppy resin, is lengthy, burdensome, and expensive. Circa 2013, in search of a heroin substitute easy to produce, highly addictive, and profitable, the Mexican crime cartels happened on synthetic fentanyl. We are presently awash in the third and deadliest wave. It is a new paradigm in killing.
With the best of intentions, Paul Janssen, MD, PhD, founder of Jansen Pharmaceutica, created fentanyl in 1959. He was lauded and honored for use of fentanyl as a level IV surgical analgesic 50–100 times more potent than morphine. Fentanyl’s highly addictive properties gradually made it a favorite of illegal drug dealers to foist on the burgeoning number of addicts. Cartel fentanyl is often sold as heroin. The first celebrity death of note was Prince in 2016. Scores of celebrities and hundreds of thousands of other unfortunate user deaths followed.
Street fentanyl, made from chemicals manufactured by some 160,000 companies in China, is formulated by innumerable small and large makeshift laboratories in cartel–controlled areas of Mexico. In a Wall Street Journal article on Mexican cartels that rule fentanyl smuggling. a 25–year–old fentanyl ‘cook’ started in his home lab, he has made up to one million pills and earned up to $2,500 USD per week! This fentanyl is so abundant and inexpensive it is used as a diluent and high enhancer for many addicting drugs. This is known as ‘cutting’ and increases the profit along the chain of distribution. Believing it is heroin or a pharma–produced product, users get an unknown and often fatal amount of fentanyl.
After nicotine and alcohol, marijuana is the most prevalent addicting substance. With more states like Missouri permitting gateway drugs like sham medical marijuana and high THC recreational marijuana, the fear and stigma of using addicting products is rapidly waning. Deleterious changes in funding law enforcement and wanton failure to criminally prosecute felons greatly compound the already out of control situation. Without effective abatement, a million total fentanyl deaths loom on an ominous horizon.
This issue of Missouri Medicine presents superb articles by knowledgeable authors on the two most common addictives in the United States: fentanyl and methamphetamines. In an all–too–common story, Ed and Mary Ternan recount the tragic poison pill death of their son, Charlie. Additionally, they discuss the organization they founded and direct (www.songforcharlie.org) to reduce poison pill deaths of others, especially the gullible, uninformed young.
Know that in a single month enough fentanyl is smuggled into the U.S. to kill every person in our country. Recall the Tylenol poisoning deaths. A terror organization or hostile nation–state could undoubtedly devastate the United States with organized, innovative, surreptitious fentanyl poisoning. An unprecedented, coordinated national effort needs to be quickly implemented to avert apocalypse.
John C. Hagan, III, MD, FACS, FAAO, is a Kansas City, Missouri, ophthalmologist and Missouri Medicine Editor since 2000.
