The announcement this week that fentanyl played a part in last month’s overdose death of Adam Harrison, son of Pawn Stars personality Rick Harrison, reverberated through the national news feed and generated predictable responses.
It was another tragic loss for a family, this one well-known because of a television show. It was another reminder of fentanyl’s scourge as it spreads like wildfire across the nation taking thousands of lives each year. It was another opportunity to blame the crisis at the U.S.-Mexico border for America’s more complex problems.
Before the news moved on, I asked three law enforcement veterans for their views about fentanyl, the devastation it has wrought and the continuing threat it poses to users and nonusers alike. Some of their answers will sound familiar. Others might surprise you.
Keith Carter is the Nevada director of the Office of National Drug Control Policy’s High Intensity Drug Trafficking Areas (HIDTA) efforts. In that role, he helps coordinate and assist law enforcement agencies in their anti-narcotics efforts. Fentanyl, which has an important medical use for pain management, is different from other street drugs in many ways.
“It’s the small amount that can cause death,” Carter says, acknowledging the ongoing public education efforts being made about the drug. “It takes a tiny amount. What fits on the tip of a pencil lead can kill people — even a regular user who gets pure fentanyl. That small amount is not only dangerous, but it’s advantageous to our drug cartels because it is easier to transport. It is a smaller amount required to transport, and it’s a high-profit drug. It’s much easier to transport than any other illicit drug that we’ve ever seen, and I’ve been in the business a long time.”
Although Adam Harrison’s overdose death made headlines, Carter said it occurred around the same time three Las Vegas visitors from Texas also suffered fatal fentanyl overdoses — a case that attracted far less attention. When it comes to the drug, overdose death has become ordinary.
Carter recalls a recent overdose case in which the user ingested just half a pill. Although drug test strip distribution is increasing, determining fentanyl’s potency makes a safe dose essentially impossible to estimate.
“In that particular case, the person overdosed, was saved by medical (first responders), so it was a good story in the respect that the person didn’t die,” he says. “That was a younger user, but we’ve had fewer juveniles in the past year overdose on drugs than what we’ve had in the past. We really think that some of that messaging, it helps. We have to get it out there. We had casual users that were succumbing to overdose. … We saw those in the news for many years. But now you have people that are addicted to the drug that are overdosing because it’s difficult to know the amount of drug that you’re using.”
For Carter, the rise of fentanyl, or something like it, was inevitable following the prescription opioid crisis.
“We just haven’t seen anything like this, and it’s a wide variety of users,” he says. “It started out early with the crack down on pharmaceutical drugs, the crackdown on opioid prescriptions, made those a little harder to get. There’s a lot more checks and balances on those. That opened the door to the drug cartels, who are in the business of making and selling drugs.”
The view from Pahrump 60 miles outside Las Vegas in rural Nye County reflects the urban trends when it comes to fentanyl use, overdose and death. As a longtime veteran of the Las Vegas Metropolitan Police Department, Nye County Sheriff Joe McGill experienced the spread of heroin use in Clark County and the crack cocaine epidemic. Although devastating, he says they pale in comparison to the dangers of fentanyl.
He alludes to the crisis at the border, but also notes that fentanyl’s potency makes it different from traditional hard street drugs such as heroin. The chaos it’s causing continues to stress his small department and first responders, who, at times, must travel an hour or more to reach a reported overdose.
“It is a problem basically on a daily basis,” McGill says, noting that his deputies are regularly resupplied with the emergency overdose treatment drug Narcan. “Fentanyl is being mixed in with everything these days. All illicit drugs on the street, you’re finding some level of fentanyl in it. It’s increasing that high for everything. The volatility of fentanyl, the fact it takes so little to stop your heart, we’re seeing fentanyl deaths all the time.”
With emergency medical service in precariously short supply and overdoses increasing, McGill says his department is “trying to play catch up. The unfortunate thing about it is, it took root before we even knew it existed in law enforcement. So, we’re trying to educate people. We’re trying to communicate the risks of it. You’re never going to stop drug use. It’s coming into the country one way or another, and people are going to use what they have for their escape from reality. But when it’s something as volatile as fentanyl is, it’s creating a real problem for law enforcement and for medical also.”
In his 31-year career with the Drug Enforcement Administration, Mike Vigil rose from working undercover cases against drug trafficking networks and cartel kingpins to directing the agency’s international operations. He agrees that fentanyl creates problems on many levels for law enforcement and society.
Although the image of the immigrant transporting a load of fentanyl by backpack across the border plays in Republican political circles, Vigil reminds us that approximately 90 percent of the drug crosses into the country through legal ports of entry. You don’t get a national drug crisis of such magnitude with flooding the market with enormous quantities of product.
“It really has nothing to do with undocumented migrants coming into the United States,” Vigil says. “The Republicans want to characterize them as monsters who are bringing it across the border. That’s totally illogical because a few backpackers aren’t creating an epidemic. You need to move it en masse, and therefore primarily through the ports of entry, and by U.S. citizens.”
The Sinaloa and Jalisco New Generation cartels dominate fentanyl manufacturing and distribution, he says, and benefit from cheap precursor chemicals from China and several other countries.
Vigil also reminds those with short memories that it was several American pharmaceutical giants, spending millions on advertising to market their prescribed products, who created a new generation of opioid users from all walks of life.
If you’ve read this far, you know there are no easy answers to extinguishing fentanyl’s wildfire in this country. It continues to kill curious experimenters and experienced users alike despite unprecedented education, interdiction and medical intervention efforts.
But perhaps that’s to be expected in a country awash in Big Pharma marketing and has the distinction of being the largest consumer of illicit narcotics in the world.
John L. Smith is an author and longtime columnist. He was born in Henderson and his family’s Nevada roots go back to 1881. His stories have appeared in Time, Readers Digest, The Daily Beast, Reuters, Ruralite and Desert Companion, among others. He also offers weekly commentary on Nevada Public Radio station KNPR.
