All must enlist in the war on fentanyl

This is shocking: Poisoning by illicit fentanyl is now the leading cause of death for adults aged 18 to 45 in the U.S., says the federal government, surpassing suicide, gun violence and car accidents.

The tragic stories are becoming commonplace.

Three young professionals in New York City ordered cocaine from the same delivery service and died alone after the coke turned out to be fentanyl.

Three adults died in a home on the Venice, Calif., canals after snorting what they thought was cocaine.

A 17-year-old Eagle Scout in northern California bought what he thought was a Percocet tablet and died slumped over the desk in his bedroom.

Five West Point cadets on spring break in Florida were poisoned by fentanyl-laced cocaine.

A 15-year-old girl was found dead in the bathroom of her Los Angeles high school after swallowing what she thought was a prescription pain pill.

You can't really call most of these deaths and near-deaths overdoses, though they are usually described that way. "Overdose" to me implies the victims were aware of what they were ingesting and overdid it. (These are not people addicted to fentanyl; they haven't developed a tolerance for opioids, although anyone who gets clean and relapses could be in danger of accidentally overdosing.) Instead, these are unwitting self-poisonings. The victims didn't sign up for fentanyl.

In 2021, the Centers for Disease Control and Prevention reports, 107,375 people in the U.S. died of drug overdose or drug poisoning. Some 67%, or 71,000, of the deaths were caused by fentanyl or other synthetic opioids.

More than three-quarters of teenagers whose deaths were classified as overdoses died by fentanyl poisoning. Many teens find the drugs through social media sites like Snapchat, TikTok and Instagram.

When prescribed legitimately, fentanyl is a potent and effective painkiller often used to treat cancer patients. My obstetrician gave it to me 30 years ago to ease the pain of labor.

But today "fentanyl is killing everyone and anyone," Julie Shamash of Los Angeles told reporters. Four years ago, her 19-year-old son died after ingesting fentanyl. "To the parents out there that think, 'Not my child,' think again. This is killing straight-A students, track stars. All races. All religions. All socioeconomic groups."

It really does look that way.

The Drug Enforcement Administration has said 6 out of 10 of the fentanyl-laced fake prescription pills it analyzed in 2022 contained a potentially lethal dose of the drug.

In powder form, fentanyl can look just like cocaine. In pill form, it's visually impossible to distinguish fake from real. In fact, as I looked at photos online, I was shocked that fake pills may actually look more legitimate than the real ones — with cleaner, sharper markings, for example.

Although much of the material used to manufacture fake pills comes into the U.S. from Mexico, it's important to note that it is not being brought in by the millions of migrants who come on foot to our southern border seeking asylum or work, contrary to what MAGA Republicans would have you believe.

"It comes in passenger cars, cargo vehicles," said Bill Bodner, special agent in charge of the DEA's Los Angeles field division. "It comes through tunnels, by ultralight aircraft. Boats come up the coast as far as Monterey."

Listen, as a baby boomer who came of age when cannabis was wrongfully demonized and Richard Nixon's misguided and racist War on Drugs was unleashed on the world, my instinct has always been to treat drug enforcement officials as relics from a "Reefer Madness" past.

But you know what? I'm raising my 12-year-old niece, who is in middle school, and I am terrified. As wrongheaded as Nixon was, and as ineffective as Nancy Reagan's "Just Say No" campaign was, the battle against illicit fentanyl, and its slogan "One Pill Can Kill," are legit.

"I get it," admitted Bodner. "People will say the DEA is an alarmist organization, it's fearmongering. But all I can tell you is what I have seen. We buy thousands of pills off the street and social media. We test them. There are no pills on the street right now that are real pharmaceutical pills. Assume it's fentanyl."

In September, describing an "urgent crisis," L.A. schools Superintendent Alberto Carvalho announced that all 1,400 of the district's schools would be provided with the overdose-reversal drug naloxone, sold under the trade name Narcan, a nasal spray that works instantly.

"I carry it," said Bodner. "All our agents carry it."

Because of fentanyl, the era of "harmless" drug experimentation with pills or powders is over. The street drug supply is poisoned. We have to make sure our social media-savvy children understand — really and truly — that one pill can kill.