Among the ten most frequently mentioned drugs in reports on overdose fatalities, the synthetic opioid fentanyl leads the way. This is according to a recent report published by the Centers for Disease Control. From 2011 through 2016, the number of fentanyl-related deaths rose by a whopping 1,000 percent. Prior to 2016, most opioid overdose deaths were due to oxycodone and heroin.

Fentanyl overdoses accounted for approximately 1,600 deaths in 2011 and 2012. However, the following year, that figure went up to 1,900. After that, the fatality rate went up by 100 percent a year. In 2016, fentanyl killed a total of 18,335 Americans, accounting for nearly 30 percent of all fatal drug overdoses.

Most of the victims were white males between 15 and 34 years old, although significant increases were observed among African-Americans and Hispanics, who experienced the fastest rate of increase. Most of these deaths occurred in the eastern regions of the U.S. The figures now show that drug overdoses kill more people in the U.S. than traffic accidents.

Fentanyl is a synthetic opioid, first developed by Janssen Pharmaceutica sixty years ago. The drug is 50 times more powerful than heroin. Amere 2 milligrams (equivalent to about three granules of table sugar) is sufficient to kill an adult human in under 60 seconds. Clinically, fentanyl is used in combination with other medications for anesthesia, sedation, and pain relief. Fentanyl gas was reportedly used by Russian security forces during a hostage situation in 2002 and was part of the “drug cocktail” employed for the execution of a prisoner at Nebraska State Penitentiary in August 2018.

Its use as a recreational drug dates to the 1970s. Today, it is often mixed into other illegal street drugs, such as heroin, often to compensate for poor quality or to increase profitability. Today, fentanyl represents the “third wave” of America’s opioid crisis, which began with oxycodone in the 1990s, and superseded by heroin when the former became unaffordable by street users.

In fact, the impetus behind the current fentanyl crisis appears to be largely economic. Fentanyl is easier and cheaper to manufacture and obtain than most opioids derived from poppy. The synthetic ingredients are not at risk of being spoiled due to weather or a bad harvest year and are easily available from China. Furthermore, one kilogram of fentanyl can be mixed with a number of other narcotics or other “filler” ingredients, translating into as much as an eightfold increase in the amount of product that can be sold on the street.

This is a particularly dangerous aspect of fentanyl. It can be added to other drugs such as cocaine or methamphetamine, meaning that a drug user may not even be aware of taking it. Another problem is that drug dealers are developing even more potent and addicting forms of fentanyl, which is already the most powerful opioid in existence.

The CDC report is the first to examine fatalities caused by fentanyl. Other analyses have looked at all opioid drugs. Opioids as a class remain the leading cause of drug overdose-related deaths in the U.S.

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K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues. In addition to writing for The Ring of Fire, he is the author of two published novels: Tamanous Cooley, a darkly comic environmental twist on Dante's Inferno, and The Missionary's Wife, a story of the conflict between human nature and fundamentalist religious dogma. When not engaged in journalistic or literary pursuits, K.J. works as an entertainer and film composer.