Lillianna Alfaro was a recent high school graduate raising a toddler and considering joining the Army when she and a friend bought what they thought was the anti-anxiety drug Xanax in December 2020.
The pills were fake and contained fentanyl, an opioid that can be 50 times as powerful as the same amount of heroin. It killed them both.
“Two years ago, I knew nothing about this,” said Holly Groelle, the mother of 19-year-old Alfaro, who lived in Appleton, Wisconsin. “I felt bad because it was something I could not have warned her about, because I didn’t know.”
The drug that killed her daughter was rare a decade ago, but fentanyl and other lab-produced synthetic opioids now are driving an overdose crisis deadlier than any the U.S. has ever seen. Last year, overdoses from all drugs claimed more than 100,000 lives for the first time, and the deaths this year have remained at nearly the same level — more than gun and auto deaths combined.
The federal government counted more accidental overdose deaths in 2021 alone than it did in the 20-year period from 1979 through 1998. Overdoses in recent years have been more frequent than they were during the black tar heroin epidemic that led President Richard Nixon to launch his War on Drugs, or during the cocaine crisis in the 1980s.
As fentanyl gains attention, mistaken beliefs persist about the drug, how it is trafficked and why so many people are dying. Experts believe deaths surged not only because the drugs are so powerful, but because fentanyl is laced into so many other illicit drugs, and not because of changes in how many people are using. In the late 2010s, deaths were skyrocketing even as the number of people using opioids was dropping.
Advocates warn that some of the alarms being sounded by politicians and officials are wrong and potentially dangerous. Among those ideas: that tightening control of the U.S.-Mexico border would stop the flow of the drugs, though experts say the key to reining in the crisis is reducing drug demand; that fentanyl might turn up in kids’ trick-or-treat baskets this Halloween; and that merely touching the drug briefly can be fatal — something that researchers found untrue and that advocates worry can make first responders hesitate about giving lifesaving treatment.
All three ideas were brought up this month in an online video billed as a pre-Halloween public service announcement from a dozen Republican U.S. senators. A report this year from a bipartisan federal commission found that fentanyl and similar drugs are being made mostly in labs in Mexico from chemicals shipped primarily from China.
In New England, fentanyl has largely replaced the supply of heroin. Across the country, it’s being laced into drugs such as cocaine and methamphetamine, sometimes with deadly results. And in cases like Alfaro’s, it’s being mixed in Mexico or the U.S. with other substances and pressed into pills meant to look like other drugs.