Fentanyl continues to be a dangerous and deadly drug in America, but now it is being mixed in with other illegal substances and increasing the risk that the first foray into drug abuse could be the last for users.
Richard Rawson, retired director for UCLA’s integrated substance abuse programs, highlighted a conference Sept. 25 at the Menominee Casino Resort. He discussed how stimulants like methamphetamine and cocaine are being laced with fentanyl in what Rawson described as the fourth wave of deadly drugs.
The first wave came in 2000 with a marked increase in the abuse of prescription opioids. Then, when doctors started to cut back on using pills as the first resort in helping to ease suffering, heroin began to surge around 2010, according to Rawson. Fentanyl, a drug more commonly used by hospitals during surgical procedures, started to become prevalent around 2015 on its own, but now its ability to be hidden among meth and cocaine has made it even more lethal than before.
“The rate of overdose death has become so severe, in large part, because the drug supply has become more lethal,” Rawson said.
Meth laced with fentanyl has become a bigger problem in the northern half of Wisconsin, while cocaine with fentanyl is more common in southern Wisconsin, especially around the Milwaukee area.
The fentanyl/stimulant mixture is manufactured mostly in China and Mexico, although India is also a big supplier, according to Rawson. He said the supply is coming to the United States in the form of powders and pills and delivered through traditional services like the U.S. Post Office.
In 2020, the United States had 56,516 confirmed fentanyl deaths, about 34% of the overall overdose fatalities, but another 32% came from fentanyl mixed with meth or cocaine, making fentanyl the culprit for two out of every three overdose deaths, Rawson said.
“The main reason that we’re seeing these deaths increase … is because the methamphetamine that’s being used is different,” Rawson said. “When I used to go to Montana and talk with them there, the methamphetamine was produced there in Montana. That was much less potent and much less pure. What we’re seeing now are people who, even without fentanyl, are at more risk for overdose death from stimulants.”
In Wisconsin, there have been about 10,000 deaths due to stimulant overdoses between 2015 and 2023.
“They know about fentanyl because they’ve seen it at night on the news for the last five years,” Rawson said. “They don’t know the role that stimulants are playing. For the most part, the people who are addicted to cocaine and methamphetamine go out and buy their stimulant … but they get fentanyl, and whether intended or not intended, they die of a fentanyl overdose.”
Menominee officials have reported that the meth coming onto the reservation has been mostly in powder form, with almost all of it coming from large outside suppliers. Rawson said that it’s easier for drug manufacturers to mix fentanyl in with powder drugs than crystallized forms like crack cocaine.
“The methamphetamine supply here is particularly dangerous because of the powder form, in many cases,” Rawson said. “It’s mostly from people who inject it, although they can overdose in other ways. With it being brought in and produced by the cartels, it’s much more potent than what we used to see made in mom and pop labs in the ’90s. That purity used to be 20-30%. Now it’s closer to 100%.”
During the presentation, Rawson was asked whether fentanyl laced into marijuana is a concern. He said that there have been instances, but using fentanyl with marijuana is more of an outlier because it’s more popular to mix it in with meth and cocaine.
Methamphetamine can produce 10 times the normal amount of dopamine in a user, which is what makes it so addictive, Rawson said.
“This is why people go, ‘I want to do that again. I want more of that,’” he said.
Meth also increases suicide rates, according to Rawson, assuming the fentanyl in the meth doesn’t kill the user outright. The attempted suicide rate in one study was 8.1%, with higher numbers found in women and Indigenous people.
“If you have folks, particularly young women, who are involved with methamphetamine or inject methamphetamine, they have a substantial suicide rate,” Rawson said. “This is very real.”
lpulaski@newmedia-wi.com
Fentanyl, meth mixed together major threat
