Unpacking the ‘war on fentanyl’

This week's cover story hinges on a startling statistic. Overdoses have become a leading cause of death for Americans ages 18-45.

The primary culprit is fentanyl, an opioid used in medicine that is also being replicated by illicit drug labs for recreational use. Precise accounting of fentanyl deaths is difficult to ascertain. But 106,699 people died of drug overdose in the United States in 2021, according to federal data. Roughly two-thirds of those deaths were attributed to "synthetic opioids other than methadone (primarily fentanyl)." 

As Monitor justice reporter Henry Gass reports in our story, the current surge in deaths represents a fourth wave of an opioid crisis that has gripped the nation for the better part of the 21st century. Tragically, many of those who died didn’t know they were taking such a dangerous drug. The compound is now added to other drugs to amplify effect, often surreptitiously. But given fentanyl's potency – 50 times that of heroin – even a slight miscalculation can be fatal.

The problem is national, but efforts to address it vary from state to state, and from community to community. Last year, we explored one approach. Story Hinckley brought readers to Oregon, which has chosen to decriminalize possession of personal amounts of hard drugs in an effort to reduce stigma and get more help to people who struggle with dependence. The strategy has had mixed results. 

Henry's story takes readers to another state with a very different approach.

In the past year, lawmakers in Texas have increased criminal penalties related to the drug. The governor's "war on fentanyl" may sound familiar to readers who remember the crack cocaine epidemic of the 1980s and '90s. But "lessons have been learned from past decades," Henry says. "There’s more awareness that addiction is as much a mental health issue as it is a criminal issue."

Lisa Wheeler, a mother who spoke with Henry but isn't in the final story, shared that her son had started off as a typical kid. He loved animals and was forever bringing home critters to care for. But in middle school, he became increasingly anti-social and started using drugs. It wasn't until later that she learned that a man in their neighborhood had been sexually abusing him and other boys. Part of her son's coping mechanism was turning to drugs.

The letter of the law in Texas takes a tough-on-crime stance that could land anyone caught using fentanyl in jail. But Henry found evidence that at least some prosecutors are making an effort to focus arrests on individuals distributing these fatal drugs, rather than targeting users. 

The message Henry says he heard was, "'We know what prosecutors did in the crack era, and we have the ability and the discretion to do better. We know we can’t prosecute our way out of this. We have to be smarter than that.'"

Whether that bears out in practice remains to be seen.