A little blue pill called “Mexican oxy” illustrates the unprecedented threat that the synthetic opioid fentanyl poses to public health in America.
Drug traffickers have started blending fentanyl into homemade blue tablets that look just like oxycodone, the prescription narcotic widely known for its overprescription and abuse. The name Mexican oxy also has been used to describe knockoff oxycodone made with heroin, but the newer fentanyl version is proving much more dangerous because fentanyl is so potent. Unlike oxycodone, which is produced in controlled pharmaceutical labs and then diverted to drug users, the amount of fentanyl in Mexican oxy varies from pill to pill, depending on how the batch was mixed and made. Some of the pills are shipped from across the border, and others are pressed here in the United States using raw materials trafficked from Mexico.
President Donald Trump pointed to the fentanyl crisis as a justification for increasing border security in both his Feb. 5 State of the Union address and a speech Friday announcing a national emergency at the U.S. southern border. A few weeks ago, Customs and Border Protection agents in Nogales, Ariz., made the largest seizure of fentanyl ever in the United States. They found 254 pounds of the product in white powder form hidden in a secret floor compartment in the back of a tractor-trailer loaded with produce that was attempting to cross into the United States through a legal port of entry. Two pounds of the fentanyl was in pill form.
“The size of a few grains of salt of fentanyl, which is a dangerous opioid, can kill a person very quickly,” Nogales Customs and Border Protection Director Michael Humphries said. The Centers for Disease Control and Prevention says fentanyl causes more fatal overdoses than any other drug in the United States, with fatalities from synthetic opioids including fentanyl jumping more than 45 percent from 2016 to 2017.
Aaron Chavez, 19, died of a fentanyl overdose at a Halloween party in Tuscon, Ariz., last year after getting two pills of Mexican oxy from a woman who was paid $200 to sneak 1,000 pills through the crossing at Nogales, according to police. Chavez was one of four people who overdosed on fentanyl at that party, thinking they were taking oxycodone. The other three survived, thanks to the work of police whom partygoers flagged down, but Chavez could not be saved.
Popping the pills at parties “is a lot more widespread than we know,” said Lt. Nate Auvenshine of the Yavapai County, Ariz., Sheriff’s Office. “There’s less stigma to taking a pill than putting a needle in your arm, but one of these pills can have enough fentanyl for three people.”
Compared to other drug scourges in U.S. history, like cocaine and heroin, fentanyl is cheaper to make, easier to transport, and much more profitable to sell. The opioid is made entirely from chemical precursors, most of which come from China, so there’s no farming involved like with heroin, cocaine, or marijuana.
And profits from fentanyl are sky-high. The Minnesota Department of Health, in a January update on the opioid epidemic, put it this way, “A kilogram of heroin is purchased for approximately $6,000 and sold for appropriately $80,000. A kilogram of fentanyl is purchased for approximately $6,000 and sold for approximately $1.6 million.”
One pill of Mexican oxy can cost users $9 to $30, according to law enforcement. The 1,000 pills the woman in Arizona brought across the border for $200 had a street value of anywhere between $9,000 and $30,000.
Most fentanyl comes into the United States in privately owned vehicles through legal border crossings, according to the U.S. Drug Enforcement Agency. Authorities in Arizona seized 445 pounds of fentanyl in 2018, after capturing only 172 pounds the previous fiscal year. Trump’s signature wall would likely have little impact on fentanyl trafficking, though increasing drug enforcement at U.S. ports of entry could help.
As drug enforcement authorities struggle to get a handle on the fentanyl crisis, health care providers, families, communities, and churches grapple with how to help the increasing number of opioid addicts. Last year, the U.S. Department of Health and Human Services put out a resource manual for faith and community leaders responding to the opioid epidemic. It includes practical suggestions such as hosting recovery groups, providing childcare and rides to work for recovering addicts, and educating teens about the dangers of opioids and how to avoid them. HHS also notes that federal funding is available for faith-based efforts to fight substance abuse. In a speech to the National Governors Association last year, HHS Secretary Alex Azar underscored the importance of faith-based intervention in epidemic: “Americans of faith have taken a leading role in the compassionate approach we need to take on this [opioid] crisis, and we’re eager to support their work, however we can.”