Every morning, Lisa Manning walks past the bedroom where her 18-year-old son, Dustin, died of an accidental overdose of the opioid drug fentanyl. Although it's a constant reminder of the day last year when her husband, Greg, found Dustin slumped over on his bed, the Mannings can't bear to move out of the house.
"Part of me thinks he's still here, I guess," she says. "I'd feel like we were leaving him if we moved so soon."
Paramedics in Lawrenceville, Georgia, weren't able to save Dustin on May 26, 2017. Less than an hour later, they received another call from a half mile away. Joe Abraham, 19, a childhood friend of Dustin's, was unresponsive in his bedroom, dead from an unrelated fentanyl overdose.
Dustin and Joe weren't close friends anymore, but the two recent high school graduates both became statistics in an opioid crisis that's gripping the nation and shaking communities like Lawrenceville, a city of 30,000.
"Everyone knew Dustin," says Lisa Manning. "He was a baseball player. So when people saw these two kids dying from drugs, they knew it could just as easily be their sons."
There were about 64,000 fatal drug overdoses in the U.S. in 2016, the highest total ever recorded. Most involved opioids, a class of highly addictive drugs that includes prescription painkillers like Oxycontin and illicit drugs like heroin. About one-third of the deaths involved fentanyl, the latest and most deadly opioid involved in the crisis.
Mexican Drug Cartels
A synthetic painkiller, fentanyl is so powerful that ingesting an amount equal to a few grains of salt can be fatal. Fentanyl is cheap and made entirely in a lab, and Mexican drug cartels obtain it easily over the internet from China. They add it into heroin, cocaine, and methamphetamine (commonly known as "meth") that's smuggled into the United States to increase the drugs' potency. Dealers also use fentanyl to make fake prescription pills, like the counterfeit Vicodin that killed pop singer Prince in 2016 and the tainted Xanax that killed rapper Lil Peep in November.
In most cases, drug users have no idea that what they're taking has fentanyl in it. That's a primary reason why overdoses have eclipsed car accidents as the leading cause of death for Americans under 50. And the victims are getting younger. In 2015, nearly 800 teens died of overdoses, about a 20 percent increase from the previous year, according to the Centers for Disease Control and Prevention.
The current crisis has its roots in the late 1990s, when powerful new painkillers like Oxycontin went on the market. They were supposed to help patients, such as people with cancer, deal with intense pain. But doctors overprescribed them and some patients became addicted.
As Americans' use of prescription opioids skyrocketed (see chart, p. 9), a black market developed around the drugs for recreational use. The federal government began cracking down around 2010, but by then thousands of users were dependent on the drugs.
Many of those who were addicted to pills soon found a cheaper alternative in heroin. Now fentanyl--50 times more powerful than heroin and 100 times stronger than morphine--is being mixed into these drugs, greatly increasing the risk of fatal overdoses.
"It's the most dangerous drug I've ever investigated," says Major John Merrigan, an 18-year veteran of the Vermont State Police. "It's a drug of mass destruction."
A Health Emergency
The Northeast has been one of the hardest hit regions. Fentanyl killed more than 2,000 people in Pennsylvania in 2016 and a similar number in Massachusetts. New Hampshire and Vermont have also been devastated by the drug.
But the problem isn't limited to the East Coast. In Milwaukee, where overdose deaths are almost triple those of homicides, 11 people died of fentanyl overdoses in a four-day period in October, including a 16-year-old boy found inside a parked car.
And in the Dayton, Ohio, area, 365 people died of overdoses from January through May 2017, nearly matching the total for the entire previous year. Dayton officials compared the effects of the opioid crisis in the city to a "mass casualty event," such as a pandemic or terrorist attack.
The epidemic is forcing agencies not used to dealing with drug addiction to confront the problem. Schools and colleges are trying to help students get off drugs (see "New Subject on Campus: Opioids," below), and some child welfare services are at a breaking point, as kids are being orphaned or removed from their addicted parents' care at a shocking pace.
"We've gone from having 2,500 children in care three years ago to having 5,500 kids in care," Marilyn Moores, a juvenile court judge in Indianapolis, told NPR. "It has just exploded our systems."
In October, President Trump declared the opioid epidemic a health emergency, and Attorney General Jeff Sessions assigned 90 federal agents to a new field office to help combat the illicit opioid trade. Last month, Trump...