The Truth About Fentanyl: Most is coming not from across the southern border but from unregulated pharmacentical companies in Chaina.

• Author: Castillo, Tessie

For "Ryan Lay, August 16, 2016, began like any other day. The seventeen-year veteran Cincinnati police officer showed up for second shift at 1 P.M., swapped a few jokes with fellow officers, and was quickly dispatched to his first call--a drug overdose.

Officer Lay pulled up to a two-family home, where he found a white male in his late thirties unconscious in a garage. The man, whom Lay knew, was an employee of Home Depot who had recently started buying street heroin after a long addiction to prescription painkillers.

Overdoses were not uncommon in police District Three, one of Cincinnati's low-income housing areas. Officer Lay typically responded to two or three such calls a week. Most weren't fatal and he was often able to revive overdose victims with naloxone, a medication that reverses the effects of opioids, such as heroin.

Lay sprayed a dose of naloxone up the man's nose. After another first responder administered a second dose, the man woke up. But before Lay was able to see the man safely transported to the hospital, he was already on his way to a second call--also a drug overdose.

After this call, I need to head back to the station and stock up on more naloxone, he thought.

But Lay never made it back to the station. After the second overdose incident, he was called out to another. Then another. Then another. By the time his shift ended, Lay had responded to thirteen overdoses. Other officers in his district were experiencing the same thing.

"It was overwhelming," Lay relates in a phone interview. "The calls for service for overdoses put everything else on hold. [We] didn't know what to do. It happened so fast."

Over the coming days, the onslaught of overdose calls continued. By the end of the week, Cincinnati emergency rooms had handled an estimated 174 overdoses, three of them fatal. Typically, they would see fewer than four per day.

The officers had no idea what was causing all the overdoses. Something had happened to the heroin supply. Autopsies at the medical examiner's office would soon provide the answer: Fentanyl had come to Cincinnati.

FENTANYL IS A SYNTHETIC OPIOID THAT IS more than fifty times as potent as heroin. It was first synthesized in 1959 to relieve pain in surgery and for cancer patients. Medical providers typically administer it via injection or by prescribing a transdermal patch that allows the drug to be slowly absorbed into the bloodstream.

But, beginning in 2014, large quantities of illicit fentanyl, in the form of a white powder, began arriving in the United States from China.

Chinas chemical and pharmaceutical industry is vast and largely unregulated, so it's not difficult for any of the country's estimated 160,000 licensed and unlicensed chemical companies to create fentanyl from synthetics that mimic the effects of opium. Synthetic opioids are easier to manufacture than natural opiates derived from poppy plants, such as heroin, and more lucrative. Customers around the world can easily purchase fentanyl over the Internet and request a shipment for personal use or to sell.

In fact, one kilogram of fentanyl purchased in China for $3,000-$5,000 can generate up to $1.5 million in revenue for U.S.-based street dealers.

Today, almost half of the...