Let’s start with the saga of rainbow fentanyl. I first heard about this stuff last month. It all started with a warning from the DEA over pastel-colored opioids. That turned into a warning that fentanyl could end up in your kid’s Halloween candy. This was a ridiculous idea.
To be honest, I mostly heard about rainbow fentanyl because people in my social media feeds were dunking on how quickly it got spun up into a political weapon. This is Ronna McDaniel, the chairwoman of the Republican Party, appearing on Fox News in what is theoretically a segment about the November midterms.
I’m thinking about rainbow fentanyl now because, to me, the way this story spread was instructive. It morphed in this way that a lot of stories about drugs do, from a real fear—about a drug that is dangerous—to a manufactured one. And it seemed like some of the only people taking any of that fear seriously were on Fox News. Brian Mann, who covers drug use and abuse over at NPR, he noticed this too. “It for a moment felt like the old days of the drug war, ‘just say no’ narrative. Be afraid. Be very, very afraid,” Mann said. “And of course, at the kernel of it, that’s because there is this scary thing happening out there. And the Republicans really did find a way to insert that narrative into their talking points.”
It seemed to Brian Mann that Republicans backed Democrats into a corner on fentanyl—and they haven’t let up. Now that the election is over, this narrative of fentanyl as a kind of boogeyman isn’t going to go way. “Just factually, fentanyl is really horrible. It is a boogeyman. And what’s more, it’s killing young people,” Mann said.
On Monday’s episode of What Next, I spoke with Mann about why staying silent about fentanyl isn’t an option. Our conversation has been condensed and edited for clarity.
Mary Harris: When I called up Brian Mann to talk about fentanyl, there was one story that loomed large in my mind: A few weeks back, the Wall Street Journal published an article describing the overdose deaths of three people in New York City back in March of 2021. These folks were well-educated, high-achieving, and they were young—26, 38, and 40. They had all ordered cocaine from a delivery service, and it had been laced with fentanyl.
In the past, Mann might have considered a story like this to be fearmongering. Now, he doesn’t think about it like that. Because these days three-quarters of all drug-involved deaths involve fentanyl.
Brian Mann: For the first time that I can find, we’re in a space where if you take hard illicit drugs—whether it’s cocaine, whether it’s a party pill—it’s very real that it could kill you. We actually have entered the world of Nancy Reagan’s “just say no” narrative: Just don’t do drugs because it’s deadly, deadly stuff. It turns out a lot of that was hype. Drugs were bad, yes. They hurt communities, and they hurt people, but they usually weren’t fatal. Most people recovered from crack. Most people recovered even from meth. And now it’s different. This is a big challenge, in part because so many people have lost credibility in talking to young people. It’s a big challenge now coming to them and saying, “Listen, you need to wake the hell up.”
Can you give some basics on fentanyl? What it is, and where it came from? It’s a synthetic opioid, right?
Yeah, that’s right. And it’s been around for a long time. If you go to the hospital and you have a severe injury, there’s a really good chance that you will be given fentanyl because it’s very powerful, and it’s very effective at easing pain. But over time, the Mexican drug cartels have realized that this is also a really cheap, easy-to-manufacture street drug. So it’s been slowly trickling into the American drug supply. Really over the past five years, it’s gone everywhere.
Did it really start with the Mexican drug cartels? Because my understanding is it’s come from China as well, and it’s pretty easy to manufacture domestically.
You’re absolutely right that China provides most of the precursor chemicals, the raw ingredients that go into fentanyl. And for a long time, some of the actual fentanyl was coming from China and people were cooking fentanyl in the U.S. just like they were cooking methamphetamines in the U.S. But what we’ve seen over the past five years is that the cartels have cornered the market on this stuff. Drug enforcement in Mexico has largely broken down completely. There’s almost no interdiction efforts. There are labs around Mexico City and across Mexico where they’re producing massive quantities of fentanyl and also shaping it into what look exactly like pharmaceutical-grade opioid pills. And then they’re shipping these north. It’s penetrated pretty much every drug market in the United States, every street market. Wherever you go now, you find people who are using methamphetamines. They’re also using fentanyl.
Is that because it’s cut into the drug or because they’re just mixing and matching?
It’s cut into the drugs by the cartels. It’s a cheap add-on that really boosts the quality of the high, and it also gets people addicted really fast. It’s also super, super cheap to make. Heroin is costly to make. Cocaine is costly to make. Fentanyl is dirt cheap to make, and it’s super easy to smuggle. This is the dream drug. The cartels have finally found the perfect drug.
Dream for them, but nightmare for people who take it, potentially.
It’s a devastating nightmare. It’s a horror, but it’s super profitable, and for the attrition that they see among their customers—and by that, I mean the deaths that we see among their customers—they’re getting enough additional people addicted and hooked that it’s still a profit center. The heartbreaking thing that I’m seeing is that more and more people who were using prescription opioids at one point and then using heroin at one point, they’re now actually seeking fentanyl. It’s so powerful that it gives them that euphoric high that they no longer get from heroin or from OxyContin.
Fentanyl has been around since the 1960s. My understanding is that it entered the recreational drug scene mostly because of a supply-and-demand problem. People who had gotten addicted to opioids all of a sudden found themselves seeking off-market opioids, and that created a lot of demand and there just wasn’t enough supply. And all of a sudden fentanyl was there to replace, say, heroin. And then my understanding is that the general public began to understand the impact of fentanyl around 2016. So, what happened in 2016?
2016 was the year that the death toll began to surge. We saw about 20,000 additional overdose deaths that year. That was the first big alarm that it wasn’t any longer a treatable long-term illness; that this was more of a terminal illness for many, many people.
Did folks know right away that it was fentanyl that was to blame?
One of the things that’s horrible about this public health crisis is that the information that we have about drug overdoses and fatal drug overdoses is incredibly poor. We’re always behind in understanding what’s going wrong, and that’s contributed to the death toll in the U.S.
Once there was an understanding that fentanyl was surging onto the recreational drug market, was there a coordinated response?
The short answer is that there was not a coordinated response. What we’ve seen over time is a lot of confusion and disarray within the major government agencies that deal with drug addiction, within the public health community, within the medical field. We saw, for example, during the Trump administration, a diplomatic crisis that almost completely wrecked the ability to target fentanyl producers in Mexico.
In the final year of the Trump administration, the Drug Enforcement Administration and other federal agencies arrested a top Mexican official in Los Angeles. And Mexico was already leery of this whole drug war model. They were already thinking it was not working very well for Mexico. It was creating a lot more violence in Mexico. But that arrest essentially shattered the final vestiges of the ability of U.S. law enforcement to operate in Mexico and to mount these big, complex raids on laboratories and pill mills and other places in Mexico.
And another piece that’s unraveled is that a few months ago, you’ll remember that Nancy Pelosi, the House speaker, visited Taiwan and infuriated the Chinese. And so there again, there was a diplomatic breakdown where the Chinese, who were never terribly helpful at stopping these precursor chemicals from going to Mexico, again backed away from any real partnership with the U.S.
Those two big diplomatic crises have left the U.S. with almost no tools to stop the flow of fentanyl until it reaches the U.S.-Mexico border. That’s the first strong chance we have to stop fentanyl, and we are making more busts than ever before, seizing more fentanyl than ever before. But all the experts I talked to say that’s a drop in the bucket. Basically, the cartels are able to pump as much of this into the U.S. as they want.
Another place where there’s been a profound failure is in the health care community. Addiction is an illness, and because of fentanyl, it’s now a fatal illness. But if you go to an emergency room in most parts of the U.S. after having an overdose for fentanyl, they’ll prop you back up, they’ll put you together again, and they’ll send you out the door. Contrast that with what happens if you come in with, say, a heart ailment or something that looks like cancer in your lungs, or some other serious health problem. They will channel you into a whole series of medical responses that will help you survive. But if you go to that same family doctor and say, “I’m really struggling with an opioid addiction,” or “My son or daughter is struggling with opioid addiction,” nine times out of 10 that doctor will not know what to do. They will not want to work with you. They will distance themselves from helping you.
And so there’s this political breakdown, there’s this diplomatic breakdown, there’s this law enforcement breakdown, but we’re also at this point where for a lot of people who want help, it’s damned hard to get it.
Can we talk about the politics of fentanyl a little bit more? I want to do that because you’ve been pretty clear that a lot of the fentanyl is coming from Mexico. But I wonder if, even given that, you think the way Republicans have linked fentanyl to the border is fair?
A lot of what Republicans have said about the border, based on our reporting, is just factually wrong. And the main connection where it is factually wrong is that they’ve linked it to undocumented migrants. They say that people seeking refugee status or coming to the U.S. to work, that they’re the prime vector for fentanyl.
And it really does look unequivocally true that most of the fentanyl coming in is coming through ports of entry. It’s being smuggled in—in trucks, in cargo shipments, things like that.
It’s a business. It’s coming in like everything else that comes in through the U.S. border to go to Walmart.
That’s exactly right. And there’s a supply chain that the cartels have created that’s pretty reliable and pretty dependable. One funny story: During the pandemic, when a lot of that supply chain was really disrupted, one of the problems that the cartels had was that they were generating so much money in the U.S. from selling fentanyl and other drugs that they were having a hard time actually shipping the cash. The pandemic was shutting down a lot of their typical routes. It was hard. They had supply chain problems just like everybody else. And cash was the biggest problem.
Fentanyl, you can ship it in such micro amounts. One person on their body can carry enough fentanyl that you can cut it later in the U.S. to supply a whole city. So getting it into the country is really, really easy. Getting the cash out, that was a little bit harder.
But that’s one of the most inaccurate things that Republicans are saying. The next thing that is really challenging about the Republican narrative is just: What would the answers be? Near the end of his time in office, then-President Trump was talking about firing missiles into the Mexico to bomb some of these drug labs. That’s crazy. That’s not going to happen. But that gives you a sense for just how few options there are on the table. And so that’s the thing that is at the heart of the Republican narrative that I can’t sort out. Like, OK, so if you think the Biden administration is getting this wrong, what would you do instead? The answer that I generally hear is we would build a wall. But again, most of these drugs are coming in through legal ports of entry already. So what would a wall do? And I can’t get answers to that question.
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The Republican talking points do remind me of the crack epidemic a little bit, in that talking about fentanyl as an issue having to do with migrants and Mexico—it just racializes what is a public health issue.
Race always comes in to drug policy questions in the U.S. It’s an inevitable part of the conversation. Many of the public health experts who I talked to they say that if you aggressively recriminalize addiction and restigmatize addiction, you are going to cause a lot more deaths. That is one of the concerns. People are really worried that long after the votes are counted for 2022, we’re going to be seeing basically crack-style laws around fentanyl, where carrying micro amounts of fentanyl will get you mandatory minimum sentences. We’ll fill prisons up with people for carrying small amounts of this very powerful drug with very little evidence that that will help save lives, or stop addiction, or stop people from using fentanyl. And very good evidence that it will mostly target people of color and poor white Americans.
I’m well aware that I’m one of the many gloomy, gloomy reporters out there talking about really depressing stuff, and there’s a tune-out factor. So what I try to do is I try to talk about things that might really help and what are the policy solutions that do seem to be moving the needle a little bit.
One of them is communicating with young people in a really honest, factual way. Even now, even today, most people who experience addiction do recover. They do get better. And they go back to having a healthy, productive life. There has been a decline in addiction and heavy drug use among younger people, which is really hopeful. Unfortunately, they’re still dying at much higher rates because the drugs are so dangerous.
There is also a lot of evidence that there are other answers to this public health crisis. Let me just name a couple of them. There are now medical treatments for addiction—for opioids in particular. Narcan, or naloxone, that reverses overdoses so they don’t become fatal. There’s more efforts to get that drug out onto the streets, out into communities. And there are other drugs that can really help people avoid relapses into addiction.
Another thing that often doesn’t get talked about enough is that the Affordable Care Act, Obamacare, which has been controversial for a lot of reasons, is actually the prime mover of addiction treatment in the country. And it’s been very effective. It’s probably saved more lives than any other single policy initiative in the country simply by funding much more addiction treatment.
So the good news here is that there are treatments. There are strategies that really can affect this deadly curve. There are some very affordable, simple strategies that can really help here if we can keep talking about those and if we can get people to pay attention to those. That’s not going to be easy. It is definitely a thing that sometimes has me screaming, frankly, that there are tools and there are strategies that could save a lot of these young people.
Probably the best strategy is not to recriminalize them and to drive them underground and to force them into hiding to continue their drug use in secret. Probably the solution is to help them get health care. Pretty boring, right? It’s pretty boring to say when that 25-year-old goes to an emergency room, goddammit, you’ve got to get them on track to get care and to get help and to move through a really good professional medical care system that respects them and treats them with dignity. It’s not going to work every time, right? This is a dangerous disease. But it’s a lot better than saying, “Hey, you better go back underground and you better go hide again and use illicitly because we got nothing that we can do to help.” In fact, that’s not true. We do have tools that can help and hopefully more and more of these people will get access to that.