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Episode
265

Fentanyl: The Drug Devastating America

May 24, 2022
Weird World
-
21
minutes

It is a drug that went from relative obscurity to being the number one cause of death for Americans aged 18-45.

In this episode, we'll look at the drug destroying hundreds of thousands of lives across the country.

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[00:00:00] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English. 

[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.

[00:00:22] I'm Alastair Budge, and today we are going to be talking about Fentanyl, the drug devastating America.

[00:00:30] It’s the story of how one synthetic drug went from relative obscurity to being the number one cause of death for Americans aged 18-45, overtaking guns, car accidents, and suicide.

[00:00:46] In this episode we’ll talk about the drug itself, what fentanyl does to the body and why it is so dangerous, we’ll look at how it managed to spread so quickly through the country, and what the US authorities are trying to do about it.

[00:01:01] I should add that this episode is going to be followed by another standalone episode on San Francisco, a city that has been ravaged by fentanyl, so these two episodes will form quite a nice duo.

[00:01:17] OK then, let’s get right into it.

[00:01:21] In 1960 a Belgian pharmacist named Dr Paul Janssen developed a new kind of drug to relieve pain. 

[00:01:31] He called it fentanyl, and it was incredibly effective. Just a small dose was required to relax a patient and relieve pain. As a result, it was quickly adopted by the medical community as a way to relieve pain and suffering, especially for patients suffering from terminal conditions.

[00:01:56] And for many years fentanyl remained a tightly controlled drug used in a medical setting. Administered correctly it helped countless patients relieve pain and suffering.

[00:02:09] And when Dr Paul Janssen died in 2003 at the ripe old age of 77, his obituary mentioned fentanyl only once, it was practically an afterthought in a glowing career that included being awarded more than 100 patents and authoring more than 850 scientific papers. 

[00:02:34] Clearly, Dr Janssen was a talented scientist, but he died knowing very little about the true impact that his creation would have.

[00:02:45] It wouldn’t be until 2013, 10 years after Dr Janssen’s death, that illegally produced fentanyl burst onto the scene in the United States, and by 2016, just three years later, fentanyl had become a household name and the most deadly opiate in the country, killing more Americans than any other drug.

[00:03:10] Now it isn’t just the most deadly drug, a fentanyl overdose is the leading cause of death for Americans under the age of 45. 

[00:03:20] To put it another way, for any American who dies before their 46th birthday, a fentanyl overdose is the most common cause. 

[00:03:32] The problems started when fentanyl moved from being in the hands of trained medical professionals to the hands of criminals.

[00:03:41] See, in the right hands, produced in a medical setting and administered correctly, fentanyl isn’t particularly dangerous. 

[00:03:50] In fact, it has a relatively high what’s called “therapeutic index”, which is a medical term for the difference between the amount of a drug needed to have a positive medical effect and the amount that can be dangerous.

[00:04:05] In clinical conditions, fentanyl is normally administered via a patch or a nasal spray, where very small amounts of the drug go slowly into the bloodstream, so it is relatively safe.

[00:04:20] But the problems arise when it is produced and sold outside a clinical environment, and taken recreationally by people who don’t know exactly what it is they are putting into their bodies.

[00:04:34] See, the potency of fentanyl, its power, its strength, is around 50 times that of heroin and 100 times that of morphine. 

[00:04:46] Just two milligrams of fentanyl, like a couple of grains of salt, can kill a full-grown adult.

[00:04:54] It’s typically smoked, snorted, or injected, with injections being particularly dangerous because the user has very little idea about the strength of what they are putting directly into their bloodstream

[00:05:09] As one director of a police laboratory said, “You’re injecting yourself with a loaded gun.” 

[00:05:16] It has a similar effect to drugs like heroin or morphine, a rush, a high, a feeling of euphoria as the chemicals bind to the opioid receptors in the brain.

[00:05:28] It feels good, blocks out pain, and gives its users a temporary sense of happiness.

[00:05:36] But it is highly addictive, the high is shorter and more intense than other opiates like heroin, meaning it can completely consume its users lives.

[00:05:49] It appeared on the illegal drug scene in the US really in the mid 2010s to fill an existing demand for opiates. Increasing numbers of Americans had become addicted to prescription opioids and as there was a tightening of restrictions on who was prescribed opioids, an increasing number of opioid addicted people were left without any legal opportunities to feed their addiction.

[00:06:18] Heroin was one option, and the number of heroin addicts skyrocketed. But heroin isn’t cheap, and there was still stigma surrounding it from its association with the AIDS epidemic in the 1980s. 

[00:06:33] The stage was set for a new drug, one that could be produced cheaply, easily, and didn’t necessarily need to be injected.

[00:06:44] That drug was Fentanyl.

[00:06:46] It’s a completely synthetic opioid, meaning it can be produced in a laboratory and making it much cheaper to produce than other natural opiates like heroin or morphine.

[00:06:59] Heroin, on the other hand, needs to be harvested from poppies, processed, and transported often thousands of miles across land and smuggled in ships before it reaches its final destination.

[00:07:15] Illegal fentanyl is thought to have a much simpler supply chain.

[00:07:20] Initially, it was first produced in China, and then often sent via normal mail, in shipments of under 1 kilo, to the United States, where it would go almost directly onto the streets, and into the hands of addicts.

[00:07:35] 1 kilo of the drug can be bought for around $3,000 wholesale, and this 1 kilo, given how pure the drug is, would be enough fentanyl to kill 500,000 adults.

[00:07:51] After increasing pressure from the United States on the Chinese government, there has been a crackdown on fentanyl laboratories in China, and a subsequent reduction, or at least believed subsequent reduction, in the amount of Chinese-produced fentanyl arriving in the United States.

[00:08:09] But this crackdown opened the doors for Mexican cartels, which buy the chemicals required to produce fentanyl directly from Chinese suppliers and then produce the fentanyl in Mexico, before smuggling it northwards to the United States. 

[00:08:26] Given that it is so much more powerful than drugs like heroin or meth, it takes up a lot less space, so you might only need a small handbag to supply an entire city’s addicts with fentanyl for a month. 

[00:08:42] As you can see, the logistics of producing, transporting, and selling fentanyl are just so much simpler than other drugs.

[00:08:52] And the result of this is that it is very cheap for the end user, for the drug addict to get high. Indeed, a hit of fentanyl, enough to get a user high, or kill someone who isn’t used to it, typically costs just a few dollars, the same price as a cup of coffee.

[00:09:12] There are several effects of the drug being so cheap, effects that you will no doubt be able to anticipate, to guess. Firstly, it has increased the demand for it. As it’s so cheap, people can afford to take it frequently, and having enough money to pay for it is less of a problem than more expensive drugs.

[00:09:34] Secondly, it has meant that people have switched from other, comparatively safer opioids, from prescription drugs like OxyContin or even illegal drugs like heroin, to fentanyl. It’s stronger, it’s cheaper, and there’s more of it around.

[00:09:53] Thirdly, drug dealers often add fentanyl to other drugs precisely because it’s cheaper. From cocaine to methamphetamine, police are increasingly finding that dealers are cutting these more expensive drugs with fentanyl because they make more money and the end user still gets high.

[00:10:13] The result of all of this is that there are more and more people taking fentanyl, both knowingly and unknowingly

[00:10:22] And both cases are problematic.

[00:10:25] When someone buys illegal fentanyl, knowing it’s fentanyl, it’s very hard for them to know how strong it is. 2mg of fentanyl, which can be a fatal dose is, as we said, just like a couple of grains of sand, so it's very easy to accidentally overdose, or for a batch of fentanyl to be made too strong.

[00:10:48] This is dangerous enough for people who know they’re taking fentanyl, but it’s even more so for people who think they’re taking something else.

[00:10:58] For the heroin user who thinks he is taking heroin, if he takes a “normal” amount of what he thinks is heroin and it is in fact partly or completely fentanyl, it can be lethal.

[00:11:11] And even for people who think they are taking a completely different drug, not an opiate, they are increasingly fatally surprised to find it has been cut with fentanyl.

[00:11:23] There was a famous case in March of this year, March of 2022, where five young military cadets died on a spring break when they took what they thought was cocaine, but it was laced with fentanyl. 

[00:11:38] And an even more famous case of someone taking what he thought was another drug but it was in fact fentanyl was of the musician Prince. He thought he was taking Vicodin, a type of prescription painkiller, but it was actually a pill that had been laced with fentanyl. 

[00:11:57] He was found dead in an elevator six hours later.

[00:12:02] Fentanyl was no longer something that was restricted to people living on the street, people forgotten by mainstream society; it was something that drug dealers were putting everywhere, and the death toll was increasing.

[00:12:17] In 2003, when the inventor of fentanyl, Dr Janssen, died, there were only 1,400 fentanyl deaths in America compared to 2,080 from heroin. 

[00:12:31] In 2014, the year of the so-called “third wave” of fentanyl into the country, this had climbed to 5,544, in 2020 it had gone up 10 times again, to 56,516, and although the statistics haven’t yet been released, it looks like over 70,000 Americans died from a fentanyl overdose in 2021, so that’s almost 200 people every single day.

[00:13:03] Or to put another way, it’s 8 people an hour, so statistically during the time you’ve been listening to this episode, at least one person has died from a fentanyl overdose.

[00:13:16] And, to state the obvious, these are all human beings, sons, daughters, fathers, mothers, brothers and sisters, people who love and who are loved, people who, for one reason or another, have fallen into a cycle of addiction and paid the ultimate price for it.

[00:13:36] Because fentanyl addiction is so gripping, because it is so hard to escape, and because the drug is so cheap, fentanyl addiction is for many a one-way street, one which starts with a loss of family and a roof over your head and ends on the street, dead after an overdose.

[00:13:58] In terms of who is falling victim to fentanyl, it’s overwhelmingly a male problem, with men making up 73% of fentanyl deaths in 2020. 

[00:14:10] Although white Americans make up the majority of fentanyl deaths, it’s a drug that affects people of all ethnicities and ages, not all proportionally, not all to the same extent.

[00:14:23] In fact, the most at risk group is black men aged over 55, a group which is four times more likely to overdose on fentanyl than any other group.

[00:14:36] Of course, the drug doesn’t discriminate, but its potency and low price makes it the drug of choice for people who have hit rock bottom, people who are often struggling with homelessness, mental illness, and other forms of personal problems which are then compounded by falling into a cycle of fentanyl abuse.

[00:14:59] Now, with the country in the middle of this grip of addiction, what is actually happening, and what can be done about this?

[00:15:07] Well, in the next episode we’ll look at the specific case of San Francisco, a city that is practising a harm reduction approach, where the use of hard drugs including fentanyl has been effectively decriminalised. 

[00:15:23] But San Francisco is an anomaly, it’s unusual in this respect.

[00:15:28] The US government is, as you would expect, full of plenty of words, policies and ideas about how to solve the issue of fentanyl addiction. Its strategy is primarily based on stopping the supply of fentanyl in the first place, stopping the drug getting into the country, and taking it off the streets when it's there. 

[00:15:50] From cracking down on drug cartels to increased police presence on the streets to prosecuting dealers, the overall policy is in line with the country’s War on Drugs policy, the movement that started in the 1970s and advocates a total crackdown on drug trafficking and use.

[00:16:11] At least in terms of the number of people dying from fentanyl overdoses, it doesn’t look like it’s working. More and more people are dying, and there doesn’t seem to be any reversal in the trend.

[00:16:25] The problem is that fentanyl is pretty much the perfect drug from a drug trafficker’s point of view.

[00:16:33] You can produce it in a laboratory, meaning there’s no need for fields, farmers, the right weather, and it’s much easier to hide from the authorities than a large field.

[00:16:44] It’s incredibly powerful, which means that small volumes can be transported easily without customs officials realising.

[00:16:53] All this means that it can be sold very cheaply, thereby increasing the amount of people who are able to take it.

[00:17:01] The result of this is that it is an incredibly lucrative business to be in, the fentanyl business.

[00:17:09] A drug trafficker can buy or produce a kilo of the drug for around $3,000. This is enough to make half a million fentanyl pills, enough to kill 500,000 people who haven’t used the drug before, or get 500,000 experienced users high.

[00:17:28] If a pill is sold for only $4, this means the 1 kilo of fentanyl can be turned into $2 million of street fentanyl. Obviously, there are some costs involved, but you can see how much money is involved.

[00:17:45] The only problem with fentanyl, from the drug trafficker's point of view, is that it’s a drug that kills its users, although there seems to be no shortage of people who are willing to try it.

[00:17:57] All this being said, the problem of fentanyl is only one part of America’s opioid crisis, a subject which we covered in detail in episode 230. 

[00:18:08] It might be the most potent part, the most deadly part, and it is the drug that is responsible for the greatest number of deaths, but it is only one piece of the puzzle.

[00:18:20] After all, fentanyl emerged as a product to meet the demands of America’s increasingly addicted population. 

[00:18:28] After tens of millions of Americans first got hooked on prescription opioids, fentanyl was there as a cheaper, more powerful and more available alternative.

[00:18:40] The reality is, and even American officials have admitted as much, that fentanyl is so cheap to produce, so easy to transport, and so profitable to sell, that it will be incredibly difficult, nigh impossible, to completely eliminate from the streets of American cities.

[00:19:00] It might be destroying lives by their hundreds of thousands, but it is here to stay, and the sad reality is that there doesn’t seem to be any coherent plan to do anything about it.

[00:19:14] OK then, that is it for today's episode on Fentanyl, the drug devastating America.

[00:19:21] I hope it's been an interesting one, that you've learnt something new, and I’m sorry to not finish on a high note, so to speak, but when it comes to this particular subject there isn’t a huge amount of good news to report.

[00:19:35] As a reminder, next up we’ll be looking at what’s happening in San Francisco, a city that has been ravaged by fentanyl, and one where there were more deaths from fentanyl than COVID. So keep a look out for that one.

[00:19:50] As always, I would love to know what you thought of this episode. 

[00:19:53] Is fentanyl something that you’ve heard about in your country? 

[00:19:57] What do you think could, or should be done, about the issue of fentanyl in the United States? 

[00:20:02] Who is to blame? The pill-prescribing doctors, the drug traffickers, the people taking drugs, or is it a product of structural problems in American society?

[00:20:14] I would love to know, so let’s get this discussion started. You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.

[00:20:27] You've been listening to English Learning for Curious Minds, by Leonardo English.

[00:20:32] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.

[END OF EPISODE]

Continue learning

Get immediate access to a more interesting way of improving your English
Become a member
Already a member? Login

[00:00:00] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English. 

[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.

[00:00:22] I'm Alastair Budge, and today we are going to be talking about Fentanyl, the drug devastating America.

[00:00:30] It’s the story of how one synthetic drug went from relative obscurity to being the number one cause of death for Americans aged 18-45, overtaking guns, car accidents, and suicide.

[00:00:46] In this episode we’ll talk about the drug itself, what fentanyl does to the body and why it is so dangerous, we’ll look at how it managed to spread so quickly through the country, and what the US authorities are trying to do about it.

[00:01:01] I should add that this episode is going to be followed by another standalone episode on San Francisco, a city that has been ravaged by fentanyl, so these two episodes will form quite a nice duo.

[00:01:17] OK then, let’s get right into it.

[00:01:21] In 1960 a Belgian pharmacist named Dr Paul Janssen developed a new kind of drug to relieve pain. 

[00:01:31] He called it fentanyl, and it was incredibly effective. Just a small dose was required to relax a patient and relieve pain. As a result, it was quickly adopted by the medical community as a way to relieve pain and suffering, especially for patients suffering from terminal conditions.

[00:01:56] And for many years fentanyl remained a tightly controlled drug used in a medical setting. Administered correctly it helped countless patients relieve pain and suffering.

[00:02:09] And when Dr Paul Janssen died in 2003 at the ripe old age of 77, his obituary mentioned fentanyl only once, it was practically an afterthought in a glowing career that included being awarded more than 100 patents and authoring more than 850 scientific papers. 

[00:02:34] Clearly, Dr Janssen was a talented scientist, but he died knowing very little about the true impact that his creation would have.

[00:02:45] It wouldn’t be until 2013, 10 years after Dr Janssen’s death, that illegally produced fentanyl burst onto the scene in the United States, and by 2016, just three years later, fentanyl had become a household name and the most deadly opiate in the country, killing more Americans than any other drug.

[00:03:10] Now it isn’t just the most deadly drug, a fentanyl overdose is the leading cause of death for Americans under the age of 45. 

[00:03:20] To put it another way, for any American who dies before their 46th birthday, a fentanyl overdose is the most common cause. 

[00:03:32] The problems started when fentanyl moved from being in the hands of trained medical professionals to the hands of criminals.

[00:03:41] See, in the right hands, produced in a medical setting and administered correctly, fentanyl isn’t particularly dangerous. 

[00:03:50] In fact, it has a relatively high what’s called “therapeutic index”, which is a medical term for the difference between the amount of a drug needed to have a positive medical effect and the amount that can be dangerous.

[00:04:05] In clinical conditions, fentanyl is normally administered via a patch or a nasal spray, where very small amounts of the drug go slowly into the bloodstream, so it is relatively safe.

[00:04:20] But the problems arise when it is produced and sold outside a clinical environment, and taken recreationally by people who don’t know exactly what it is they are putting into their bodies.

[00:04:34] See, the potency of fentanyl, its power, its strength, is around 50 times that of heroin and 100 times that of morphine. 

[00:04:46] Just two milligrams of fentanyl, like a couple of grains of salt, can kill a full-grown adult.

[00:04:54] It’s typically smoked, snorted, or injected, with injections being particularly dangerous because the user has very little idea about the strength of what they are putting directly into their bloodstream

[00:05:09] As one director of a police laboratory said, “You’re injecting yourself with a loaded gun.” 

[00:05:16] It has a similar effect to drugs like heroin or morphine, a rush, a high, a feeling of euphoria as the chemicals bind to the opioid receptors in the brain.

[00:05:28] It feels good, blocks out pain, and gives its users a temporary sense of happiness.

[00:05:36] But it is highly addictive, the high is shorter and more intense than other opiates like heroin, meaning it can completely consume its users lives.

[00:05:49] It appeared on the illegal drug scene in the US really in the mid 2010s to fill an existing demand for opiates. Increasing numbers of Americans had become addicted to prescription opioids and as there was a tightening of restrictions on who was prescribed opioids, an increasing number of opioid addicted people were left without any legal opportunities to feed their addiction.

[00:06:18] Heroin was one option, and the number of heroin addicts skyrocketed. But heroin isn’t cheap, and there was still stigma surrounding it from its association with the AIDS epidemic in the 1980s. 

[00:06:33] The stage was set for a new drug, one that could be produced cheaply, easily, and didn’t necessarily need to be injected.

[00:06:44] That drug was Fentanyl.

[00:06:46] It’s a completely synthetic opioid, meaning it can be produced in a laboratory and making it much cheaper to produce than other natural opiates like heroin or morphine.

[00:06:59] Heroin, on the other hand, needs to be harvested from poppies, processed, and transported often thousands of miles across land and smuggled in ships before it reaches its final destination.

[00:07:15] Illegal fentanyl is thought to have a much simpler supply chain.

[00:07:20] Initially, it was first produced in China, and then often sent via normal mail, in shipments of under 1 kilo, to the United States, where it would go almost directly onto the streets, and into the hands of addicts.

[00:07:35] 1 kilo of the drug can be bought for around $3,000 wholesale, and this 1 kilo, given how pure the drug is, would be enough fentanyl to kill 500,000 adults.

[00:07:51] After increasing pressure from the United States on the Chinese government, there has been a crackdown on fentanyl laboratories in China, and a subsequent reduction, or at least believed subsequent reduction, in the amount of Chinese-produced fentanyl arriving in the United States.

[00:08:09] But this crackdown opened the doors for Mexican cartels, which buy the chemicals required to produce fentanyl directly from Chinese suppliers and then produce the fentanyl in Mexico, before smuggling it northwards to the United States. 

[00:08:26] Given that it is so much more powerful than drugs like heroin or meth, it takes up a lot less space, so you might only need a small handbag to supply an entire city’s addicts with fentanyl for a month. 

[00:08:42] As you can see, the logistics of producing, transporting, and selling fentanyl are just so much simpler than other drugs.

[00:08:52] And the result of this is that it is very cheap for the end user, for the drug addict to get high. Indeed, a hit of fentanyl, enough to get a user high, or kill someone who isn’t used to it, typically costs just a few dollars, the same price as a cup of coffee.

[00:09:12] There are several effects of the drug being so cheap, effects that you will no doubt be able to anticipate, to guess. Firstly, it has increased the demand for it. As it’s so cheap, people can afford to take it frequently, and having enough money to pay for it is less of a problem than more expensive drugs.

[00:09:34] Secondly, it has meant that people have switched from other, comparatively safer opioids, from prescription drugs like OxyContin or even illegal drugs like heroin, to fentanyl. It’s stronger, it’s cheaper, and there’s more of it around.

[00:09:53] Thirdly, drug dealers often add fentanyl to other drugs precisely because it’s cheaper. From cocaine to methamphetamine, police are increasingly finding that dealers are cutting these more expensive drugs with fentanyl because they make more money and the end user still gets high.

[00:10:13] The result of all of this is that there are more and more people taking fentanyl, both knowingly and unknowingly

[00:10:22] And both cases are problematic.

[00:10:25] When someone buys illegal fentanyl, knowing it’s fentanyl, it’s very hard for them to know how strong it is. 2mg of fentanyl, which can be a fatal dose is, as we said, just like a couple of grains of sand, so it's very easy to accidentally overdose, or for a batch of fentanyl to be made too strong.

[00:10:48] This is dangerous enough for people who know they’re taking fentanyl, but it’s even more so for people who think they’re taking something else.

[00:10:58] For the heroin user who thinks he is taking heroin, if he takes a “normal” amount of what he thinks is heroin and it is in fact partly or completely fentanyl, it can be lethal.

[00:11:11] And even for people who think they are taking a completely different drug, not an opiate, they are increasingly fatally surprised to find it has been cut with fentanyl.

[00:11:23] There was a famous case in March of this year, March of 2022, where five young military cadets died on a spring break when they took what they thought was cocaine, but it was laced with fentanyl. 

[00:11:38] And an even more famous case of someone taking what he thought was another drug but it was in fact fentanyl was of the musician Prince. He thought he was taking Vicodin, a type of prescription painkiller, but it was actually a pill that had been laced with fentanyl. 

[00:11:57] He was found dead in an elevator six hours later.

[00:12:02] Fentanyl was no longer something that was restricted to people living on the street, people forgotten by mainstream society; it was something that drug dealers were putting everywhere, and the death toll was increasing.

[00:12:17] In 2003, when the inventor of fentanyl, Dr Janssen, died, there were only 1,400 fentanyl deaths in America compared to 2,080 from heroin. 

[00:12:31] In 2014, the year of the so-called “third wave” of fentanyl into the country, this had climbed to 5,544, in 2020 it had gone up 10 times again, to 56,516, and although the statistics haven’t yet been released, it looks like over 70,000 Americans died from a fentanyl overdose in 2021, so that’s almost 200 people every single day.

[00:13:03] Or to put another way, it’s 8 people an hour, so statistically during the time you’ve been listening to this episode, at least one person has died from a fentanyl overdose.

[00:13:16] And, to state the obvious, these are all human beings, sons, daughters, fathers, mothers, brothers and sisters, people who love and who are loved, people who, for one reason or another, have fallen into a cycle of addiction and paid the ultimate price for it.

[00:13:36] Because fentanyl addiction is so gripping, because it is so hard to escape, and because the drug is so cheap, fentanyl addiction is for many a one-way street, one which starts with a loss of family and a roof over your head and ends on the street, dead after an overdose.

[00:13:58] In terms of who is falling victim to fentanyl, it’s overwhelmingly a male problem, with men making up 73% of fentanyl deaths in 2020. 

[00:14:10] Although white Americans make up the majority of fentanyl deaths, it’s a drug that affects people of all ethnicities and ages, not all proportionally, not all to the same extent.

[00:14:23] In fact, the most at risk group is black men aged over 55, a group which is four times more likely to overdose on fentanyl than any other group.

[00:14:36] Of course, the drug doesn’t discriminate, but its potency and low price makes it the drug of choice for people who have hit rock bottom, people who are often struggling with homelessness, mental illness, and other forms of personal problems which are then compounded by falling into a cycle of fentanyl abuse.

[00:14:59] Now, with the country in the middle of this grip of addiction, what is actually happening, and what can be done about this?

[00:15:07] Well, in the next episode we’ll look at the specific case of San Francisco, a city that is practising a harm reduction approach, where the use of hard drugs including fentanyl has been effectively decriminalised. 

[00:15:23] But San Francisco is an anomaly, it’s unusual in this respect.

[00:15:28] The US government is, as you would expect, full of plenty of words, policies and ideas about how to solve the issue of fentanyl addiction. Its strategy is primarily based on stopping the supply of fentanyl in the first place, stopping the drug getting into the country, and taking it off the streets when it's there. 

[00:15:50] From cracking down on drug cartels to increased police presence on the streets to prosecuting dealers, the overall policy is in line with the country’s War on Drugs policy, the movement that started in the 1970s and advocates a total crackdown on drug trafficking and use.

[00:16:11] At least in terms of the number of people dying from fentanyl overdoses, it doesn’t look like it’s working. More and more people are dying, and there doesn’t seem to be any reversal in the trend.

[00:16:25] The problem is that fentanyl is pretty much the perfect drug from a drug trafficker’s point of view.

[00:16:33] You can produce it in a laboratory, meaning there’s no need for fields, farmers, the right weather, and it’s much easier to hide from the authorities than a large field.

[00:16:44] It’s incredibly powerful, which means that small volumes can be transported easily without customs officials realising.

[00:16:53] All this means that it can be sold very cheaply, thereby increasing the amount of people who are able to take it.

[00:17:01] The result of this is that it is an incredibly lucrative business to be in, the fentanyl business.

[00:17:09] A drug trafficker can buy or produce a kilo of the drug for around $3,000. This is enough to make half a million fentanyl pills, enough to kill 500,000 people who haven’t used the drug before, or get 500,000 experienced users high.

[00:17:28] If a pill is sold for only $4, this means the 1 kilo of fentanyl can be turned into $2 million of street fentanyl. Obviously, there are some costs involved, but you can see how much money is involved.

[00:17:45] The only problem with fentanyl, from the drug trafficker's point of view, is that it’s a drug that kills its users, although there seems to be no shortage of people who are willing to try it.

[00:17:57] All this being said, the problem of fentanyl is only one part of America’s opioid crisis, a subject which we covered in detail in episode 230. 

[00:18:08] It might be the most potent part, the most deadly part, and it is the drug that is responsible for the greatest number of deaths, but it is only one piece of the puzzle.

[00:18:20] After all, fentanyl emerged as a product to meet the demands of America’s increasingly addicted population. 

[00:18:28] After tens of millions of Americans first got hooked on prescription opioids, fentanyl was there as a cheaper, more powerful and more available alternative.

[00:18:40] The reality is, and even American officials have admitted as much, that fentanyl is so cheap to produce, so easy to transport, and so profitable to sell, that it will be incredibly difficult, nigh impossible, to completely eliminate from the streets of American cities.

[00:19:00] It might be destroying lives by their hundreds of thousands, but it is here to stay, and the sad reality is that there doesn’t seem to be any coherent plan to do anything about it.

[00:19:14] OK then, that is it for today's episode on Fentanyl, the drug devastating America.

[00:19:21] I hope it's been an interesting one, that you've learnt something new, and I’m sorry to not finish on a high note, so to speak, but when it comes to this particular subject there isn’t a huge amount of good news to report.

[00:19:35] As a reminder, next up we’ll be looking at what’s happening in San Francisco, a city that has been ravaged by fentanyl, and one where there were more deaths from fentanyl than COVID. So keep a look out for that one.

[00:19:50] As always, I would love to know what you thought of this episode. 

[00:19:53] Is fentanyl something that you’ve heard about in your country? 

[00:19:57] What do you think could, or should be done, about the issue of fentanyl in the United States? 

[00:20:02] Who is to blame? The pill-prescribing doctors, the drug traffickers, the people taking drugs, or is it a product of structural problems in American society?

[00:20:14] I would love to know, so let’s get this discussion started. You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.

[00:20:27] You've been listening to English Learning for Curious Minds, by Leonardo English.

[00:20:32] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.

[END OF EPISODE]

[00:00:00] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English. 

[00:00:12] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.

[00:00:22] I'm Alastair Budge, and today we are going to be talking about Fentanyl, the drug devastating America.

[00:00:30] It’s the story of how one synthetic drug went from relative obscurity to being the number one cause of death for Americans aged 18-45, overtaking guns, car accidents, and suicide.

[00:00:46] In this episode we’ll talk about the drug itself, what fentanyl does to the body and why it is so dangerous, we’ll look at how it managed to spread so quickly through the country, and what the US authorities are trying to do about it.

[00:01:01] I should add that this episode is going to be followed by another standalone episode on San Francisco, a city that has been ravaged by fentanyl, so these two episodes will form quite a nice duo.

[00:01:17] OK then, let’s get right into it.

[00:01:21] In 1960 a Belgian pharmacist named Dr Paul Janssen developed a new kind of drug to relieve pain. 

[00:01:31] He called it fentanyl, and it was incredibly effective. Just a small dose was required to relax a patient and relieve pain. As a result, it was quickly adopted by the medical community as a way to relieve pain and suffering, especially for patients suffering from terminal conditions.

[00:01:56] And for many years fentanyl remained a tightly controlled drug used in a medical setting. Administered correctly it helped countless patients relieve pain and suffering.

[00:02:09] And when Dr Paul Janssen died in 2003 at the ripe old age of 77, his obituary mentioned fentanyl only once, it was practically an afterthought in a glowing career that included being awarded more than 100 patents and authoring more than 850 scientific papers. 

[00:02:34] Clearly, Dr Janssen was a talented scientist, but he died knowing very little about the true impact that his creation would have.

[00:02:45] It wouldn’t be until 2013, 10 years after Dr Janssen’s death, that illegally produced fentanyl burst onto the scene in the United States, and by 2016, just three years later, fentanyl had become a household name and the most deadly opiate in the country, killing more Americans than any other drug.

[00:03:10] Now it isn’t just the most deadly drug, a fentanyl overdose is the leading cause of death for Americans under the age of 45. 

[00:03:20] To put it another way, for any American who dies before their 46th birthday, a fentanyl overdose is the most common cause. 

[00:03:32] The problems started when fentanyl moved from being in the hands of trained medical professionals to the hands of criminals.

[00:03:41] See, in the right hands, produced in a medical setting and administered correctly, fentanyl isn’t particularly dangerous. 

[00:03:50] In fact, it has a relatively high what’s called “therapeutic index”, which is a medical term for the difference between the amount of a drug needed to have a positive medical effect and the amount that can be dangerous.

[00:04:05] In clinical conditions, fentanyl is normally administered via a patch or a nasal spray, where very small amounts of the drug go slowly into the bloodstream, so it is relatively safe.

[00:04:20] But the problems arise when it is produced and sold outside a clinical environment, and taken recreationally by people who don’t know exactly what it is they are putting into their bodies.

[00:04:34] See, the potency of fentanyl, its power, its strength, is around 50 times that of heroin and 100 times that of morphine. 

[00:04:46] Just two milligrams of fentanyl, like a couple of grains of salt, can kill a full-grown adult.

[00:04:54] It’s typically smoked, snorted, or injected, with injections being particularly dangerous because the user has very little idea about the strength of what they are putting directly into their bloodstream

[00:05:09] As one director of a police laboratory said, “You’re injecting yourself with a loaded gun.” 

[00:05:16] It has a similar effect to drugs like heroin or morphine, a rush, a high, a feeling of euphoria as the chemicals bind to the opioid receptors in the brain.

[00:05:28] It feels good, blocks out pain, and gives its users a temporary sense of happiness.

[00:05:36] But it is highly addictive, the high is shorter and more intense than other opiates like heroin, meaning it can completely consume its users lives.

[00:05:49] It appeared on the illegal drug scene in the US really in the mid 2010s to fill an existing demand for opiates. Increasing numbers of Americans had become addicted to prescription opioids and as there was a tightening of restrictions on who was prescribed opioids, an increasing number of opioid addicted people were left without any legal opportunities to feed their addiction.

[00:06:18] Heroin was one option, and the number of heroin addicts skyrocketed. But heroin isn’t cheap, and there was still stigma surrounding it from its association with the AIDS epidemic in the 1980s. 

[00:06:33] The stage was set for a new drug, one that could be produced cheaply, easily, and didn’t necessarily need to be injected.

[00:06:44] That drug was Fentanyl.

[00:06:46] It’s a completely synthetic opioid, meaning it can be produced in a laboratory and making it much cheaper to produce than other natural opiates like heroin or morphine.

[00:06:59] Heroin, on the other hand, needs to be harvested from poppies, processed, and transported often thousands of miles across land and smuggled in ships before it reaches its final destination.

[00:07:15] Illegal fentanyl is thought to have a much simpler supply chain.

[00:07:20] Initially, it was first produced in China, and then often sent via normal mail, in shipments of under 1 kilo, to the United States, where it would go almost directly onto the streets, and into the hands of addicts.

[00:07:35] 1 kilo of the drug can be bought for around $3,000 wholesale, and this 1 kilo, given how pure the drug is, would be enough fentanyl to kill 500,000 adults.

[00:07:51] After increasing pressure from the United States on the Chinese government, there has been a crackdown on fentanyl laboratories in China, and a subsequent reduction, or at least believed subsequent reduction, in the amount of Chinese-produced fentanyl arriving in the United States.

[00:08:09] But this crackdown opened the doors for Mexican cartels, which buy the chemicals required to produce fentanyl directly from Chinese suppliers and then produce the fentanyl in Mexico, before smuggling it northwards to the United States. 

[00:08:26] Given that it is so much more powerful than drugs like heroin or meth, it takes up a lot less space, so you might only need a small handbag to supply an entire city’s addicts with fentanyl for a month. 

[00:08:42] As you can see, the logistics of producing, transporting, and selling fentanyl are just so much simpler than other drugs.

[00:08:52] And the result of this is that it is very cheap for the end user, for the drug addict to get high. Indeed, a hit of fentanyl, enough to get a user high, or kill someone who isn’t used to it, typically costs just a few dollars, the same price as a cup of coffee.

[00:09:12] There are several effects of the drug being so cheap, effects that you will no doubt be able to anticipate, to guess. Firstly, it has increased the demand for it. As it’s so cheap, people can afford to take it frequently, and having enough money to pay for it is less of a problem than more expensive drugs.

[00:09:34] Secondly, it has meant that people have switched from other, comparatively safer opioids, from prescription drugs like OxyContin or even illegal drugs like heroin, to fentanyl. It’s stronger, it’s cheaper, and there’s more of it around.

[00:09:53] Thirdly, drug dealers often add fentanyl to other drugs precisely because it’s cheaper. From cocaine to methamphetamine, police are increasingly finding that dealers are cutting these more expensive drugs with fentanyl because they make more money and the end user still gets high.

[00:10:13] The result of all of this is that there are more and more people taking fentanyl, both knowingly and unknowingly

[00:10:22] And both cases are problematic.

[00:10:25] When someone buys illegal fentanyl, knowing it’s fentanyl, it’s very hard for them to know how strong it is. 2mg of fentanyl, which can be a fatal dose is, as we said, just like a couple of grains of sand, so it's very easy to accidentally overdose, or for a batch of fentanyl to be made too strong.

[00:10:48] This is dangerous enough for people who know they’re taking fentanyl, but it’s even more so for people who think they’re taking something else.

[00:10:58] For the heroin user who thinks he is taking heroin, if he takes a “normal” amount of what he thinks is heroin and it is in fact partly or completely fentanyl, it can be lethal.

[00:11:11] And even for people who think they are taking a completely different drug, not an opiate, they are increasingly fatally surprised to find it has been cut with fentanyl.

[00:11:23] There was a famous case in March of this year, March of 2022, where five young military cadets died on a spring break when they took what they thought was cocaine, but it was laced with fentanyl. 

[00:11:38] And an even more famous case of someone taking what he thought was another drug but it was in fact fentanyl was of the musician Prince. He thought he was taking Vicodin, a type of prescription painkiller, but it was actually a pill that had been laced with fentanyl. 

[00:11:57] He was found dead in an elevator six hours later.

[00:12:02] Fentanyl was no longer something that was restricted to people living on the street, people forgotten by mainstream society; it was something that drug dealers were putting everywhere, and the death toll was increasing.

[00:12:17] In 2003, when the inventor of fentanyl, Dr Janssen, died, there were only 1,400 fentanyl deaths in America compared to 2,080 from heroin. 

[00:12:31] In 2014, the year of the so-called “third wave” of fentanyl into the country, this had climbed to 5,544, in 2020 it had gone up 10 times again, to 56,516, and although the statistics haven’t yet been released, it looks like over 70,000 Americans died from a fentanyl overdose in 2021, so that’s almost 200 people every single day.

[00:13:03] Or to put another way, it’s 8 people an hour, so statistically during the time you’ve been listening to this episode, at least one person has died from a fentanyl overdose.

[00:13:16] And, to state the obvious, these are all human beings, sons, daughters, fathers, mothers, brothers and sisters, people who love and who are loved, people who, for one reason or another, have fallen into a cycle of addiction and paid the ultimate price for it.

[00:13:36] Because fentanyl addiction is so gripping, because it is so hard to escape, and because the drug is so cheap, fentanyl addiction is for many a one-way street, one which starts with a loss of family and a roof over your head and ends on the street, dead after an overdose.

[00:13:58] In terms of who is falling victim to fentanyl, it’s overwhelmingly a male problem, with men making up 73% of fentanyl deaths in 2020. 

[00:14:10] Although white Americans make up the majority of fentanyl deaths, it’s a drug that affects people of all ethnicities and ages, not all proportionally, not all to the same extent.

[00:14:23] In fact, the most at risk group is black men aged over 55, a group which is four times more likely to overdose on fentanyl than any other group.

[00:14:36] Of course, the drug doesn’t discriminate, but its potency and low price makes it the drug of choice for people who have hit rock bottom, people who are often struggling with homelessness, mental illness, and other forms of personal problems which are then compounded by falling into a cycle of fentanyl abuse.

[00:14:59] Now, with the country in the middle of this grip of addiction, what is actually happening, and what can be done about this?

[00:15:07] Well, in the next episode we’ll look at the specific case of San Francisco, a city that is practising a harm reduction approach, where the use of hard drugs including fentanyl has been effectively decriminalised. 

[00:15:23] But San Francisco is an anomaly, it’s unusual in this respect.

[00:15:28] The US government is, as you would expect, full of plenty of words, policies and ideas about how to solve the issue of fentanyl addiction. Its strategy is primarily based on stopping the supply of fentanyl in the first place, stopping the drug getting into the country, and taking it off the streets when it's there. 

[00:15:50] From cracking down on drug cartels to increased police presence on the streets to prosecuting dealers, the overall policy is in line with the country’s War on Drugs policy, the movement that started in the 1970s and advocates a total crackdown on drug trafficking and use.

[00:16:11] At least in terms of the number of people dying from fentanyl overdoses, it doesn’t look like it’s working. More and more people are dying, and there doesn’t seem to be any reversal in the trend.

[00:16:25] The problem is that fentanyl is pretty much the perfect drug from a drug trafficker’s point of view.

[00:16:33] You can produce it in a laboratory, meaning there’s no need for fields, farmers, the right weather, and it’s much easier to hide from the authorities than a large field.

[00:16:44] It’s incredibly powerful, which means that small volumes can be transported easily without customs officials realising.

[00:16:53] All this means that it can be sold very cheaply, thereby increasing the amount of people who are able to take it.

[00:17:01] The result of this is that it is an incredibly lucrative business to be in, the fentanyl business.

[00:17:09] A drug trafficker can buy or produce a kilo of the drug for around $3,000. This is enough to make half a million fentanyl pills, enough to kill 500,000 people who haven’t used the drug before, or get 500,000 experienced users high.

[00:17:28] If a pill is sold for only $4, this means the 1 kilo of fentanyl can be turned into $2 million of street fentanyl. Obviously, there are some costs involved, but you can see how much money is involved.

[00:17:45] The only problem with fentanyl, from the drug trafficker's point of view, is that it’s a drug that kills its users, although there seems to be no shortage of people who are willing to try it.

[00:17:57] All this being said, the problem of fentanyl is only one part of America’s opioid crisis, a subject which we covered in detail in episode 230. 

[00:18:08] It might be the most potent part, the most deadly part, and it is the drug that is responsible for the greatest number of deaths, but it is only one piece of the puzzle.

[00:18:20] After all, fentanyl emerged as a product to meet the demands of America’s increasingly addicted population. 

[00:18:28] After tens of millions of Americans first got hooked on prescription opioids, fentanyl was there as a cheaper, more powerful and more available alternative.

[00:18:40] The reality is, and even American officials have admitted as much, that fentanyl is so cheap to produce, so easy to transport, and so profitable to sell, that it will be incredibly difficult, nigh impossible, to completely eliminate from the streets of American cities.

[00:19:00] It might be destroying lives by their hundreds of thousands, but it is here to stay, and the sad reality is that there doesn’t seem to be any coherent plan to do anything about it.

[00:19:14] OK then, that is it for today's episode on Fentanyl, the drug devastating America.

[00:19:21] I hope it's been an interesting one, that you've learnt something new, and I’m sorry to not finish on a high note, so to speak, but when it comes to this particular subject there isn’t a huge amount of good news to report.

[00:19:35] As a reminder, next up we’ll be looking at what’s happening in San Francisco, a city that has been ravaged by fentanyl, and one where there were more deaths from fentanyl than COVID. So keep a look out for that one.

[00:19:50] As always, I would love to know what you thought of this episode. 

[00:19:53] Is fentanyl something that you’ve heard about in your country? 

[00:19:57] What do you think could, or should be done, about the issue of fentanyl in the United States? 

[00:20:02] Who is to blame? The pill-prescribing doctors, the drug traffickers, the people taking drugs, or is it a product of structural problems in American society?

[00:20:14] I would love to know, so let’s get this discussion started. You can head right into our community forum, which is at community.leonardoenglish.com and get chatting away to other curious minds.

[00:20:27] You've been listening to English Learning for Curious Minds, by Leonardo English.

[00:20:32] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.

[END OF EPISODE]