TRANSCRIPT:
The Inside Story: The Fentanyl Threat
Episode 94 – June 1, 2023
NATASHA MOZGOVAYA, VOA Correspondent:
In 2019, the city of Sammamish, quiet community east of Seattle, was shocked by the death of two classmates from Skyline High School who died within a month from one another from an accidental Fentanyl overdose.
Olga Davidov-Beirer, teenage son Lucas died from Fentanyl overdose:
I lost my son Lucas in September 2019 to fentanyl. He was 16 year old. He was a junior in school and it was his supposed to be his first day after a summer break, He had actually appointment scheduled with his counselor, to talk about scholarship, because at that time he wanted to do something in space and then unfortunately he passed away. I found him totally unresponsive on Monday, 8 a.m.
NATASHA MOZGOVAYA:
Just a month earlier, Olga Davidov-Beirer and her son attended a funeral for Tom Beatty.
Olga Davidov-Beirer, teenage son Lucas died from Fentanyl overdose:
I talked to Lucas after funeral, even though I had no idea that Lucas buys pills. But I, I talked to him, and I said Lucas, I don't know what it is, because nobody was still saying about fentanyl. But I said, I want to make sure that I'm not a mom who loses a child.
NATASHA MOZGOVAYA:
Following sports-related back injury Lucas was doing prescribed physical therapy and occasionally taking Ibuprofen to deal with the pain - she had no idea he was buying illicit pills.
Olga Davidov-Beirer, teenage son Lucas died from Fentanyl overdose:
Now I had to say that all of a sudden Lucas passed away.
NATASHA MOZGOVAYA:
Her son became one of the eight teenagers who died in the King County in 2019
from opioid overdose.
The investigators concluded Lucas took what he thought to be Percocet – a powerful painkiller, but the pill was laced with a deadly dose of fentanyl.
Olga Davidov-Beirer, teenage son Lucas died from Fentanyl overdose:
I heard that from his friends - it must be fentanyl, must be fentanyl, and then when I started hearing, I'm like, what is fentanyl?
NATASHA MOZGOVAYA:
A lethal dose of fentanyl is as small as two milligrams. The year Lucas died, Seattle Police Department seized over 200,000 fentanyl pills, and the numbers keep growing, getting to over 750,000 pills in 2022. Jacob Galvan, Acting Special Agent in Charge of the Drug Enforcement Administration in Seattle, speaks about the alarming results of the laboratory tests.
Jacob Galvan, Drug Enforcement Administration:
We're seeing fentanyl in everything - not only the counterfeit pills, but we're seeing it in cocaine and methamphetamine. And again, all the counterfeit pills have it. What we see is that six out of 10 of these fake pills contain a lethal dose. You can't tell the difference between a real pill and a fake pill.
NATASHA MOZGOVAYA:
Since the teenagers’ deaths, educational programs were introduced in local schools, and Naloxone kits distributed to staff to treat accidental overdoses. Olga Davidov-Beirer, who leads these days an Early Bird Alliance initiative to provide families with resources about drug addiction, says it is an uphill battle.
Olga Davidov-Beirer, teenage son Lucas died from Fentanyl overdose:
I honestly can think it can happen to anyone. Just everyone needs to be aware that, well, these things are sold or distributed on the street, which might be a poison.
NATASHA MOZGOVAYA:
For the U.S. law enforcement agencies that are dealing with the opioid crisis in the country since the 1990s, Fentanyl poses a new kind of threat due to the simplicity of its production.
Jacob Galvan, Drug Enforcement Agency:
Cocaine is manufactured differently. It's grown. You need more infrastructure. You need more land. With fentanyl, these are just chemicals that are used to produce this. Precursor chemicals made in China are shipped to Mexico. Those chemicals are taken by the cartels, and they make the pills that are then ultimately smuggled into the U.S.
NATASHA MOZGOVAYA:
The drugs trafficking brings violence to the heart of urban communities. Illegally modified automatic weapons, hundreds of thousands of dollars in cash, and 27 kilograms of illicit fentanyl-laced pills were seized from a Seattle apartment in March as part of a nationwide law operation against synthetic opioids.
Homeland Security Seattle Lead Agent Robert Hammer said the drugs came from Mexico through the southwest state of Arizona, but China is the primary source of the precursor chemicals.
The White House says it is building a global coalition to “prevent illicit drug manufacturing, detect emerging drug threats, disrupt trafficking, address illicit finance, and respond to public safety and public health impacts.”
Joseph Biden, U.S. President:
By bolstering our work together in the North American drug dialog with Mexico and building on a new global coalition against synthetic opioids, we're working to get these killer drugs like fentanyl out of our communities.
NATASHA MOZGOVAYA:
Chinese Foreign Ministry spokesperson Mao Ning says there is no illegal fentanyl trafficking between China and Mexico.
Mao Ning, Chinese Foreign Ministry:
China has not received any notification from Mexico that it has seized controlled fentanyl precursors from China.”
NATASHA MOZGOVAYA:
Fentanyl is a shape shifter, which makes it elusive target. Some fake pills are made to look like their legitimate pharmaceutical counterparts. Others are dyed in rainbow colors to make them more attractive to younger customers. The newest version of fentanyl is coming to Washington state in a powder form. Agent Galvan says social media companies should be held more accountable for identifying drugs promotion on their platforms.
Jacob Galvan, Drug Enforcement Administration:
The cartels, they've mastered social media. They use social media as the avenue to get these into communities and to people. They use different codes. They use emojis as different codes. Your conversation can just be a series of emojis of what you want, how much it is, where to meet and that.
NATASHA MOZGOVAYA:
With the risk of overdose so great, why would drug cartels sell fentanyl-laced pills that could kill their clients?
Jacob Galvan, Drug Enforcement Administration:
What people don't understand is that the cartels are concerned with one thing and that's just making money, and they don't care about who they harm who they kill as long as they keep making money. And with the social media because they're able to access millions of people, they'll take that risk.
NATASHA MOZGOVAYA:
In Western Washington state, from 2018 to 2022 the amount of Fentanyl seized by the DEA increased by 2,206%, but the US attorney Nick Brown urges to be realistic about curbing the threat.
Nick Brown, U.S. Attorney, Western Washington District:
Fighting cartels is an ongoing effort. And you know, we don't want to get too far ahead of ourselves and talk about dismantling. We're really focused on doing everything we can to disrupt these organizations. Any time that you can arrest as many people and charge as many people as we have across the country it's going to have an impact.
NATASHA MOZGOVAYA:
While the law enforcement representatives admit they focus on stopping the heavy dealers, city residents are worried for safety from drug users. On a Third avenue in Seattle downtown, drug-related offenses rose 40% in 2019-2022, and despite the efforts to relocate the addicts from tent encampments to appropriate shelters, scenes like this – an ambulance responding to address an emergency at the hot spot of drugs sales right next to the bus stop – are still frequent.
In Ballard neighborhood, reopening this public park that has been closed for over a year for restoration following the forceful removal of homeless encampment, has been met with mixed feelings.
Melissa Wax, Seattle resident:
I was very nervous actually watching the fences come down this morning because I just - you know, the length of time that we lived with what was going on here was really hard.
NATASHA MOZGOVAYA:
Melissa Wax lives across the street from the park.
Melissa Wax, Seattle resident:
People were dying in the park, I saw people being dragged out in body bags, and just fires and explosions and drug abuse and fights. And as a parent with two kids that walk to school right through here too it was like terrifying.
NATASHA MOZGOVAYA:
Among the local families, performers, and businesses that came to celebrate park reopening there were protesters.
Stop the Sweeps activists:
Seventeen people died in this district. That is disturbing.
NATASHA MOZGOVAYA:
2022 was a record-breaking year with 310 homeless deaths in the King county, with fentanyl overdoses leading the charts. Councilmember Dan Strauss says the local authorities are better equipped to deal with the crisis now than at the beginning of the COVID-19 pandemic.
Dan Strauss, Seattle City Council member:
We've got the Unified Care Team and the Regional Homelessness Authority operational within our city which was not in place in 2020. And the Unified Care Team is expanding to neighborhood-based models so that we can scale our response to the level of the crisis.
NATASHA MOZGOVAYA:
Scattered on the pavement surrounding the Ballard Commons Park and in front of the adjacent public library, there are dozens of bronze leaves, with names and dates of life of homeless people from the area, including one commemorating Christy Hughes who, according to the Leaves of Remembrance obituary, died of an overdose in a tent in August 2020.
Dr. Nathan Kittle, addiction specialist, HealthPoint:
Take too much of an opioid and it suppresses your desire to breathe in your body. And so, people just stop breathing and that's what leads to death. We see pockets of overdoses happening from a, you know, a bad batch of fentanyl pills. There's more varieties that are out there now but made still to look like common brand name pain pills. And so, they look like an Oxycodone pill that someone would get from a pharmacy and so, sadly what we're seeing is that a lot of people who maybe aren't used to using opioids either are thinking they're getting a pain pill from a friend, and it ends up being fentanyl and then they end up having an overdose.
NATASHA MOZGOVAYA:
Doug DeJoe says what gives him hope is seeing people turn their lives around. He was one of them. Former English teacher and songwriter from Nashville, Tennessee, he got addicted to opioids following his cancer treatment health complications and opioid prescription.
Doug DeJoe, Community Health Outreach Worker, Tacoma Needle Exchange:
At that time they were they were prescribing that stuff pretty regularly and telling you that you know it's not addictive, it will help you. And then it gets to the point where you just don't go anywhere, and you don't do anything except lay up in the bed and watch TV and get high.
Brad Finegood, Behavioral Health Strategic Advisor with Public Health, Seattle & King County:
As the valve, as you will say, got cut off for inappropriate prescribing of prescription drugs, it created this – basically, this void in the marketplace. And what we saw was all of a sudden, these counterfeit drugs come into our system.
NATASHA MOZGOVAYA:
In summer 2021 Lupe Hurtado started working as a peer counselor with the Tacoma Needle Exchange, community-based program that was established in 1988 with the goal to prevent infections associated with injection drug use by providing people with addiction clean syringes. The first person she was trying to help died from an overdose.
Lupe Hurtado, Peer Care Navigator, Tacoma Needle Exchange:
He was a veteran and he told me a lot of stories. And I was helping him get stabilized on Suboxone. I lost contact with him. We have a board in the front of where people can put pictures and mementos of people they've lost to overdose, and I saw his picture on the board and it was really hard to deal with.
NATASHA MOZGOVAYA:
In 2021, Washington state’s Pierce County recorded nearly four times Fentanyl-related deaths as 2019. In the first half of 2022, there was another increase of 80% in synthetic opioids fatal overdoses. Following the drugs’ market switch to Fentanyl that is taken as pills or smoked, the Needle exchange staff saw new requests: for medicine that rapidly reverses an opioid overdose.
Stephanie Prohaska, Director of Operations, Tacoma Needle Exchange:
Lots of Naloxone, we've seen a lot more overdoses and we've seen a decrease in syringes.
NATASHA MOZGOVAYA:
Tacoma Needle Exchange team retrofitted a van to provide supplies for homeless encampments around the city of Tacoma and for tribal outreach.
Stephanie Prohaska, Director of Operations, Tacoma Needle Exchange:
So, we load it up with supplies and we have drawers here - safe sex items, cotton, cookers, ties torniquets, socks, wound care kits, toothbrush, toothpaste, internal condoms, - and then drive it to the site and we will sit here with it and offer supplies to people out of it.
NATASHA MOZGOVAYA:
Critics of the program are saying that making the addicts’ life more comfortable reduces the motivation to start rehabilitation. Needle Exchange staff cite research that found that offering help without judgement brings people with substance addiction into the orbit of social services.
Doug DeJoe, Community Health Outreach Worker, Tacoma Needle Exchange:
These people at a bare minimum deserve a human connection, somebody to care for their health and well-being. And that's what we do.
NATASHA MOZGOVAYA:
Doug DeJoe says that with fentanyl the chance for timely intervention may not be there.
Doug DeJoe, Community Health Outreach Worker, Tacoma Needle Exchange:
I really don't know where this is going but it's scary because people are just dropping.
NATASHA MOZGOVAYA:
All parts of U.S. society are touched by fentanyl addiction.
Jacob Galvan, Drug Enforcement Administration:
We see it in rural. We see it in inner cities. We see it in any race, any gender – it’s affected.
NATASHA MOZGOVAYA:
There are communities hit harder than others.
Brad Finegood, Seattle & King County Public Health Department:
Really there are communities of color that are disproportionately impacted by overdose, that fentanyl has really exacerbated some of those disparities. Specifically American Indian, Alaska Natives, black individuals and LatinX individuals have experienced disproportionate impact.
Lupe Hurtado:
It kind of made me feel even more as a target.
I felt like I was more exposed as a person of color.
I just didn't like to be sober, I, you know, felt like me as myself was not enough. I felt like drugs gave me an emotional buffer to deal with physical pain, emotional pain, the traumas I've been through in my life.
I lost my apartment. I got evicted. I lost my job, and I was homeless. I also worked as a sex worker. That's how I sustained my habit and was able to survive.
NATASHA MOZGOVAYA:
Loss of custody for her older son and a new pregnancy convinced Lupe to seek treatment.
Lupe Hurtado, Peer Care Navigator, Tacoma Needle Exchange:
I was on Suboxone throughout my whole pregnancy. My son was born and he was healthy and I continued to use Suboxone and I go to therapy, I help others. That's how I stay sober. And you know what? Last three months I got custody of my older son back. So, you know, there's been a lot of amazing changes that have happened in my life, and also working here. I feel like it gives me purpose to be of service to other people who need help.
NATASHA MOZGOVAYA:
Lupe says that her own experience helps her empathize with those who face similar challenges.
Lupe Hurtado, Peer Care Navigator, Tacoma Needle Exchange:
Stigma in some ways equals death for some people. Overdose, especially with Fentanyl, is like the number one accidental death - cause of accidental death in Pierce County. People feel ashamed about their drug use. Thus they use alone. And when you're alone using, you can't save yourself from an overdose. Narcan saves people's lives, but it has someone has to give you Narcan. It's not something you can give yourself.
Stephanie Prohaska, Director of Operations, Tacoma Needle Exchange:
We don't know how long Fentanyl is going to be around. We don't know what the next drug is going to be and we don't know what the next drug after that is going to be, things come in waves and they affect people differently.
NATASHA MOZGOVAYA:
In hope to lower the numbers of fatal Fentanyl overdoses, Naloxone boxes provided by the Needle exchange program are being installed next to the first aid kits in Tacoma public institutions.
Gabby Fuentes, Manager, Tacoma Public Library:
You just hold it like this, you don’t want to drop it because it can deploy the spray, but it’s not harmful if it gets deployed – you just have to start again with another one.
NATASHA MOZGOVAYA:
Tacoma public library staff in Washington state learned a new skill – how to administer Naloxone – a drug that can temporarily reverse opioid overdose. And a new vending machine allowing patrons to get Naloxone for free joins the hot coffee and the COVID tests that library offers these days as part of its services.
Tony Sonsteng, Library Associate:
I'd like to think that I would be able to do it but I might need to find somebody else to support me if I needed it.
We were a little bit nervous at first just to see what people's reactions were going to be…
Jasmine Matthews, Tacoma resident:
It’s a community hub it’s a place for people to gather, and so just the ideal place for something like that, ‘cause you never know who is going to walk through the door and who is going to need, you know, help.
McKayla, Tacoma resident:
Putting it up in a public space, in a vicinity of public, it’s like letting know that it’s OK to do it in a public place while you're smoking and stuff like OD'ing in the bathroom - they are saying, go ahead. I carry NARCAN on me because I have friends that do it but I don’t think it should go in public places, because there are kids in this place and stuff.
NATASHA MOZGOVAYA:
Gabby Fuentes, library’s manager, says opioid crisis is the reality the community is dealing with.
Gabby Fuentes, Tacoma Public Library Manager:
Things have changed so much in the pandemic for our community. We've seen more poverty. We've seen more drug use. We've seen overdose deaths. So, for us to fill that information and resource need, it was a clear next step for us to move into this partnership with the Needle Exchange and provide that resource to our community directly.
A lot of people have reached out to us to say they've lost family members to addiction recently and that just knowing that they have the tool to be able to prevent the death like that has just been so important to our community.
NATASHA MOZGOVAYA:
Healthcare experts believe that making Naloxone more accessible to the public could prevent scores of deaths from overdose.
Dr Caleb Banta Green, Director for the Center for Community Engaged Drug Education Epidemiology Research, University of Washington:
There's good evidence- we keep seeing over and over and over again - that of all of the populations you want to make sure have Naloxone it's people who use opioids and or those who are friends and family and loved ones of them, they're most likely to see an overdose and most likely to see the greatest number of overdoses.
NATASHA MOZGOVAYA:
For unsheltered people, there might be no one around when Narcan could save their lives.
Kent Hay, Auburn Homeless outreach administrator:
The worst is to find somebody dead, because that's you know, that's the end game.
NATASHA MOZGOVAYA:
In the suburban and rural communities, homelessness coupled with drug addiction can be less visible than in the big cities. For Kent Hay, homeless outreach director in Auburn, a city of 78,000 people south of Seattle, it means daily walks trying to convince people living in the parks and in the woods to get treatment and shelter.
Kent Hay:
Elizabeth!
Elizabeth, homeless:
Who is this?
Kent Hay:
It’s Kent.
NATASHA MOZGOVAYA:
Kent Hay has been coming to this encampment by the Green River for more than two years.
Elizabeth:
I need to get this done. OK.
Kent Hay:
Yeah.
Elizabeth:
All right.
NATASHA MOZGOVAYA:
When homelessness is coupled with drug abuse, moving people to shelters is a challenge.
Kent Hay, Auburn Homeless outreach administrator:
It's hard to get those people to participate in any treatment. I just had a guy - I took him to get on Suboxone treatment. We've been working together for a while and he'll disappear, you know he'll do some things and then disappear.
NATASHA MOZGOVAYA:
Some will find themselves on the streets again and again - after violating shelters’ rules.
Kent Hay, Auburn Homeless outreach administrator:
The majority of people who come out here don’t have just one problem. It’s chemical dependency and mental health, it’s mental health and CPS (Child Protective Services,) it’s CPS and just like the guy we saw, court orders and court conditions.
NATASHA MOZGOVAYA:
Addressing the combined challenges of drug addiction and homeless can be politically polarizing. King County Councilmember Sarah Perry says the solution requires response on multiple levels, including community involvement.
Sarah Perry, King County Councilmember:
These are our people. They come from our zip codes. They stay in our zip codes. These are our kids and our parents and our siblings and our cousins. They can't just go away somewhere. We have to own this together and do the right thing so everyone has a safe place to live and everybody feels safe walking around.
NATASHA MOZGOVAYA:
Letting addicts decide when they are ready for treatment is inhumane, says former county councilmember Kathy Lambert. She wants mandatory in-patient rehab.
Kathy Lambert, Former King County Councilmember:
I know in the very beginning that you don't want to be there and that's fine. But two or three weeks later, when you have the alcohol or the drugs out of your system, all of a sudden you see things very differently and very clearly. And that's what these people need. They need a place where they are essentially forced to use their time to get their bodies cleaned up so that they can make good decisions. And like anybody else, if you walked along the street you saw somebody having an appendicitis attack, you don't say to them, I'll take care of you when you're ready. You immediately scooped them up and get them services. That's what's needed here.
NATASHA MOZGOVAYA:
Unlike other chronic conditions, drugs use is often seen as an easy choice, which can be far from some people’s reality. Mia Pridemore says she started using drugs at 15.
Mia Pridemore:
My parents were drug addicts and my whole family was drug addicts, and it was accepted. It was so it was just it was almost expected, and it was like it was just the way of life. It was just the way my grandparents, everybody around me was doing it. And so, I wasn't normal if I didn't.
Brad Finegood, Seattle & King County Public Health Department:
The more exposure a person has to an adverse childhood experience, or some type of trauma makes them much more susceptible to developing some type of substance use disorder or some type of addiction down the line. If we can provide the right support for people, then people can heal and people can get better. If what we're doing retraumatizes people, causes people more pain, then we're going to be in this cycle of not being able to heal as a community and not being able to work with the people who are struggling to heal.
NATASHA MOZGOVAYA:
At the University of Washington’s Center for Community Engaged Drug Education Research, Dr. Caleb Banta-Green says improving social and medical services is more effective and less damaging than mandatory treatment.
Caleb Banta-Green, University of Washington:
Your risk of overdose when you come out is dramatic. Arrests are not benign. They impact people's education opportunities, work opportunities, housing opportunities. They are not benign, they are harmful. And so before we start trying to force people to treatment, what I would argue is why don't we make far better treatment services that people actually want? Because when we do, they line up for it.
NATASHA MOZGOVAYA:
For Mia Pridemore and her boyfriend Thomas Carpino it took over 6 months to get the treatment and move to the subsidized housing.
Mia Pridemore:
I knew I needed to get off the pills because it was either jail or death. You know, all my friends around me were dying from it.
Thomas Carpino:
I was looking at myself as more like a death dealer, dealing out the pills, and after losing family members to them, I’ve seen the ugliness to them, and I didn't want to sell them no more. But I was addicted to them so I couldn't stop doing them.
NATASHA MOZGOVAYA:
Brad Finegood, Behavioral Health Advisor for the Seattle & King County Public Health Department, says fentanyl is 50 times more powerful than heroin.
Brad Finegood, Seattle & King County Public Health Department:
One of the big differences between fentanyl and other drugs is it has such a short half-life. So it's so powerful and it has such a short half-life that it goes in and out of people's system so quick. After a while people aren't using because they want to get high. People are using because the withdrawal symptoms are so severe, to keep themselves from getting sick.
NATASHA MOZGOVAYA:
Pridemore and Carpino say they were able to hold jobs while abusing other drugs. With Fentanyl, it was impossible.
Mia Pridemore:
It takes you over, it's like, you don't care about anything else but your next fix. You know, I had a nice car, and I had, you know, we had a home and it's like I lost all those things because all I cared about was my next fix.
NATASHA MOZGOVAYA:
They moved 230 kilometers from the town of Yakima to Auburn that took pro-active approach in dealing with opioid crisis, establishing walk-in clinics for patients suffering from substance addiction.
Dr. Nathan Kittle, HealthPoint:
It's pretty challenging to switch over from Fentanyl to Buprenorphine, which is the medication that I prescribe here in the clinic. With other opioids prior to Fentanyl that switch could happen pretty easily within a day.
NATASHA MOZGOVAYA:
For some addicts, Kittle says recovery will be continued medication, akin to insulin for diabetics. Others addicts, he says, make other choices.
Dr. Nathan Kittle:
There are people who can make lifestyle changes, can change their habits, can change the people that are around, can change the environment they're around, and maybe the medicine's good for a year or two. And then they can kind of come off of it because the rest of their life has improved so much.
NATASHA MOZGOVAYA:
With monthly injections of buprenorphine, Pridemore and Carpino say they are feeling hopeful for the first time in years.
Mia Pridemore:
I'm not on the streets anymore. (crying) I have a home I have a roof over my head where I can take showers every day and sleep in my bed every night and warm meals every day. And I look forward to getting a job and staying clean.
Thomas Carpino:
It was like I couldn't live life. It had its hold on me and there was no getting out of it. I think now just waking up not being on pills is a relief.
NATASHA MOZGOVAYA:
The National Institute on Drug Abuse estimates that the relapse rate for opioid addiction is between 40 and 60 percent.
Kent Hay, Auburn Homeless outreach administrator:
It’s hard to follow through. The follow through is the issue.
NATASHA MOZGOVAYA:
In his 2024 budget request to Congress, President Biden called for $46.1 billion investment for National Drug Control Program agencies. It may help to curb the opioid surge – yet while there is the lethal drug’s supply – and demand, be it curious teenagers or people self-medicating to overcome traumas, outreach workers such as Kent Hay will likely keep walking, meeting those suffering from addiction where they are and trying to get them help.
###
