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Deaths from overdoses have jumped again — but this time a single drug may be to blame

fentanyl heroin
Bags of heroin, some laced with fentanyl, are displayed before a press conference regarding a major drug bust, at the office of the New York Attorney General. Drew Angerer/Getty

  • More Americans died from drug overdoses in 2016 than in any previous year.
  • Unlike other reported rises in overdose rates, this one seems tied to fentanyl — an opioid painkiller roughly 35 times stronger than heroin.
  • The drug is still legally prescribed for rare cases of severe pain, but most of the deaths are tied to illicit forms of the drug coming from China and Mexico.
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More Americans died from drug overdoses in 2016 than in any previous year, according to a report released Thursday from the Centers for Disease Control and Prevention.

More than 63,600 people were killed by opioid painkillers — 11,200 more than last year.

There's a clear standout drug in the picture: fentanyl, which is roughly 35 times stronger than heroin. That makes it a cheap substitute to put in fake pills sold illegally as brand-name painkillers like Norco, Percocet, and Xanax.

Fentanyl, which is mostly being manufactured in underground labs in China and Mexico, began making its way to the US in shipments disguised as office supplies around 2013. In the three years since, the number of overdose deaths involving fentanyl has skyrocketed at a rate that outpaces deaths from any other opioid, including heroin, hydrocodone, and oxycodone.

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BI Graphics_Drug overdose deaths in the US (1999–2016)
Business Insider / Samantha Lee

The death rate from those other opioids (light green in the chart above) has continued to rise too, albeit at a slightly slower pace. That could suggest that recent efforts aimed at curbing widespread over-prescribing practices could be having an impact.

Illicit fentanyl is hiding inside fake painkillers

tennessee fentanyl percocet
Seized fake Percocet pills that actually contain fentanyl. Tommy Farmer/Tennessee Bureau of Investigation via AP

Beginning in 2013, cops doing drug busts encountered a surprise: instead of finding illegal hydrocodone and oxycodone inside pills labeled Norco and Percocet, they found a much stronger drug: fentanyl.

Since fentanyl is so much more potent than other opioid painkillers, drug traffickers only need to pack their drugs with small amounts of it to provide users a powerful punch. But a tiny bit too much can be deadly.

Most of the illicit fentanyl that cops have seized appears to be coming from China and Mexico.

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Components from China make their way to Mexico, where drug makers fashion them into large quantities of deadly powder. Traffickers pack up the powder in boxes disguised with harmless labels and smuggle it into the US. In Southern California, authorities recently seized a group of boxes labeled as office supplies that were later found to be part of a drug manufacturing scheme. One of them contained a quarter-ton pill press — used to punch out pills — that had been labeled “hole puncher."

Between 2013 and 2014 drug busts that turned up fentanyl rose by 426%.

The US Drug Enforcement Administration may not have adequately prepared for the surge. In a 2015 report on national drug threats, DEA officials stated that fentanyl was "unlikely to assume a significant portion of the opioid market."

It appears that prediction was incorrect. Instead of decreasing or flat-lining, the rate of drug overdose deaths from fentanyl increased 88% every year between 2013 and 2016, according to the latest CDC data.

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But not everyone who takes the stronger pills is aware of what they're using.

Music legend Prince, who died last year from a fentanyl overdose, may have unwittingly taken the drug. Pills found in his home were labeled "Watson 385," a stamp used to identify some hydrocodone-based painkillers, but tests revealed that those pills contained fentanyl.

Last year, the news website Fusion anonymously interviewed fentanyl traffickers in Mexico, where a version of the drug is mixed into heroin and called "El Diablito," or the little devil.

"There’s almost nobody making pure heroin anymore, because El Diablito is so much stronger," one trafficker told Fusion.

Health Drugs CDC
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