Synthetic drug wave deepens crisis across the US

Synthetic opioids are reshaping drug use across the United States. In Columbus, Ohio, a 48-year-old army veteran named Mike smokes fentanyl in an alley in the Linden neighbourhood. He has lived with opioid addiction for 20 years. A dose costs three or four dollars, and fentanyl is 50 to 100 times stronger than heroin. Supplies may also contain substances made in basements or bathtubs.

The danger is not limited to opioids. Xylazine and medetomidine—animal sedatives also known as tranq—can extend fentanyl’s effects, slow breathing and resist naloxone, the medicine used to reverse opioid overdoses. Xylazine can also cause severe skin ulcers. Naloxone helped reduce deaths after the United States recorded 110,000 overdose deaths in 2022, but fatalities later fell only to around 70,000 last year.

At Glenwood Church, the Hope Dealer Community supports people recovering from addiction. Its leader, Scott Sanders, said 78% of fatal overdoses in Franklin County during the last 12 months involved stimulants. Drug samples collected through the group’s work with the CDC found medetomidine in one of Mike’s samples. In Chicago, a dealer supplying fentanyl for Mexican cartels said his network remained active despite US efforts targeting the cartels and suspected traffickers. The accounts show how changing drug mixtures are affecting users, families and recovery services, while making overdoses harder to reverse.