Five West Point cadets are among six college students who overdosed March 10 on fentanyl-laced cocaine at a spring break rental home in Florida. 

Paramedics administered at the scene the overdose-reversal drug naloxone and rushed the students to local hospitals. As of Friday, two were still on ventilators and their condition listed as critical. When contacted by phone, the police department and the hospitals declined to give any update.

The incident burst into the news as a marker of the lethality of fentanyl and how it is now tainting not only opioids but also cocaine and other drugs. In a statement at the scene, a Fort Lauderdale Fire Department battalion chief said that two of the victims did not intentionally inhale the drug but overdosed from secondary fentanyl exposure while administering CPR.  

Incidental fentanyl poisoning is “extremely rare,” according to the American College of Medical Toxicology. The CEO of Burning Tree Programs recovery center, Peter Piraino, told the Sun that the probability of two cases at once is like “both hitting the lottery at the same time.” 

“Given my 30 years of law enforcement experience, fentanyl is probably the biggest national security threat and public health crisis I’ve ever seen,” the acting special agent in charge of the DEA’s New York Division, Tim Foley, tells The New York Sun.

On Friday, 18 Republican lawmakers sent an open letter to President Biden expressing “serious concern” over what they called his “failure of leadership” on the overdose crisis and for not mentioning fentanyl in his one-year press conference. “Is addressing fentanyl a top priority of your Administration?” the letter asked. 

Fentanyl usage is now the leading cause of death — more than Covid or automobile accidents — for Americans between the ages of 18 and 45, according to the CDC. A staggering 104,000 Americans died from drug overdoses between September 2020 and 2021, a nearly 30 percent increase from the year prior and the highest number ever recorded. Some 65 percent of these deaths involved fentanyl or a similar synthetic opioid. 

Unlike heroin or cocaine, fentanyl is manufactured entirely in a lab. It is 50 times stronger than heroin and 100 times more powerful than morphine. The precursor chemicals are made in China, then shipped to Mexico, where cartels turn them into fentanyl or fentanyl analogues to try to evade law enforcement.

With fentanyl, cartels don’t have to worry about a crop, or travel to Colombia or another country to obtain the base product, Agent Foley explains. Cartels then move the drug across the southern border or ship it to America through the mail.

“Fentanyl and synthetic drugs changed the whole landscape of drug trafficking,” Agent Foley says. He said it’s a battle “to keep up with the chemists.”

Fentanyl is easy to acquire in America. “I could sit down at a computer and show you how to get it” in 10 minutes, a former drug trafficker for a cartel told The Sun. The former trafficker has struggled with addiction for much of his adult life, and has worked in the drug trade on and off for decades. 

Dealers began lacing heroin with fentanyl 10 years ago, because it’s cheap, potent, and produces a similar high. “Mixed with heroin, it does double your profits or triple your profits,” the ex-trafficker explains. Now, he laments, “fentanyl is in everything.”

In February, five young adults died in a Commerce City, Colorado, apartment after snorting fentanyl-laced cocaine. In January, three dealers operating a drug delivery service in Manhattan were arrested for peddling fentanyl-laced cocaine that killed three people in one day last spring. In August, eight people overdosed from fentanyl-laced cocaine — six of them died — in separate incidents over three days on the North Fork of Long Island. 

The ex-trafficker explained that fentanyl is added to “low-grade” cocaine that’s “primarily cheap speed” in order to “level it out.” The fentanyl adds a euphoric, mellowing effect to the speed. It also makes the product physically addictive over time. The ex-trafficker said that long-term opiate users like himself “can tell” when fentanyl is in a pill or heroin or cocaine, but “a new user would not know.” 

The March 11 open letter, led by Representatives Brett Guthrie and Cathy McMorris-Rodgers, criticized the Biden administration’s focus on harm reduction measures like “safe smoking” kits, and asked about policies regarding fentanyl analogues. It also questioned Mr. Biden’s proposal to exempt fentanyl-related substances from quantity-based mandatory minimum sentences.

Harm reduction is the new political lightning rod in the opioid epidemic. The Biden administration has placed considerable emphasis on funding and expanding harm reduction and “evidence-based treatment,” while Republicans generally favor stricter border controls and a focus on interdiction. Republicans who supported harm reduction policies like syringe exchange during the Trump administration are now reversing course. 

The Biden administration has not responded to the letter, but a January White House press release stated the administration’s opposition to quantity-based mandatory minimum sentences for fentanyl and its analogues. It called for a “consensus approach” to reducing the fentanyl supply “while safeguarding against racial disparities in prosecution and sentencing and reducing barriers to scientific research for all Schedule I substances.”

Since the start of Covid, Agent Foley says, the DEA New York Division has seen less heroin and cocaine and more synthetic drugs like fentanyl and methamphetamine. Some 83 percent  of the heroin seized by the Northeast DEA since January 2022 contained fentanyl. Between  2020 and  2021, DEA seizures in New York of fentanyl powder increased 206 percent and seizures of counterfeit fentanyl pills increased 324 percent. 

The DEA is working on interdiction and has “ongoing investigations that involve cyber,” Agent Foley told The Sun. The Broward County Sheriff’s Office already made an arrest in the West Point cadets case. Yet fentanyl is easy to purchase online. Agent Foley said dealers also sell it through social media. 

In September, the DEA issued a public safety alert on “the alarming increase in the lethality and availability of fake prescription pills containing fentanyl.” One in four counterfeit prescription pills with fentanyl contain a potentially lethal dose, according to the DEA. Agent Foley thinks “the biggest thing we can do now is public awareness.”  The West Point cadets were just the latest in a recurring pattern of cluster overdose deaths from tainted cocaine. Drug experimentation in college — or any time — is more dangerous now, because of fentanyl.

“I don’t think the era of casual drug use is over,” Mr Piraino told the Sun, but “it is now more frequently leading to death.”