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Sam Quinones is a journalist and author whose latest book is The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth.

I recently met a woman who runs a shelter in Tennessee and has worked with the homeless for decades.

She was disheartened. There was a time, she told me, when we could help people recover from drugs and alcohol addiction through therapeutic intervention. This, in part, involved teaching life tools: how to prevent relapses, apply for jobs and rent apartments, recover drivers’ licenses and, above all, repair relationships with loved ones. It was hit and miss, but there was reason for optimism. “Recovery is possible” was the upbeat catchphrase.

Over the past few years in the United States, though, the drug stream has changed and social workers in homeless shelters such as hers have seen its graphic effects. Record overdose deaths grabbed the headlines – but it was more than that. People came to the shelter hallucinating, in full psychosis, terrified by unseen demons and stripped of personality that does not seem to return with sobriety. Many, she said, were so devastated by these drugs that they no longer had the mental capacity to use the tools they had been given.

It’s unclear to her whether this is the work of one drug – meth from Mexico, in particular, that began arriving in her region in unprecedented volume in 2017 – or that fentanyl is everywhere now, too. Or that so many folks on the street seem to use a variety of drugs, often at once. Or that so many in this situation also have long histories of trauma. Whatever the case, she fears that the people her shelter sees are never going to be able to overcome the physiological toll these substances have taken on their brains.

Canadians would do well to notice the warnings that are only now being recognized in the United States when it comes to the threat and complexity of the illegal drug pipeline. Increasingly, we are realizing that North America has quietly entered the era of synthetic drugs – those made in labs with chemicals, no plants involved.

The foundation of this change is the demand created by an unprecedented supply of opioid pain pills prescribed by doctors at the urging of drug companies over many years. Yet this is not the opioid epidemic. And it’s only secondarily about responding to demand.

The synthetic drug era is above all about what benefits traffickers. They can make, smuggle and sell synthetic drugs with less risk and far more profit. No need for land, sunshine, irrigation and farmers.

They need only access to shipping ports and, through them, world chemical markets. Through two ports on Mexico’s Pacific Coast, traffickers are making drugs – primarily fentanyl, an opioid, and methamphetamine, a stimulant – year-round, in staggering quantities. The unprecedented supply is creating demand in a way similar to what those overprescribed opioid painkillers did.

The U.S. drug stream is just about saturated with fentanyl and meth. Remarkably, even as Mexican meth is, for the first time, in every region of the U.S., its price has fallen 80 per cent or more in the past few years, according to conversations I’ve had with narcotics officers and addicts in several parts of the country. In Tennessee, one homeless addict told me, an ounce of meth cost US$1,250 five years ago; now it’s closer to US$225.

One tragedy of COVID-19 was that it hit just as the Mexican trafficking world had covered the United States with the two most dangerous street drugs we’ve ever known. This left addicts and those in recovery isolated and at enormous risk of death – in particular from fentanyl, a synthetic opioid far more potent than heroin. We were oblivious, focused on the virus, until November, when the Centers for Disease Control and Prevention announced that for the first time we had tallied 100,000 overdose deaths in a 12-month period: April, 2020, to April, 2021.

The onslaught is fuelled by the wild free market of producers in Mexico, by those imports of chemicals from around the world, by a criminal justice system crippled by corruption, and by guns bought easily in the U.S. and smuggled south.

The largest Mexican trafficking organizations – Sinaloa and Jalisco New Generation – make much of their money selling permissions to others to cook these drugs in their regions, along with the chemicals needed to do so. Drug-cartel sources and agents with the United States Drug Enforcement Administration (DEA) both tell me that in the past half dozen years labs have proliferated by the dozens, perhaps hundreds, in the states of west and northwest Mexico.

This unprecedented supply has changed the drug world.

I have been writing about the U.S. drug crisis for more than a decade. My reporting shows that Mexican traffickers had to shift the way they made methamphetamine about a dozen years ago. The new way relies on combinations of widely available, legal, industrial chemicals – and this is what has allowed the meth supplies we’re seeing. This meth has been accompanied by scary, rapid-onset symptoms of schizophrenia – florid hallucinations and severe paranoia – and, thus, homelessness, even in areas of the United States where housing prices are low and homelessness was rare.

Fentanyl, meanwhile, is so cheap and plentiful that for the first time in the history of drug use in the U.S. we’re seeing a street drug widely mixed into others, such as cocaine. By adding fentanyl a dealer can turn cocaine customers, who typically only buy occasionally, into opioid addicts who must buy daily to keep withdrawal sickness away.

But mixing potent fentanyl safely is a delicate task beyond the capacity of most traffickers and street dealers. This is part of what is fuelling our overdose-death numbers.

Production of “fentapills” – counterfeit Percocet, Xanax, Adderall and generic 30-milligram oxycodone pills that contain only fentanyl – has also increased geometrically since Mexican traffickers began making them in 2017. Police in Scottsdale, Ariz., seized a record 1.7 million such pills from a home in December, along with 10 kilograms of fentanyl powder. That’s more than the DEA reported seizing (1.2 million pills) in the Los Angeles metro area in all of 2020.

These supplies have solved the street dealer’s age-old dilemma: Where do I get my dope? Today, anybody can be a kingpin. One fellow I met in West Virginia once dealt grams of meth. After a decade away from the trade, he said, he returned and discovered four connections within 16 kilometres of his house who each would sell him 10 kilograms any day of the week That’s in a small West Virginia town 2,900 kilometres from the Mexican border.

So dealers have a new dilemma: Where do I sell all this supply, particularly during COVID-19 when everyone’s at home? They’ve turned to Snapchat, Instagram and other social-media apps. These are the new street corners, where kids with limited drug experience, living with their parents, buy from anonymous dealers (some still teenagers themselves) who offer home delivery.

All of which is to say that what’s been developing in our street-drug world as we’ve dealt with COVID-19 feels to me as much like a poisoning as a traditional problem of addiction. That’s what the homeless shelter director is seeing in Tennessee. And that’s what I’ve witnessed over the past few years.

I spoke with the sisters of Michael Tanner Jr., who struggled with cocaine addiction for a decade in Akron, Ohio, but died, in 2014, within months of dealers adding fentanyl to his drug of choice.

I spent time in Clarksburg, W.Va., population 16,000, which had no homeless people to speak of until the meth from Mexico arrived in unrelenting supplies in the spring of 2017. By 2018, Clarksburg’s downtown teemed with raving, meth-addicted and unhoused people, who took to stripping any house left vacant for more than a few days of everything that made it livable.

I attended a rally outside Snapchat headquarters in Santa Monica, Calif., held by parents whose kids had died from phony pills containing fentanyl sold to them by dealers advertising on the app.

We need to understand that the origin of all this is supply. If it’s true we can’t arrest our way out of this problem, it’s also true we can’t treat our way out of it, either – not while the drugs are this prevalent and dangerous. So any solution involves a mosaic of responses, which we’re not used to deploying in co-ordination: prevention first and foremost, but also expanding treatment and, absolutely, supply reduction, which is harm reduction in its most basic form.

We need to find the tools to work together as a continent. We have a North American agreement governing free trade. We need an agreement to address the vast harm done by unrelieved synthetic-drug production and the easy flow of smuggled guns.

I know the history of sensationalism surrounding street drugs. But the data, and street evidence, are clear. The myths that once swirled around drugs have become reality. As our attention was elsewhere, the era of risk-free recreational drug use slammed to an end. Even the most perfect-looking pill offered by a trusted friend can contain a deadly dose of fentanyl, and every hit is like a game of Russian roulette.

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