Ohio's overdose crisis has been heavily linked to the use of prescription painkillers or heroin, but it is not the case anymore. Health officials now warn historic levels of overdose deaths are being exacerbated by the availability of counterfeit pills laced with fentanyl, a potent and deadly synthetic drug.

Shabbir Imber Safdar, executive director of the Partnership for Safe Medicines, said fake pills are being sold as prescription painkillers such as OxyContin, the anxiety drug Xanax, and stimulant medications.

"There's a lot of young people who take Adderall, and they're not particularly careful about where they get their pills," Safdar pointed out. "I think we're going to see a rise in deaths in the 16-24 age range from fake Adderall made with fentanyl."

In May, two Ohio State University students died from suspected use of fake Adderall pills laced with fentanyl. Ohio is expected to report more than 5,200 overdose deaths for 2021, compared with just 327 in 1999.

Counterfeit medications are commonly sold through social media, on hidden sites on the "dark web" or in person by someone claiming they are real. Safdar noted an estimated four in 10 pills with fentanyl contains a potentially deadly dose.

"Even the first fake pill you ever take might kill you because if it has too much fentanyl, there's no time to get addicted, that first pill will kill you," Safdar stressed. "So it's really a game of Russian roulette when you take one of these pills that did not come from a pharmacy, which is the only safe source."

The Drug Enforcement Administration recently issued a Public Safety Alert about the rise in the lethality and availability of fake prescription pills containing fentanyl, and is encouraging people to only use prescription medications as directed by a medical professional and dispensed by a licensed pharmacist.

President Joe Biden is urging stricter penalties for drug smugglers to combat the fentanyl crisis nationwide. Meanwhile, North Carolina District Attorneys are focusing on local strategies to address the epidemic's effects in their communities.

In 2023 alone, an average of 12 people died every day from overdoses, according to North Carolina's Chief Medical Examiner.

Jeff Nieman, district attorney for Orange and Chatham counties, emphasizes the urgent need for action.

"What I see with fentanyl is a drug that accelerates the addictiveness and deadliness of substance use disorder," Nieman explained.

He argued there is a critical need for comprehensive strategies combining prevention, enhanced treatment options, and robust community support. On a federal level, the President will ask Congress for tougher penalties on drug traffickers and more regulations on substances related to fentanyl.

Todd Williams, district attorney for Buncombe County, echoes the need for a comprehensive approach. For him, it means intercepting fentanyl at the community level and holding traffickers accountable, while also expanding recovery services. Williams said he has already seen positive effects in his county through drug treatment courts.

"The program set up to provide for multiple chances at recovery," Williams emphasized. "All while ensuring that the offender is very well supervised and supported, and is not reoffending; not committing new crimes."

Both district attorneys touted the progress North Carolina has made, from creating a Fentanyl Task Force and passing an anti-money-laundering statute, to securing opioid settlement funds through Attorney General Josh Stein's office. Nieman stressed the measures are critical for supporting community efforts.

"He brought over $1 billion into the state of North Carolina," Nieman noted. "That's North Carolina in general, but the way that the settlement is structured, so that money is brought down to the local community, so that local leaders can decide how best to use that money to combat the crisis. That's key for us."

The Biden-Harris administration is also launching an "information partnership" with financial institutions, law enforcement and national security officials to crack down on drug trafficking and disrupt their means of financing.


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The most recent data from the group Trust for America's Health show overdoses and suicides remain at historic levels - despite a small decrease in 2022. But the findings for New Mexico are more encouraging than many other states.

Over the past two decades, said Brandon Reavis senior government relations manager for the Trust, said deaths from alcohol, drugs and suicide in the United States increased by 142%, from 74,000 in 2002 to almost 208,000 deaths in 2022.

"The report shows that in terms of combined deaths from alcohol, suicide and drug overdose, New Mexico is actually doing better than the national average," he said. "There was a 7% decline in the state, compared to a 1% decline across the country."

In contrast, he said, New Mexico has seen an increase in deaths from both fentanyl misuse and unintentional cocaine overdoses. While the combined rate of alcohol, drug and suicide deaths in 2022 was slightly lower for the first time in five years, it is still more than double what it was 20 years ago.

If you or someone you know is in crisis, call or text the National Suicide and Crisis Lifeline at 988.

New Mexico has had suicide prevention success using harm-reduction techniques, but Reavis said the state needs more oversight of insurance providers and sustainable funding for the 988 lifeline. He noted that the new data comes at a time when many groups are reporting more mental-health issues, especially among kids.

"New Mexico was near the bottom of the state rankings in terms of school mental-health services," she said, "so, surging resources and training for those types of services, I think, is really critical to achieving the kind of generational and foundational changes that we need here."

Suicide is often not preceded by warnings. New Mexico authorities believe there have been three suicides at the Rio Grande Gorge Bridge near Taos this year. Some community leaders say more bridge safety features are needed, but there are crisis hotline phones at the bridge, as well as an intervention security unit.


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Expanded treatment for opioid addiction is now available in New Mexico.

The state's Department of Health is offering medication-assisted treatment for opioid use disorder in four regions around the state.

Josh Swatek, harm reduction program manager for the New Mexico Department of Health, said medication to treat the addiction should help reduce opioid cravings.

"This is really designed to help reach some of the most rural communities, to really create a safety net," Swatek explained. "Folks have options for substance-use treatment in their local communities."

Swatek noted more than 2 million people in the U.S. have an opioid-use disorder. New Mexico previously offered outpatient disorder treatment in Las Cruces, Albuquerque and Roswell but has now expanded treatment to 30 public health offices. He pointed out in 2022, the state recorded slightly more than 700 deadly opioid overdoses.

Swatek emphasized his department is focused on harm reduction -- acknowledging people use drugs for a variety of reasons -- but can also live healthy, self-directed and purpose-filled lives by adopting specific strategies. He added research shows people are five times more likely to enter substance treatment programs and three-and-a-half times more likely to succeed if they have first participated in harm-reduction programs.

"We're working closely with the New Mexico department of corrections," Swatek stressed. "They're going to be required to offer substance-use treatment as well in their facilities, so that when folks are discharged there's a plan. No matter where they are in New Mexico, we can hopefully continue their treatment in a public health office, if need be."

Swatek acknowledged those struggling with addiction often are stigmatized by their community and harm-reduction programs can minimize risks until they're ready to take steps toward treatment or recovery. He observed some patients have told researchers telehealth has helped them have a greater sense of autonomy and control over their treatment.


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