In his book Fentanyl, Inc., Ben Westhoff writes, “This is a topic about this generation of young people and the addiction problem with fentanyl, the most dangerous of the opioids.” The problem affects not only the individual, but everyone, especially families.

Jeff Sessions, former Attorney General under President Trump, when referencing the Fentanyl epidemic in 2018, said, “Today, we are facing the deadliest crisis in America’s history.”

How can we reach our young population who do not expect that this deadly drug is mixed with pills that look identical to those that are prescribed by a doctor? Pills are made to look identical to their prescribed counterparts such as Xanax for anxiety or Oxycontin for pain. These young people are not drug addicts but are using drugs that are given to them by friends, purchased online, or bought from dealers on the street and believe that what they are taking is not lethal. Young people are often very trusting of others, especially if they buy the drugs online or if they are given to them by a friend.

Initially, fentanyl was synthesized by Belgian chemist Paul Janssen in 1959, when experimenting with the chemical structure of morphine. It has been safely used as an anesthetic by licensed anesthesiologists replacing morphine that can cause some dramatic negative side effects. Dr. Phillip Demman from Providence St. Jude’s Hospital, said that the use of fentanyl in surgery is controlled by educated, professional anesthesiologists who administer a scientifically calculated amount and is manufactured within the United States under quality-controlled conditions. Fentanyl used in surgery has the benefit of controlling consistent pain levels during and after surgery and aids in quicker recovery than previous anesthesia. Orange County Health Care Agency (OCHCA) refers to this as the “good fentanyl.”

The “bad fentanyl” is made synthetically in labs by rogue chemists and is more powerful than plant-grown drugs. It is available over the Dark Web and advertised online on sites like TikTok and Snap Chat. It is difficult to trace the source of the drugs since people sometimes pay by crypto currency such as Bitcoin and the drugs can be delivered directly to the buyer’s home.

According to Westhoff, much of fentanyl sold on the streets in the United States comes from Mexico where it is imported from China. China produces 90% of the synthesized chemicals for fentanyl. The chemicals are processed and cut with impurities such as baking soda, rat poison, baby powder, etc., packaged by Mexican cartels then sent through the border crossings. This is big money for the cartels and drug wars between them led to more than 33,000 people murdered in Mexico in 2018. Greed and money have driven the sale of this drug as well as many others. One would think that the drug dealers who sell this illicit deadly drug would be mindful that they are losing customers.

In China, chemical companies are viewed as prestigious businesses. The financial incentives in China for chemical and pharmaceutical companies are direct financial support provided by the government with rebates as high as 16% sometimes with no taxes due. In China, many of these manufacturing labs are unclean with dirty and rusting equipment.

Purdue Pharma is partially responsible for fentanyl’s illicit rise. The owners and board majority of Purdue Pharma, the Sackler family, drove their salespeople to lie to doctors that the use of OxyContin for pain was not addictive. These salespeople pressured doctors to over-prescribe OxyContin to treat pain. Among those prescribed OxyContin were young people who sustained injuries from sports, but when the prescription ran out, they were forced to buy the drugs off the street to feed their addiction to relieve their pain. The Sacklers made over $14 billion from OxyContin alone, and Purdue Pharma, as with other pharmaceutical companies, was motivated by greed.

In April, I spoke with Dick Ackerman of Ackerman Consulting about opioids. He is working with a group of attorneys on litigation. He has represented the city of Fullerton, in addition to others, with mass tort lawsuits suing the pharmaceutical companies who have manufactured opioids. These cities and municipalities have suffered financially with arrests and trying to treat these victims with antidotes such as Narcan to save lives. Narcan is used on people who are overdosing to reverse the effect of opioids. Narcan is an expensive drug that cities are purchasing to provide to their departments. Part of the lawsuits against the drug companies responsible for producing opiates is to get some reimbursement for these additional costs.

Filing a single lawsuit can take years to get through the courts and the litigation process is expensive and time-consuming. The city of Fullerton joined a class action lawsuit two years ago. To put this in perspective, the tobacco lawsuits took approximately 15 years before there was a settlement and perhaps the city of Fullerton might not see any resolution until 2025 as a best guess. We need to do something about fentanyl now.