- Published
Warning: This story contains descriptions of drug-taking from the start and discusses suicide
asserted
story → publish → suicide
The few grains of fentanyl sit in the silver foil as a straw, held between Mike's lips, hovers above; a cigarette lighter below.
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straw → sit → lips
The 48-year-old army veteran is crouched low in an alleyway in Columbus, Ohio's Linden neighbourhood.
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veteran → crouch → neighbourhood
"This drug will damn near make you do anything, unfortunately," he says.
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he → make → anything
The hit he's smoking cost three or four dollars.
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he → smoke → dollars
"You can snort too much and you can't take it back.
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you → snort → it
Can't call the bullet back," he says.
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he → call → bullet
He burns the foil and inhales.
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He → burn → foil
As the opioid takes hold, he grips the fence behind him.
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he → take → him
He sways as a low moan comes from deep in his throat; he could be humming a tune.
uncertain
he → sway → tune
We've spent a few days with Mike - he's been our guide through the neighbourhood's back streets.
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he → spend → streets
Everyone seems to know him and he's regarded fondly.
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he → seem → him
He helps out at a local pawn shop and gas station, and that's how he feeds his 20-year-old opioid addiction.
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he → help → addiction
Synthetic opioids are more powerful and in plentiful supply, and they have transformed the drugs landscape.
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they → transform → landscape
Fentanyl, which is entirely man-made, is 50 to 100 times more powerful than heroin, which is cultivated from poppies.
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which → make → poppies
It is now often cut with synthetic tranquillisers, which make reviving overdose victims more difficult.
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reviving → cut → victims
These are homemade threats, where cocktails of synthetics can be made in American basements and bathtubs.
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cocktails → make → basements
We have Naloxone (brand name Narcan) in our pockets, in case anyone on our team comes into contact with fentanyl or anyone around us overdoses.
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anyone → have → us
It's a nasal spray that immediately reverses opioid overdoses and its widespread adoption has transformed the number of fatal overdoses in the United States.
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adoption → reverse → States
At its peak in 2022, 110,000 Americans were dying from overdoses, mostly from opioids.
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Americans → die → opioids
The number has been dropping since, down to around 70,000 last year.
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number → drop → 70,000
But that doesn't mean the opioid crisis is over.
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crisis → mean → ?
It's likely that the reversal drug in my pocket, which has saved tens of thousands of drug users' lives, would not have worked on Mike.
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which → save → Mike
Because he wasn't just smoking fentanyl.
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he → smoke → fentanyl
The pupils in his milky blue eyes shrink to pin pricks.
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pupils → shrink → pricks
"Opioids make your pupils go smaller, but not that small," he says in a singsong voice.
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he → make → voice
Even the fentanyl, dangerous enough on its own, has other synthetics added.
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synthetics → have → own
When we ask what he thinks his drugs have been cut with, he replies: "Xylazine, and the one we can't pronounce."
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we → ask → Xylazine
Medetomidine, is what he means.
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he → mean → what
Like Xyalzine, it is also referred to as tranq and both are synthetic animal tranquilisers.
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both → refer → tranq
"Large animal tranquilisers," as one recovery expert told me.
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expert → tell → me
They help prolong the high from the fentanyl but are a sedative that slows breathing and, importantly, naloxone doesn't work against them.
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naloxone → help → them
Xylazine also causes necrotic skin ulcers, wounds so deep they can make it down to the bone and are difficult to treat.
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they → cause → bone
At the Glenwood Church on the other side of town, members of the Hope Dealer Community, a recovery group, gather for a weekly meeting.
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members → gather → meeting
For many, their struggles are written in their care-worn faces, and their eyes are those of survivors of a great trauma.
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eyes → write → trauma
They take to the stage at the front of the church and share their stories with a brutal and courageous honesty.
One man tells the story of his overdose in July 2022.
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man → take → July
Two paramedics worked on him, trying to save his life.
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paramedics → work → life
He had naloxone drips in both arms.
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He → have → arms
They hit him with the opioid reversal three times to no avail.
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They → hit → avail
"That's it, I'm gonna call it," said one of the medics.
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one → go → medics
…and 98 more, not listed.
The Aporia
