Man hand gives plastic packet with cocaine powder or another drugs. Drug dealer selling drugs junkie
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When most people think of the opioid crisis, fentanyl-laced heroin and other opiates come to mind. But a slew of states are reporting that fentanyl-laced cocaine deaths are on the rise. That’s terrifying not just because it broadens the scope of opioid related deaths, but also because fentanyl is the last thing someone who is using cocaine expects. This means education campaigns need to be retargeted to warn users the drugs they’re buying could be more dangerous and addictive than they know them to be.

Fentanyl is a painkiller that can be 50 times more powerful than heroin. It was found in over half of overdose deaths last year in ten states, according to the Centers for Disease Control. It’s not clear how many of those are cocaine related (as opposed to heroin), but CDC officials think the rising death toll has something to do with fentanyl being in more popular drugs. A new report found that people dying from all drugs increased 21.5 percent in 2016 with the biggest increase seen among cocaine users, where 2016 saw a 52 percent increase in deaths, compared to a 10 percent increase in opioid users.

Some states are worse than others, with Ohio, Rhode Island, and Washington D.C., seeing the most deaths. But others are reporting increased fentanyl-laced cocaine deaths, too.

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Connecticut, for example, reports that cocaine and fentanyl deaths have increased more than 420 percent in the last three years. In Massachusetts, cops recorded 199 samples of coke laced with the painkiller last year, which is three times as much as in 2016. It’s a very small amount of their cocaine seizures, but it’s happening. Delaware has also reported increased deaths due to fentanyl laced cocaine, along with Florida.

Jacksonville, Florida councilman Bill Gulliford told Florida Politics, “Cocaine laced with fentanyl is prevalent now. In recent toxicology reports, every sample of cocaine had fentanyl in it. The scary part of this is it’s becoming more widespread. There are incidents of this used in counterfeit Xanax.”

What’s alarming people is that, while there’s tons of education about heroin and opiates right now, a lot of people who might never use heroin would use cocaine, like college students trying to stay awake or middle-aged people trying to relive their youth on vacation. According to, the largest group of cocaine users are 18 to 25 years old and about 1.4 percent of them report using it within the last month.

According to the Drug Enforcement Agency, adding an opiate to cocaine is a common practice by drug dealers to create the effect of “speedballing,” though usually people who do that do so intentionally. The DEA, police officers, and drug users are reporting fentanyl overdoses in cocaine users who seemed to have no idea what they were getting into. Some researchers think it might just be sloppy work.

Boston Medical Center epidemiologist Traci Green told NPR that the fentanyl deaths she’s tracking don’t look intentional. “It’s more of a contamination model rather than one that is malicious or purposeful,” she said. Then again, there are others who think that adding the opiate to the coke is on purpose, so that more people get addicted and dealers can broaden their market. The one flaw in that theory, of course, is that someone who doesn’t have a tolerance to opiates might overdose with their first line, depending on the amount of fentanyl in it, so it’s not a perfect business model.

Either way, there is an increasing amount of fentanyl in cocaine, according to the experts, which means people should take extra precautions. Since drugs are addictive, it’s hard to tell people to just “stop,” but there are harm reduction methods, like testing the batch with easy to acquire strips, not doing drugs alone, and having naloxone, known as Narcan (available by prescription), on them at all times if they are serious drug users. Last spring, New York City Health Commissioner Dr. Mary T. Bassett issued a statement saying:

African Americans are especially at risk of fentanyl-laced cocaine deaths, as studies shows that they used as much cocaine as white people used heroin in the past years. If fentanyl-laced cocaine spreads, outreach needs to spread throughout all the various demographic communities. It’s not an opioid crisis, really, but an epidemic. On Thursday, Massachusetts Sen. Elizabeth Warren suggested that Congress treat the opioid crisis the same way they treated the HIV/AIDs crisis, “passing a modern version of the Ryan White CARE Act.”

That bill helped look past the stigma of HIV and being gay to hand out condoms and needle exchange programs to help people have safe sex. Back then, people assumed that if someone got HIV, it was their own fault for having risky sex or using drugs. There are similar stigmas attached to people who use narcotics, despite the fact that we know addiction is a disease and not some moral failing. A similar bill for the opioid crisis would include giving out free testing strips, naloxone, and offering free education and treatment for drug users.

While cities, states, and non-profits are already engaged in those efforts, a federal response has to come soon if the country really wants to stop people from overdosing and dying. Because the situation is obviously almost out of our control.