I had spent some time pondering what this first blogpost would be about. I wanted to write about something that mattered; something important so you would take me seriously. Maybe a tech or philosophy piece; I had every intention to start this year strong, you see. And then last Friday a friend of mine died—there is a weight that is squashing all of my insides. It is quite subdued, I am not one to be hysterical. For almost a week I have been waiting for my insides to start feeling normal again so I could come up with something to put on the page; by today I realized if I didn’t write about this and start anew I wouldn’t know how to write about anything else anytime soon. Even as an inaugural matter, at this moment this is all that feels worthwhile.
It was fentanyl, and so it would be filed in the government's statistics under “opioid-related fatal overdose”. I don’t know about all the other cases of opioid-related fatalities, but in this case the use of the word “overdose” feels particularly agitating; it makes it feel like we mean “he did too much,” like he knew better or something, when he had really been poisoned. He didn’t choose to do any fentanyl or opiates whatsoever. Whatever he did mean to do— which manages to sound a bit more spiritual, wholesome, and hip, if you could imagine that— happened to be laced with a lethal amount of the synthetic drug that ultimately killed him. I understand that street drugs are generally known to be risky, but I would resent any suggestion that my friend had somehow assumed the fentanyl risk. The assumption of any kind of opioid overdose risk seems to only make sense for someone who intentionally consumes opioid. I know most people don't do drugs with the intention of dying. That is, for the most part, people don’t mean for their dosing of any drug to be actually lethal even if they deliberately consume what is considered "a lethal dose". But then still, opioids are opioids, and everything else is— well, something different. One doesn’t assume the risk of an opioid overdose from eating a bag of gummy bears even if there have been gummy bears found laced with fentanyl.[1] I am not trying to be obtuse; at the end of the day it just feels unfair that there is not prominently a separate statistical category clarifying whom the people were who, in fact, did not know any better. Where is the CDC chart of fentanyl poisoning numbers?
Every week, more than 1,500 Americans die from taking some type of opioid, with illicit fentanyl being the primary cause.[2] In 2021, the total casualty from synthetic opioids (primarily fentanyl) in the U.S. was 80,411 people, more than ten times the number of U.S. military service members killed in Iraq and Afghanistan post-9/11.[3] These are jarring statistics. When you read numbers like these, you get an idea of the scale of what you already knew to be a serious problem in our country. It’s just that to me, the opioid epidemic was supposed to be something that only concerned me in the abstract, through its economic consequences calculated in relation to the entire country’s GDP, or impacts to the general population analyzed by demographic terms. I had only known the opioid epidemic to be something that happened to other people’s loved ones. When they found my friend, he was with his best friend, who was a partner at a biglaw firm. This detail came up multiple times as the bad news was delivered to me. “Biglaw”, when spelled as one word, first and foremost means the person makes a lot of money. It generally also means they got good grades from a reputable law school, and are on the upper side of, or at least making their way up, the echelons of society. In the case of my friend’s and his friend’s unforeseen deaths, the word “biglaw” also subtly meant that the victims were not the kind of people who normally suffered from fentanyl overdoses. It meant of all people they should have somehow been spared.
Months ago, I had a discussion with another friend about fentanyl. He was convinced that drug dealers intentionally laced all drugs, opioids or otherwise, with fentanyl to exacerbate addiction in their customers so as to increase demand across the board. There have been accounts suggesting that at least some drug dealers engage in this practice with cocaine and counterfeit pills.[4] Drug-dealing seems a pretty lucrative business to begin with, why introduce such a high level of additional risk? Naturally, “greed” can be boundless and would be the answer. Perhaps the consequence of trafficking and distributing other drugs is already so severe that the fentanyl only makes a marginal difference on top for those depraved enough.
At the time, I was dubious as I am now. Hanlon’s razor goes, “never attribute to malice that which is adequately explained by stupidity.” I can be quite naïve, and I do like to think that drug dealers are smart enough to know marginal profits are not worth actual human lives. I once looked up what a lethal dose of fentanyl looks like[5]—just two milligrams of fentanyl is considered a lethal dose, which is equal to three grains[6], or five to seven grains[7], or 10-15 grains[8] of table salt, depending on your source. The point is, it doesn’t take all too much fentanyl at all to kill a person, big or small. From 2011 to 2020, opioid prescriptions decreased by 44.4%.[9] In turn, reduced prescription availability correlates positively with heroin usage.[10] It has been my theory that, as doctors held back prescriptions, drug traffickers and dealers have been seeing such steady rise in demands for heroin that they have simply grown sloppy. It feels probable to me that drug dealers mean to lace only heroin with fentanyl as a sales tactic (drugs of the same family, at least), and in handling other non-opioid substances, they just happen to accidentally cross-contaminate those products with fentanyl. Something around three to 15 grains of table salt’s worth of fentanyl is within plausible (but never justifiable, make no mistake) margins of error to the naked eye. I know how futile all of this sounds to you; but it is important for me to think that if it had come down to someone’s conscious decision whether to deliberately include fentanyl in the batch of non-opioid drugs that ultimately made it into my friend’s hands, they would have decided against inclusion knowing that even a minuscule amount could cost lives when it comes to normally non-opioid users. It is important for me to further think that if they knew somewhere downstream of their actions two people wound up dead, at a minimum they would never sleep again for as long as they go on to live.
This piece is clearly not a eulogy. You didn’t know my friend; all that is heartfelt I save for his friends and family. I write about this here because there is nobody else to tell. To start, death happens to be an awful buzzkill to anyone unaffected; the affected have their own heartbreaks to worry about. Surviving someone else’s death is also a complex feeling; there is a whole world in it worth exploring, and whole worlds tend to take up hours. For example, I have only known this experience to be inexplicably lonely. You are the sole holder of your relationship with any given living thing; it doesn’t exist anywhere else, not even in that other being. Other people may come close to understanding how we feel, but it is so important to understand that in the end we are all in this alone together. No matter how impactful you are, no matter how much good you do and how many people love and remember you, eventually you and all that is about you will fade away, because the people who love and remember you and the people who know your impact, then the people who come after them too, will sooner or later fade into cosmic oblivion.
I had declared on New Year’s Eve that in the new year I would finally make myself fall in love, hell or high water. The big butterflies— the abnormally high-stakes big fireworks in your stomach— they have recently come and gone again already. The newfound fleetingness of life now makes any such further sprightly pursuits all a little silly. I've already been there a few times, done that, and seen what it looks like, in which case I concluded that moving forward I might as well focus all my energy on falling in love with whichever next arbitrary person was who made practical sense. Conceivably, I could be held when I find myself this lonely and low again, by somebody who means it no less.
“This perfectly nice boy as good as any other anyway.” I told my other friend, Bob.
“It is kind of like saying you will marry whomever the next random person is to come through the door. The hell with it!”
My friend who died, a radiant and loving person, would have been mortified if he were to remotely come under the impression that his death would suddenly render “love” as a grandiose concept all meaningless to me. It obviously would never, not in so dramatic a way, anyway. But these past few days I did come to consider: if you could manage surviving someone’s death, what’s a little lack of fireworks in life? At least you live. One day I see God on the dance floor, the next day I think about God letting lost souls snort fentanyl to death. Why put yourself through all the hardship just to feel swept up, when people you love can die of something so pointless, when everything you want and everything you are after will at one point or another slip through your fingers to fade away? I am obnoxiously optimistic on a normal day. I would have said if it didn’t matter one way or another we might as well live it big, savor all the rare big feels; swim in them. But alas today, me at the center of my own universe, a weight is squashing all of my insides.
“Having death on your doorstep has a way of making everything else seem inconsequential,” Bob said in an effort to comfort me. I trust that important things will appear important again. I only wish for better circumstances.
//
Sources:
[1] Peterson, B., Grainger, A., & Deliso, M. (2023, December 13). 2 arrested after gummy bears brought to elementary school in fentanyl-laced bag: Authorities. ABC News. https://abcnews.go.com/US/virginia-elementary-school-students-medical-attention-after-ingesting-fentanyl/story?id=105611083.
[2] Klobucista, C., & Ferragamo, M. (2023, December 22). Fentanyl and the U.S. Opioid Epidemic. Council on Foreign Relations. https://www.cfr.org/backgrounder/fentanyl-and-us-opioid-epidemic.
[3] Id.
[4] Ordonez, V., & Salzman, S. (2023, February 1). If fentanyl is so deadly, why do drug dealers use it to lace illicit drugs? ABC News. https://abcnews.go.com/Health/fentanyl-deadly-drug-dealers-lace-illicit-drugs/story?id=96827602.
[5] STAT News. (2016, September 29). Why fentanyl is deadlier than heroin. STAT News. https://www.statnews.com/2016/09/29/why-fentanyl-is-deadlier-than-heroin/.
[6] Centers for Disease Control and Prevention. STEM Uncovering the Opioid Epidemic Lesson. CDC Museum Public Health Academy. https://www.cdc.gov/museum/pdf/cdcm-pha-stem-uncovering-the-opioid-epidemic-lesson.pdf.
[7] Massachusetts Government. Trial Court Safety Advisory and Protocols for Fentanyl and Carfentanil. Retrieved from https://www.mass.gov/doc/trial-court-safety-advisory-and-protocols-for-fentanyl-and-carfentanil/download.
[8] Drug Enforcement Administration. (2022, August 30). DEA warns brightly colored fentanyl used to target young Americans. Retrieved from https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans.
[9] American Medical Association. (2021). 2021 Overdose Epidemic Report. Retrieved from https://end-overdose-epidemic.org/wp-content/uploads/2021/09/AMA-2021-Overdose-Epidemic-Report_92021.pdf.
[10] National Center for Drug Abuse Statistics. (2023). Opioid Crisis Statistics [2023]: Prescription Opioid Abuse. Retrieved from https://drugabusestatistics.org/opioid-epidemic/.
