Tag: opioid epidemic

What's Fueling The Rise Of Meth?

Ohio, Nevada, Utah and parts of Montana have seen a recent rise in methamphetamine use.

In rural Ohio, an increasing number of opioid users are turning to methamphetamine to get high, driven in part by a medication that is meant to help them stay sober.

“Right now that’s our biggest challenge—is methamphetamines,” Amanda Lee, a counselor at Health Recovery Services in McArthur, Ohio, told NPR. “I think partly because of the Vivitrol program.”

Vivitrol is an injectable medication used to support recovery from opioid addiction. It works by blocking opioid receptors in the brain, so that people are not able to get high off opioids. However, Lee points out that when the underlying cause of addiction—like pain or trauma—is not addressed, desperate users simply find a new substance to abuse.

“The Vivitrol injection does not cover receptors in the brain for methamphetamines, so they can still get high on meth,” Lee said. “So they are using methamphetamines on top of the Vivitrol injection.”

Lee said that in her opinion, methamphetamine is much more debilitating than opioids.

“There’s paranoia. There is hallucinations. It almost looks like people have schizophrenia,” she said. “Methamphetamines scare me more than opiates ever did.”

“You can’t really describe the smell,” said Detective Ryan Cain, lead narcotics detective for Vinton County, Ohio. “It’s a combination of lithium out of a battery. A lot of them use Coleman camp fuel. It’s a solvent. They use ammonium nitrate, which is usually out of a cold pack. And all of it’s very cancerous.”

Trecia Kimes-Brown, the county prosecutor, has seen how meth addiction, like opioids, involves the whole family.

“When you’re living in a house where people are making meth, it’s not just the health effects. These kids are living in these environments where, you know, they’re not being fed,” she said. “They’re not being clothed properly. They’re not being sent to school. They’re being mistreated. And they have a front-row seat to all of this.”

In addition to meth produced locally, cheap meth from Mexico is now trafficked into Ohio by drug cartels south of the border, according to officials.

Ohio isn’t unique in how the drug crisis has shifted. In Kentucky, the focus on preventing opioid addiction also contributed to an increase in meth addiction.

“People say, ‘Why do you not have an opioid problem? Why does Daviess County not suffer the same problems?’” Sheriff Keith Cain said last month. “I’d like to say it’s because of progressive police work. But I think the prime reason we don’t have an opioid problem here is because our people are addicted to meth.”

Nevada, Utah and parts of Montana have also seen a rise in methamphetamine use recently.

“Meth is kind of the forgotten drug out there, and it’s still a huge problem in our society,” Lt. Todd Royce with Utah Highway Patrol said last month. “It’s a horrible epidemic and it destroys families.”

View the original article at thefix.com

15 June 2018
SAMHSA’s Opioid Overdose Prevention Toolkit Gets An Update

The refreshed online resource offers a variety of strategies, information and advice on how to prevent opioid overdoses.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has updated its Opioid Overdose Prevention Toolkit, which contains resources about opioid overdose prevention.

The toolkit is divided into various sections, depending on the target audience.

The beginning outlines the opioid crisis and strategies that can be implemented to minimize overdose deaths. Such strategies include encouraging people to learn how to prevent/manage an opioid overdose, making sure there is access to treatment, having naloxone be easily accessible, encouraging the public to call 911, and encouraging those prescribing medications to utilize state prescription drug monitoring programs.

Five Essential Steps For First Responders

The guide then shifts into a section geared toward first responders and outlines five steps that they should take. The steps include evaluating a person for signs of an overdose, calling 911, giving naloxone, supporting the person’s breathing and monitoring their response. The guide also warns that what appears to be an overdose can sometimes be something else.

“If a person does not respond to naloxone, an alternative explanation for the clinical symptoms should be considered,” the guide states. “The most likely explanation is that the person is not overdosing on an opioid but rather some other substance or may be experiencing a non-overdose medical emergency.”

Information For Prescribers

The guide also has a section geared toward prescribers, which outlines 12 prescribing recommendations split into three categories: determining when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up and discontinuation; and assessing risk and addressing harms of opioid use.

“When potentially harmful behaviors are identified (e.g., high-volume use of opioids; taking opioids in combination with alcohol, benzodiazepines, or other respiratory depressants; using illicit opioids where contents of substance cannot be confirmed), it is important to offer education that can reduce that individual’s risk for overdose,” the guide states. “Providing basic risk reduction messaging, overdose prevention education, and a naloxone prescription can be lifesaving interventions.”

The guide also covers legal and liability topics, as well as claims coding and billing for prescribers.

Safety Advice For Patients & Family Members

This section is geared toward patients and family members of patients and covers an array of topics, from the signs of an overdose to preventing an overdose.

It also outlines best practices for naloxone use and storage.

“Store naloxone in a safe and quickly accessible place at room temperature and protected from light,” the guide reads. “Keep all medicine in a safe place where children or pets cannot reach it.”

Recovering From Opioid Overdose

This is the section for those in recovery from opioid overdose.

“Survivors of opioid overdose have experienced a life-changing and traumatic event,” the guide states. “They have had to deal with the emotional consequences of overdosing, which can involve embarrassment, guilt, anger, and gratitude, all accompanied by the discomfort of opioid withdrawal. Most need the support of family and friends to take the next steps toward recovery.”

The guide talks the user through why support is vital in recovery and also has a lengthy list of helpful resources at the end.

View the original article at thefix.com

14 June 2018
Opioid Deaths Have Surpassed Vietnam War Fatalities, Study Says

A new study examined the 15-year period from January 2001 to December 2016 to determine the number of American deaths caused by the opioid crisis.

American deaths as a result of the opioid crisis have surpassed those during the Vietnam War, a new study has found.

According to the Washington Post, less than 1% of American deaths in the year 1968 were due to serving in the Vietnam war. Now, a new study has found that in 2016, 1.5% of deaths were at the hands of opioids.

The study, which was published in the Journal of the American Medical Association, looked at the 15-year period from January 2001 to December 2016 to determine the number of American deaths caused by the opioid crisis.

It found that between 2001 and 2016, the number of deaths caused by the opioid crisis rose from 9,489 to 42 ,245—a 345% increase.

According to the study, in 2001, opioids were responsible for 0.4% of deaths, or 1 in 255 people. But 15 years later, in 2016, that rose to 1.5%, or 1 in 65 deaths—a 292% increase. Study authors found that the greatest impact was on those ages 24 to 35, an age group in which 20% of deaths were associated with opioids. Study authors also found that deaths connected to opioids were more prominent in men than women.

In all, study authors estimate that in 2016 alone, nearly 1.7 million years of life were lost in the U.S. population due to the opioid crisis.

“These findings highlight changes in the burden of opioid-related deaths over time and across demographic groups in the United States,” study authors wrote. “They demonstrate the important role of opioid overdose in deaths of adolescents and young adults as well as the disproportionate burden of overdose among men.”

Study findings also indicated that there has been an increase in the number of opioid-related deaths in those 55 and older.

“The relative increase in recent years requires attention, as it could be indicative of an aging population with increasing prevalence of opioid use disorder,” study authors noted. “This is particularly problematic as recent estimates from the United States suggest that the prevalence of opioid misuse among adults aged 50 years and older is expected to double (from 1.2% to 2.4%) between 2004 and 2020.”

Because of the impact on those of younger ages, study authors also indicated that there is a need to put more programs and policies in place.

“Premature death from opioid-related causes imposes an enormous public health burden across the United States,” study authors wrote. “The recent increase in deaths attributable to opioids among those aged 15 to 34 years highlights a need for targeted programs and policies that focus on improved addiction care and harm reduction measures in this high-risk population.”

According to the Post, this research leaned on Centers for Disease Control and Prevention (CDC) data, which is thought to underestimate the number of opioid deaths by 20 to 30%, resulting in a “conservative estimate” of the true impact of the crisis.

View the original article at thefix.com

14 June 2018
Cocaine Safety Tips Rolled Out As Part Of NYC Awareness Campaign

Though critics feel the safety tips are promoting drug use, the health department counters, “We can’t connect New Yorkers to treatment if they are dead.”

New York City is trying to get the word out about cocaine laced with fentanyl with a new harm reduction effort: issuing cocaine safety tips.

As CBS New York reports, this effort has been spearheaded by the NYC Department of Health and Mental Hygiene because in 2016, fentanyl was found in 37% of overdose deaths involving cocaine—an 11% jump from the previous year.

The Department of Health also told Forbes, “In New York City, someone dies of a drug overdose every seven hours. In 2017, there were 1,441 overdose deaths confirmed to date; opioids were involved in over 80% of those deaths.”

To help make the public aware, warnings against cocaine that could be laced with fentanyl have been printed up on coasters, and health officials have been handing out them out at bars and nightclubs on the Lower East Side of Manhattan.

The coasters being passed around the city ask in bold pink letters, “Using Cocaine?” and they warn the reader that “fentanyl, a drug stronger than heroin, is being mixed into cocaine and is causing a spike in drug overdose deaths.”

Several of the safety tips on these coasters include using cocaine with other people so they can help you in case of an overdose. These coasters also recommend you have naloxone (Narcan) at the ready in case you’ve accidentally ingested fentanyl.

The coasters inform the public where to access naloxone, and they recommend downloading the Stop OD NYC app, which has important information on the dangers of fentanyl. (These coasters also list the helpline 888-NYC-WELL, where you can talk to counselors and link up with a number of resources.)

New York City Mayor Bill de Blasio told CBS New York, “When the health department tries to figure out a public health campaign, they are very mindful of not wanting to have unintended consequences. But, let’s be blunt, tragically there’s a lot of people using cocaine and thinking it’s safe… Any way to tell people it’s not safe anymore and could be laced with an extraordinarily lethal drug—that’s our obligation to get that information out.”

Officials from the health department also told the network, “The city is not encouraging drug usage—we are encouraging safety. We can’t connect New Yorkers to treatment if they are dead.”

View the original article at thefix.com

13 June 2018
Actor Jackson Odell Found Dead At Sober Living Facility

Odell had appeared on a variety of sitcoms including “The Goldbergs,” “Arrested Development” and “Modern Family.”

Actor Jackson Odell has been found dead at a sober living facility in Tarzana, California on Friday, June 8.

Odell was 20 years old at his time of death, the cause of which has yet to be confirmed through an autopsy. E! News reported that the LA County Coroner’s Office stated that no drugs or drug paraphernalia were found at the scene of his death. Odell’s last drug test had been clean.

According to TMZ, Odell had been in the sober living facility for three weeks.

The Los Angeles Times reported that Ed Winter, assistant chief of investigations for the Los Angeles County Coroner’s Office, stated that Odell had a “history with heroin” and that autopsy results would be delayed due to toxicology tests that will be done in order to evaluate if anything was in Odell’s system at the time of his death.

Odell was an actor and a musician who had portrayed Ari Caldwell on ABC’s The Goldbergs from 2013 to 2015. In addition to other small acting roles on shows such as Modern Family and Arrested Development, he was a singer-songwriter who contributed original songs for the soundtrack of the film Forever My Girl.

Odell’s family released a statement that focused on the young man’s spirit and place in his family:

“The Odell family has lost our beloved son and brother, Jackson Odell on Friday,” the statement read. “He will always be a shining light and a brilliant, loving and talented soul. He had so much more to share. Our family will always carry that truth forward. Our wish is that the rest of the world who knew and loved him does as well. We are now going to try to make sense of our immeasurable loss privately. We will not be making any further statements.”

Comedian and songwriter Josh Wolf created songs with Odell, and Wolf’s wife, Bethany, directed the movie Forever My Girl, for which Odell co-wrote the song “Don’t Water Down My Whiskey.”

Yahoo News published Josh Wolf’s tribute to Odell:

“It’s important that people know how ready he was to live. How happy he was to be alive. How much more he had to share with all of us. We are simply crushed. Please go to his site, listen to his music, watch his videos… celebrate his life with us. We love you, Jackson.”

Modern Family star Ariel Winter shared on Twitter that she had known Odell since they were 12 years old. “We didn’t talk much as we entered into our high school years, but I’m glad I got to spend time with him before his end. Very hard for me to hear about anyone passing away, but someone so young really saddens me.”

View the original article at thefix.com

12 June 2018
"Shock Value" Anti-Opioid PSAs Debut To Mixed Response

The four videos feature actors portraying individuals who go to extremely violent lengths to enable their opioid dependency.

The Trump administration unveiled a quartet of public service announcements (PSAs) as part of its proposed $4.6 billion fight against the opioid epidemic.

The four videos, all purported to be based on true stories, feature actors portraying individuals who go to extreme lengths to enable their opioid dependency: one is seen smashing their hand with a hammer, while another drives a car into a dumpster.

The videos, which began airing on television and and social media on June 7, have drawn not only comparison to the Partnership for a Drug-Free America’s “This is your brain on drugs” campaign of the 1980s, but also a mixed response from drug policy organizations, with some expressing positive views while others labeled the PSAs as “shock value” or “disingenuous and misleading.”

The ad campaign, which is the first stage in an educational effort called “The Truth About Opioids,” is a joint effort between the Office of National Drug Control Policy (ONDCP), the Truth Initiative and the Ad Council.

An array of media partners, including Facebook, Google, YouTube and Amazon have committed to donating airtime and ad space for the PSAs, which according to Ad Council CEO Lisa Sherman, is worth roughly $30 million.

Jim Carroll, deputy director of the ONDCP, was unable to provide an exact figure on how much his agency spent on the campaign, but noted that “very few government dollars” were used, due to the Truth Initiative and Ad Council donating their work and the media partners’ donated airtime.

Fred Mensch, president of the nonprofit Partnership for Drug-Free Kids—the Partnership for a Drug-Free America’s moniker since 2010—spoke highly of the PSAs, which he described as having “the potential to generate a dialogue between parents and kids on this complex health issue.”

But Daniel Raymond, deputy director of planning and policy at the Harm Reduction Coalition, called the spots “the 21st century version of the egg-in-the-frying-pan” commercial, referring to the “your brain on drugs” spot, which was created by Partnership for Drug-Free Kids.

“We don’t need shock value to fight the overdose crisis,” said Raymond. We need empathy, connection and hope for people struggling with opioids. The White House missed an opportunity to combat stigma and stereotypes, portraying people who use opioids as irrational and self-destructive.”

Stefanie Jones, director of audience development for the Drug Policy Alliance, praised the Truth About Opioids web site for providing useful information and resources, but found that the ads “take really extreme cases,” she said. “It’s all about self-harm to seek opioids, and they also end with the same ‘fact’ about how dependence can start after five days, and that’s just an incredible simplification.”

The nature of the PSAs seem to suggest what Trump alluded to in March 2018 about a “large-scale rollout of commercials” intended to raise awareness about opioid dependency.

At the time, Trump said that he had long been in favor of “spending a lot of money on great commercials showing how bad [opioid dependency] is.” He added that his administration would make the spots “very, very bad commercials” in which “you scare [audiences] from ending up like the people commercials,” and cited similar examples in anti-smoking PSAs.

In May 2018, Axios quoted an unnamed source with an alleged connection to the PSAs, who said that “[Trump] thinks you have to engage and enrage.”

View the original article at thefix.com

12 June 2018
How US Public Schools Are Taking Action Against The Opioid Crisis

From drug searches to peer-support groups, schools across the nation are taking a number of approaches to combat the opioid epidemic.

Some high schools aren’t wasting time and are confronting the opioid crisis head-on.

According to CBS 6 News, Shenendehowa High School in Clifton Park, New York is one such school. At the high school, drug searches with police K-9s take place about twice per month, says Saratoga County Deputy Sheriff Ken Cooper, who serves as the school resource and emergency liaison officer.

“Kids start out with marijuana use, they don’t think that the next thing is heroin or another drug, but it is,” Cooper told CBS.

During the searches, trained K-9s locate any illegal items in a student’s locker. If the dog finds something, it scratches at a locker or barks. According to Cooper, students have reacted mostly positively to the searches.

“I think overall students, parents are OK with us coming in and searching. They don’t want drugs on campus,” he tells CBS.

Another step being taken at the high school is stationing school resource officers throughout, with the hope that students will feel comfortable talking to them if they have friends who may be using drugs.

“We want them to give us the good information, so we can actually help,” Cooper told CBS.

Additionally, CBS reports, the school has trained teachers, school nurses and other staff members about the signs of substance use disorders. The school also advertises a help hotline and students are even learning about opioids in their health classes.

Shenendehowa High School isn’t alone in taking an early approach to the crisis.

In Lakewood, Ohio, a peer-to-peer approach is being taken. High school students have partnered with a nonprofit called Recovery Resources of Cleveland and have created the Casey’s Kids program, according to Cleveland.com. In the program, high schoolers chosen by health teachers and counselors work to educate middle school students about substance use disorders.

“There’s a lot of research that says kids sort of have better outcomes in this program when it’s delivered by other kids. They’re more apt to listen and trust information that’s delivered by other kids,” said Lakewood City Schools’ Teaching and Learning Director Christine Palumbo.

Some states are even passing laws requiring schools to educate students about the opioid crisis, according to Education World.

In 2014, New York passed a law requiring schools to update their health curriculums to teach students about the opioid crisis.

Recently, Maryland followed suit and passed the Start Talking Maryland Act, which mandates that public schools educate students about the dangers of opioid use, beginning in the third grade. The bill also mandates that nursing staff be trained to administer the opioid overdose antidote, naloxone.

“It’s a crisis that we need to identify and make educators as well as parents aware of it, and provide the resources to deal with it,” Thomas V. Mike Miller Jr. (D), the bill’s lead sponsor, told The Baltimore Sun.

View the original article at thefix.com

11 June 2018
Fentanyl-Related Deaths Skyrocket In Ohio

“There is nothing that worries me more than synthetic opiates—and what will be the next, more powerful synthetic that hits the street,” said one police official.

Fentanyl is taking over the illicit drug market in the greater Cincinnati area, sparking a 1,000% increase in overdose deaths in Hamilton County.

In 2013, authorities there logged 24 fentanyl-related deaths. Last year, they counted 324, according to the Cincinnati Enquirer.

The drug’s popularity has grown so explosively it’s overshadowed heroin deaths. Last year, the Hamilton County coroner found fentanyl involved in 85% of overdose deaths the office examined, while the county’s crime lab detected the substance in more than 90% of the drugs tested in the first five months of this year.

“Fentanyl and similar synthetic opiates have produced overdoses and deaths in not only unprecedented numbers but previously unimaginable,” Newtown Police Chief Tom Synan told the Ohio paper. “It is no longer a heroin epidemic but a synthetic-opiate epidemic.”

The problem in Ohio mirrors the issue nationwide, Synan said. In 2016, according to a research letter published in the Journal of the American Medical Association, fentanyl was involved in roughly half of opioid-related deaths.

“It’s the small amounts of the extremely deadly substances that are killing people,” Hamilton County coroner Dr. Lakshmi Sammarco told the paper.

Just days after the Cincinnati paper published its report, the Billings Gazette in Montana detailed an apparent uptick in fentanyl-related deaths in the county that houses Fort Peck Indian Reservation. There, officials are bumping up naloxone training efforts and considering reactivating a regional drug task force.

And in May, the Minneapolis Star Tribune detailed a spike in fentanyl-related overdoses in Minnesota, where officials are pushing to treat fatal overdoses as homicides.

Even as the epidemic spreads, officials in Ohio are warning it could get worse as underground chemists start pumping out new analogues of the dangerous drug, some of which could be more potent.

And, as officials elsewhere have warned, fentanyl is starting to pop up in cocaine and meth supplies.

“The introduction of synthetic opiates like fentanyl has killed tens of thousands of Americans and should be seen as the country’s most pressing health, national security issue and social crisis we face right now,” Synan said. “There is nothing that worries me more than synthetic opiates—and what will be the next, more powerful synthetic that hits the street.”

View the original article at thefix.com

11 June 2018
The US Workforce Is Taking More Drugs

A new study about workplace drug testing found that opioid use declined between 2016 and 2017, while use of other drugs is on the rise.

Members of the workforce in the United States are testing positive for drugs more often than they have in the past 10 years, according to a new study that analyzed more than 10 million drug test results.

The study, conducted by Quest Diagnostics, painted an interesting picture of the ways that drug use is affecting different areas of the country. Overall, 4.2% of people drug tested at work tested positive, up from 3.5% in 2012, which was a 30-year low.

“It’s unfortunate that we mark 30 years of the Drug-Free Workplace Act with clear evidence that drugs continue to invade the country’s workplaces. Not only have declines appeared to have bottomed out, but also in some drug classes and areas of the country drug positivity rates are increasing,” said Barry Sample, senior director of science and technology at Quest Diagnostics.

The data, perhaps unsurprisingly, showed that marijuana use is up in states that have legalized recreational use. It also indicated that use of cocaine and methamphetamine is on the rise.

“These changing patterns and geographical variations may challenge the ability of employers to anticipate the ‘drug of choice’ for their workforce or where to best focus their drug prevention efforts to ensure a safe and healthy work environment,” Sample said.

Cocaine use increased for the fifth year in a row. The jump was particularly sharp in Nebraska (which had a stunning 91% increase between 2016 and 2017), Idaho (88% increase) and Washington (31% increase).

Use of methamphetamine was up in midwest and southern states. Between 2013 and 2017 positive tests for methamphetamine positivity increased 167% in the region covering Illinois, Indiana, Michigan, Ohio, Wisconsin; 160% in the region covering Alabama, Kentucky, Mississippi, Tennessee; 150% in the region covering New Jersey, New York, Pennsylvania; and 140% in the region covering the eastern seaboard from Delaware to Florida.

The number of people testing positive for opioids declined 17% between 2016 and 2017, suggesting that efforts to address the opioid epidemic have been paying off.

“The depth of our large-scale analysis supports the possibility that efforts by policymakers, employers, and the medical community to decrease the availability of opioid prescriptions and curtail the opioid crisis is working to reduce their use, at least among the working public,” said Kim Samano, scientific director at Quest Diagnostics.

Matt Nieman, general counsel at the Institute for a Drug-Free Workplace said that the opioid numbers were encouraging, but there was still work to be done.

“The 10-year high in positivity rates—spurred by nationwide surges in cocaine and methamphetamine positivity as well as double-digit marijuana spikes in states with newly implemented recreational laws—serves as a stark warning that efforts to prevent substance abuse in the workplace are as important today as ever,” he said.

View the original article at thefix.com

8 June 2018
Catching Fentanyl Shipments Is "Death By A Thousand Cuts"

“You used to have the tractor-trailer running up the interstate, that had to be met by someone and distributed. Now, you have an individual sitting somewhere in middle America ordering this thing, and it arrives as a parcel at their house.”

Despite knowing that fentanyl is being shipped into the United States using the U.S. Postal Service, UPS and FedEx, law enforcement officials are largely unable to stop trafficking of the deadly synthetic opioid.

“The sheer logistical nature of trying to pick out which packages contain opioids makes it much more challenging,” Robert E. Perez, an acting executive assistant commissioner at United States Customs and Border Protection, part of the Department of Homeland Security, told The New York Times. “It’s unlike anything we’ve encountered.”

Fentanyl shipments are difficult to detect because they are so small. A dose of fentanyl the size of a grain of sand can be deadly, and since it is powerful in such small amounts drug dealers can turn a huge profit shipping tiny packages.

“When you’re dealing with very small, minute quantities, it’s kind of like death by a thousand cuts,” said Patrick J. Lechleitner, the special agent in charge of the Washington office of Homeland Security Investigations, a division of Immigration and Customs Enforcement (ICE).

A kilogram of cut fentanyl costs about $80,000, and can be sold on the street for a profit of $1.6 million, according to the Drug Enforcement Administration (DEA), making it about 20 times as profitable as heroin.

“This is what makes the opioid crisis so unique and dangerous,” said Peter Vincent, who led ICE’s international operations during the Obama administration. “Traditionally, law enforcement has focused on large quantities of drugs like marijuana and cocaine. But very small amounts of opioids can bring tremendous profits.”

In addition, the fact that fentanyl can be shipped directly to residential addresses after it is bought online makes it even more difficult to intercept.

“You used to have the tractor-trailer running up the interstate, with its contraband, that had to be met by someone and distributed,” Lechleitner said. “Now, you have an individual sitting somewhere in middle America ordering this thing, and it arrives as a parcel at their house.”

Authorities have made some progress in stopping fentanyl shipments, most of which are said to come from China and Mexico. Last year, border security seized 1,485 pounds of fentanyl, and this year they have already seized 1,060 pounds of the drug. People have been arrested and charged after receiving mail-order fentanyl shipments.

This year, President Trump and Congress have approved more than $80 million to aid in the detection of opioids. Senator Rob Portman (R-Ohio) said that the funding is key to making a difference in the amount of deadly opioids reaching Americans.

“There’s no doubt that more funding is an important component if we’re going to make real progress,” said Portman.

Despite that, many border officials continue to feel like they’re looking for a needle in a haystack when it comes to detecting fentanyl shipments.

View the original article at thefix.com

7 June 2018