The potent opioid increasingly is afflicting people of color in American cities. “I’ve seen a lot of terrible drugs,” said a veteran drug counselor. “This is the worst.”
MILWAUKEE — Glenda O. Hampton doesn’t need to look far to witness the devastation of the fentanyl epidemic in her neighborhood on Milwaukee’s north side.
She has found men lying on the curb, barely conscious, their legs splaying into the street as cars whiz by. She can count at least three people in recent months who sought treatment at the storefront rehabilitation center she runs, then relapsed and died from using fentanyl.
“I’ve seen a lot of terrible drugs,” said Ms. Hampton, 68, a tiny figure seated behind her crowded desk, as a group counseling session was underway down the hall. “This is the worst.”
The synthetic opioid fentanyl has swept across the United States in recent years, the latest wave of a drug crisis that began with opioid painkillers and was followed by heroin. Fentanyl is a startlingly potent drug, 100 times more powerful than morphine, that was linked to the deaths of more than 70,000 Americans in 2021. They included first-time users who ingested more fentanyl than their bodies could handle, unsuspecting college students taking party drugs like cocaine that were laced with fentanyl, and people with longstanding addictions searching for cheap and plentiful highs.
In cities like Milwaukee, fentanyl is increasingly a crisis in heavily Black and Latino neighborhoods. It is spreading within communities that are already straining under the weight of poverty, disinvestment and violent crime, and are now struggling to control a drug whose reach grows every year.
A federal report released in July said that drug overdose deaths in the United States — which are largely driven by fentanyl — hit people of color the hardest, with rates among young Black people during the coronavirus pandemic rising the most sharply. Data from Milwaukee County showed that from 2020 to 2021, fatal overdoses increased by 6 percent among white people, but 55 percent among Black people.
In 2021, more than 500 drug-related deaths in Milwaukee County were tied to fentanyl, officials said, and this year’s death toll is expected to be even higher.
“Unfortunately, this epidemic is affecting communities of color really hard,” Cavalier Johnson, the mayor of Milwaukee, said in an interview. “The number of fentanyl-related deaths has continued to grow, and so too has the share of people of color who have succumbed to fentanyl-related deaths.”
Mayor Johnson, a native of the predominantly Black north side of Milwaukee, has faced a cascade of crises since becoming mayor in 2021. The city budget is strained, with rising pension costs leading officials to consider cuts to libraries, the city’s police force and fire departments. The number of homicides in Milwaukee, a city with a population of 577,000, nearly doubled from 2019 to 2021.
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And the pain from the fentanyl epidemic is visible on the streets.
“It’s blatantly open to see,” said Rafael Mercado, a former drug trafficker who now volunteers as a community organizer. Mr. Mercado walks around parks to clean up drug paraphernalia, yet sales of fentanyl and other illegal substances occur in plain view, near fast-food restaurants, in parking lots and on street corners.
“The demand is too high,” Mr. Mercado said. “You’re fighting the drug war, but with no results.”
Health officials, social workers and former users traced the acceleration of Milwaukee’s fentanyl crisis, in part, to the pandemic, when so many people were isolated and unable to work. From 2019 to 2020, overdose deaths nationally rose by 30 percent, according to the Centers for Disease Control and Prevention.
Rodney Hill, a 62-year-old Milwaukee resident, said he encountered fentanyl for the first time in 2021 while smoking what he thought was cocaine.
“It’s just more powerful than anything I’ve ever used,” he said. “My ear was pounding so much after smoking that stuff. It was hurting like somebody had put a nail in my ear.”
Mr. Hill said he had heard from friends that fentanyl use was rapidly spreading, particularly because it is inexpensive, easily obtained and so frequently mixed in with other drugs. He has been in recovery since February, he said, but maintaining his sobriety is a struggle.
“I have to pray and have strong willpower to not use,” he said. “Fentanyl is killing people. It’s wicked.”
Drug dealers who sell fentanyl routinely cut it into other substances like cocaine or marijuana, but with little idea of how much fentanyl ends up in the final product. The Drug Enforcement Administration said in November that fentanyl-laced fake prescription pills were increasing in their lethality, and that six of 10 pills analyzed by the agency this year contained a potentially fatal dose of fentanyl. “It remains the deadliest drug threat facing the U.S.,” the agency said in a statement.
Desilynn Smith, a counselor at the drug rehabilitation center Gateway to Change, has felt the fentanyl crisis creeping closer.
“In my community, this is everywhere,” she said. “Every day, I wake up, and I hear of four or five overdoses. Every three or four days, I’m getting a call from someone saying, ‘Hey, you remember so-and-so? He died from the fentanyl.’”
Last year, fentanyl devastated Ms. Smith’s family when her husband, Hamid Abd-Al-Jabbar, died from an overdose, leaving Ms. Smith grappling with grief and regret.
She has channeled her energies into her work at Gateway to Change, where she is the clinical director and counsels people who are fighting addiction.
Earlier this month, in a room with the 12 steps of Narcotics Anonymous printed on the walls, Ms. Smith stood in front of a group who placed their cellphones in a communal box, sat on wooden chairs and described their internal battles.
I’ve been dreaming about my addictions, one man said, his voice muffled behind a mask. A woman fiddled with a bracelet on her wrist and spoke of her cravings, strong ones. If I wasn’t here, she said, I’d be high right now.
The Opioid Crisis
From powerful pharmaceuticals to illegally made synthetics, opioids are fueling a deadly drug crisis in America.
- Settlements: Walmart will pay $3.1 billion to resolve thousands of lawsuits over its pharmacies’ roles in the opioid crisis. The agreement follows deals announced by CVS and Walgreens to pay about $5 billion each.
- Pregnant Women: The Biden administration plans to expand the use of medication to treat substance use disorders in pregnant women as part of its effort to combat the drug crisis.
- A Daring Addiction Strategy: Rhode Island is the first state to legalize supervised drug consumption sites, which some experts believe will help lower overdose rates.
- McKinsey’s Sway: From poppy fields to pills, a trove of documents shows how the consulting firm gave opioid makers an “in-depth experience in narcotics.”
“You’ve got to recover for you,” Ms. Smith told her.
A few miles away, at the Milwaukee County medical examiner’s office, employees are overwhelmed by the number of overdose deaths they have processed this year. They have yet to catch up with a backlog of cases.
Sara Schreiber, the office’s forensic technical director, said that deaths linked to fentanyl had “far surpassed” those linked to heroin and that the number of drug-related fatalities in the city had skyrocketed because of fentanyl use.
“It’s so easily synthesized, it’s so easily obtained,” she said. “You don’t need to cultivate a plant to get it like you needed to with heroin.”
When drug-related deaths are reported in Milwaukee, she said, the people who have succumbed are typically found at home, sometimes with a needle in their arm or a tourniquet in place — a reflection of the drug’s fast-acting potency.
Local and state officials say they understand the problem and are fighting it with whatever tools they have, including the increased distribution of naloxone, a medication used to reverse opioid overdoses, and test strips that detect the presence of fentanyl.
But officials are also confronting reluctance from some communities where addiction is common, said Representative Sylvia Ortiz-Velez, who represents Milwaukee in the state Legislature.
“It’s a taboo subject. People don’t want to talk about it,” she said. “There’s a shame involved.”
Isaac Solis, a resident of Milwaukee, lost his 25-year-old son, Bubba, to fentanyl, sending him into a deep well of grief. When he emerged, Mr. Solis became an activist in the city, warning of the dangers of the drug.
Mr. Solis’s son died from a pill containing fentanyl, a death that Mr. Solis called a poisoning, because he did not believe that Bubba was aware of what he was ingesting. That ignorance is common, Mr. Solis said, and he routinely tells parents to be aware that pills can be deadly.
People in some parts of the city don’t think pills are an issue, he said. “It was thought of as a suburb thing,” he added, “kids getting together and stealing drugs from their parents’ medicine cabinets.”
Mr. Solis sees signs of the fentanyl epidemic regularly, whether it is the sales of drugs out in the open or a stranger overdosing in public. At a Walgreens, he saw someone passed out in the restroom, and when he informed an employee, he was told that it happened all the time.
At least once a week, Mr. Solis goes to St. Adalbert Cemetery, where his son’s body lies in a crypt encased with pink granite. On a recent afternoon there, he recounted Bubba’s life and its tragic end.
His death could have been prevented if more people knew of the dangers of fentanyl, Mr. Solis said — it occurred at a house where people were in the next room. As part of his work to spread awareness, Mr. Solis tells people that if they hear a drug user snoring heavily, as Bubba was that night, they could administer naloxone and save a life.
“I’m reliving it every day,” he said.