When fentanyl arrived in Washington, D.C., around 2014, none of our patients in the methadone clinic knew they were consuming it. They thought they were buying their usual heroin. But the Mexican cartels and major distributors that trafficked heroin across the border were starting to mix in fentanyl, a lab-synthesized opioid. Even the local dealers were unaware.
Our patients could sense that something was different, though. At 50 times the potency of heroin, how could they not? The high from the fentanyl component of what they had just snorted or injected came on more quickly and intensely than did heroin, thereby accelerating addiction to the drug. For dealers, this ensured an even more faithful customer base.
