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Fentanyl Eclipses COVID-19 as a Public Health Crisis

C.D. Casscells, M.D. | 10/7/2022

As the hysteria wanes from almost three years of COVID-19, and we continue to suffer the collateral damage from the ill-advised lockdown policies, our need for a return to normal is shattered by the harsh data emerging from Fentanyl death statistics.
Nationally, there are now more daily Fentanyl deaths than COVID-19. Over the past three years, according to the Centers for Disease Control (CDC), there have been four times wherein the death toll rose to 140% of expected; April 2020, Winter 20/21, Sept. 2021, and Jan. 2022. The overall COVID-19 attributed deaths totaled slightly over one million people, 75% over the age of 65 (all retired), with only 4.2% under the age of 45 (with much more life left to live). There was an equal number of pneumonia deaths as COVID-19 and virtually no recorded Flu deaths. The current daily COVID-19 deaths are hovering at about three hundred/day, which is well within expected death rates for the virus du jour. There is no crescendo or increase. The infection has reached an endemic level where COVID-19, and we will co-exist in perpetuity. Meanwhile, the Fentanyl epidemic of deaths increases exponentially with no end in sight.
Fentanyl, introduced as an anesthetic agent in the early 1980’s, killed 730 by overdose in 1999 and 9580 in 2015, reaching over 100,000 in 2021, doubling from April 2019 to April 2021, and extrapolated growth projects over 100,00 deaths from overdose by September 2022, with the majority associated with the synthetic opioid Fentanyl. According to CBS News and the Centers for Disease Control, in 2016 alone, more Americans died from Fentanyl than in all of the Vietnam war and the worst year of AIDS (1995).
The loss of usable productive years of life from Fentanyl deaths already vastly exceeds COVID-19, considering that most COVID-19 deaths were in the old, non-working, infirmed, and chronically ill, while the Fentanyl deaths were disproportionately in the young opiate naïve. You may wish to disregard the overdose deaths of the chronic heroin addict callously, but that is not the demographic of the fentanyl deaths.
Fentanyl is a synthetic (man-made) narcotic which is, on average, one hundred times stronger than opium, from which all other known narcotics derive… Morphine, Demerol, Heroin, Codeine, Hydrocodone, Oxycodone, Propoxyphene, etc. Because it is made synthetically, it is not linked agriculturally to the opium derived from the Poppy plant. Interdiction has been historically aimed at the Poppy plant fields as the plant produces only the L-dimer (active isomer) and, as such, was twice as powerful as synthetic opium, which in the lab yields only 50% active molecules. (l and R). Fentanyl easily avoids that economic yield problem at one hundred times the strength. But we have not developed interdiction methods for the precursors to Fentanyl as we had for the Opium Poppy. We cannot just defoliate Fentanyl from the sky like we did opium fields with Agent Orange.  
Narcotics once were controlled by the U.S. Drug Enforcement Agent (DEA), physician prescription, and pharmacists, but much of that highly regulated business was ceded to the cartels and illegal street dealers with the great crackdown on prescription pain medication following the OxyContin Purdue Pharma Sackler scandal. As such, the street drug market was left to compete in an unregulated space, steadily increasing the potency of their product to make it more desirable. And they made it cheaper. In addition, the street drug salesmen (dealers) modify their products with benzodiazepines (Valium, Xanax), Benadryl, and xylazine (horse tranquilizer) to make their products more potent and desirable. None of these laced additives are reversible with Narcan, so the combination is more deadly.
As an additive, Fentanyl supercharges all other recreational and hard-core narcotics. Marijuana, Xanax, Ecstasy, Cocaine, Crack, Ruffies, Valium, Hashish, and Heroin are all often “laced” with inexpensive Fentanyl to make them more marketable for the drug dealer. In addition, any sugar pill can be imprinted or colored to look like prescription medication or even candy and laced with Fentanyl to become deadly, especially to the teenage partygoer just trying to fit in.
While it is undeniably sad to lose a grandmother an average of ten days earlier than expected to COVID-19, the tragedy is far greater to lose a 15-year-old granddaughter who has 70 more years of life to expect to one rainbow-colored pill given to her at her first party. The politics of immigration aside, she is far too young to be an innocent victim of those policies. Soon enough, we will all know such a child lost.
The magnitude of the problem cannot be overstated. While “Deaths from Unknown Causes” are now the leading death certificate diagnosis worldwide, most likely reflecting vaccine deaths, they do not include “Overdose Deaths,” which are an easily made clear-cut post-mortem diagnosis. So, while some may try to conflate these death tolls, they are clearly different and need to be analyzed as such.
The DEA and the U.S. Customs and Border Protection report that only a fraction of the drug traffic across our southern border can be apprehended due to manpower shortages, yet Fentanyl seizures have increased exponentially. The assumption is that the seizures merely reflect the massive flood of the deadly drug coming across. A tiny, easily hidden amount can cause widespread death. The obvious truth is that we are facing a public health crisis that is often worse than COVID-19 was ever imagined to be at its worst. Yet, we do nothing except try to push Narcan into the mix in schools and on the street. We are only at the beginning of this next catastrophe, and no effort is being mounted to address the obvious near future.
From a data standpoint, all the outcome metrics clearly show poor results from the Public Health response to COVID-19, despite an infusion of federal money (which has not been accounted for). But with the Fentanyl epidemic, the simple calculation of lost years of life, regardless of productivity, shows that Fentanyl is collectively wasting well over one thousand times as many years of life as COVID-19 ever did at its worst.
Delaware is the third or fourth worst state for Fentanyl deaths per capita, depending on whether you use CDC or Family Against Fentanyl data. Delaware is an integral part of the D.C. to New York City supply chain, whose origins are clearly the U.S./Mexico border, with ingredients from China and labs in Mexico, according to the DEA. Interrupting these two supply chains is essential.
Unless drastic measures are taken immediately, the effects of the Fentanyl epidemic in the U.S. will make the COVID-19 response look a far distant second worst. While the response to COVID-1 was very poorly conceived and executed with disastrous results, the lack of response to Fentanyl will be far more deadly. Oddly, both public health crisis outcomes have bad policies, and China is their origin.
(All data is taken from:,,, and CBS News October 17, 2017,


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