Fentanyl — a synthetic opioid that has caused spates of fatal overdoses across the United States — isn't just a transient drug being trafficked through Nebraska on its way to other states, investigators say.
Illicit versions of the powerful painkiller are showing up on local streets and causing overdoses across Nebraska, proving a game-changer for law enforcement trying to prevent this state from experiencing the epidemic levels of abuse seen in the eastern U.S., authorities said.
"This is not someone else's problem," said Nebraska State Patrol Lt. Jason Scott, who oversees investigations for the Omaha troop area.
Fentanyl is 50 to 100 times the strength of fellow opioid morphine.
Mexican cartels import the drug from Asia, primarily China, and add it to heroin, cocaine, methamphetamine and other drugs in hopes of increasing addiction and boosting their illicit business, federal and state investigators said.
In Lincoln, three men died with fentanyl in their systems during the past two years. Lancaster County Attorney Joe Kelly says one of those deaths was directly attributed to the drug.
And across the state in Crawford, a state trooper recently overheard a medical call about an unresponsive person at a hotel, went on the call and treated the person with an antidote called Narcan used to revive someone who overdosed on fentanyl.
Fentanyl's emergence has slowed testing procedures at Nebraska's crime laboratories, as the drug's potency creates a unique hazard. Those labs saw a threefold increase in cases involving fentanyl and fentanyl variants during the first nine months of 2017, compared with all of last year, the state reported last month.
While other illegal drugs like meth and heroin are bad for human health, they are not hazardous to work with, Scott said. Fentanyl requires investigators to use protective clothing when handling any white powders that might contain traces of the drug.
In Ohio in May, an officer brushed a white powder off his uniform with his bare hand and overdosed at the police station an hour later.
"The days of us cutting into kilos on the side of the road are over," said Scott, who's been involved in drug investigations for 15 of his 19 years as a trooper.
And at the Nebraska State Patrol Crime Laboratory in Lincoln, the staff keeps Narcan on hand, just in case.
Fentanyl turned up in Nebraska quicker than Scott expected after he saw a nationwide drug alert from an East Cost law enforcement agency two years ago.
A week later, his investigators found fentanyl during an interdiction stop on the interstate.
This state's efforts to combat prescription drug abuse might already be contributing to an increase in fentanyl addiction and overdoses — an unintentional side effect as people replace one high with another. Still, officials hope they can adjust and learn from other states, much like a decade ago when Nebraska took aim at homecooked meth.
"We’ve been lucky being a state that doesn’t necessarily see these things first," said Pam Zilly, director of the Nebraska State Patrol Crime Laboratory.
Celeste Laird, who manages the laboratory's forensic chemistry area, said her team hasn't had any close calls with fentanyl.
But the drug has changed their testing procedures, she said: They now screen tiny amounts of suspicious white substances and forgo weighing suspected fentanyl to prevent even the smallest particles from becoming airborne.
"It can’t be just business as normal,” Laird said.
Recently, in a sample from a drug seizure, scientists there detected a mixture of caffeine and carfentanil, a synthetic derivative of fentanyl said to be 10,000 times the strength of morphine. It is generally used to tranquilize elephants.
Special Agent Matthew Barden of the U.S. Drug Enforcement Administration in Omaha said when drug dealers cut heroin with fentanyl, using amounts equal to a few grains of salt, even those border on lethal dosages.
Meanwhile, the price per kilogram of fentanyl has dropped from as much as $20,000 to around $3,500, he said. Dealers add granular amounts to heroin and other drugs for more lucrative profits.
What shocks the 25-year veteran drug investigator is dealers are warning customers to keep a bucket of ice water nearby when they get high, in case someone overdoses, Barden said.
"That is about as inhumane as a human being can be," he said.
Other drugs are being cut with fentanyl, too, say DEA agents and other law enforcement in the region. For example, Scott said investigators with the Douglas County Sheriff's Office recently seized marijuana laced with fentanyl.
Law enforcement officials worry the drug market will try to outmaneuver state and federal laws by tweaking the chemical makeup of fentanyl, similar to what has happened with K2 and other forms of so-called synthetic marijuana.
"They would just move a molecule, and all of the sudden they're outside the statute," Scott said.
Last week, U.S. Attorney General Jeff Sessions announced the DEA would schedule all fentanyl analogues and fentanyl-related substances on an emergency basis, speeding up the process outlawing possession, manufacturing and distribution to address this problem.
The Nebraska Attorney General's Office has drafted legislation to update the state's drug laws in a similar way, which lawmakers are expected to consider next year.
While Lincoln hasn't seen the large numbers of overdoses experienced in other communities, that doesn't mean the city is immune, said Kelly, the Lancaster County attorney.
At Lincoln Treatment Center, a woman began treatment there two years ago after a near-fatal overdose. She was addicted to heroin, but didn't know her hit had been laced with fentanyl, said clinic supervisor Mindy Mousel.
And most patients who are trying to subdue other opioid addictions are encountering the temptation of fentanyl patches being sold illicitly on the street, Mousel said.
Efforts to combat prescription drug abuse could send more addicts to heroin and fentanyl, Kelly said.
But he points to the state's experience in the years after 2005, when lawmakers restricted the sale of the decongestant pseudoephedrine with the goal of crippling meth production at clandestine labs across the state.
Since then, large homegrown meth operations have been largely rooted out, Kelly said.
Officials hope the state's prescription drug monitoring program will have similar effects: reducing illegal diversion of fentanyl and other opioids from medicine cabinets throughout Nebraska, so drug investigators can focus on stopping the importation of drugs from elsewhere.
"It kind of puts it on one front for us rather than battling on multiple angles," said Scott, the State Patrol investigator.
Awareness and vigilance remain key, he and Barden agreed, and Barden said law enforcement can't do enough to warn people about fentanyl and the dangers of illicit use.
"Drugs are bad," he said, "and they’re worse than they’ve ever been."