"In the Room with Peter Bergen" transcript: Episode 12

Episode 12: Can the Fentanyl Epidemic Be Stopped?

In the past five years, overdose death rates have skyrocketed in the United States, with fentanyl—a synthetic, cheaply produced opioid—now a leading cause of death for 18-45 year-olds. How do the chemicals used to make fentanyl get from China to Mexico to the United States? Why would drug dealers sell a substance that’s killing off so many of their customers? What is the Biden administration doing to stop these deaths? And what can ordinary Americans do to keep their communities safe?

Please note: Our show is produced for the ear and made to be heard. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please check the audio before quoting in print.

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[SOUNDS OF A PARTY]

Kalie Shorr: I was living in LA and going to these parties in the Hills and seeing a lot of people around me casually using recreational drugs. I'd see a group of girls kind of hush hush walking into the bathroom together, like seven of them.

[SOUNDS OF MUSIC, LAUGHTER]

Kalie Shorr: And I'm like, I know what you're doing in there.

[SOUNDS OF MUSIC, PEOPLE TALKING]

Kalie Shorr: And I'd be like, ‘Hey,’ without being weird or judgey. Like, ‘I’d just like to tell you about this little thing called a fentanyl test strip.’

Fentanyl test strips. They look a little like COVID home tests.

Kalie Shorr: I always have them. And they're so small. They're like the size of a Crest white strip. You can fit, I mean, I've, I've put 25 in my purse before. I've probably put more than that. You can actually do a test in the top of a, like a bottle cap. You really don't need a lot of resources to test.

To do a test, drugs are combined with water. Then, the end of the test strip is stuck into the liquid.

Kalie Shorr: I've never, in the hundreds of times that I've done this, received a negative reaction from someone. I've had people who are like, you know, I actually don't need this, but I know someone else at this party who does. And so they'll take some.

Kalie Shorr, a singer-songwriter in LA, has become the city's fairy godmother of party safety. She sidles up to people at every bar and concert she goes to, offering up fentanyl test strips so they can make sure the drugs they're taking aren't laced with the synthetic opioid that claimed tens of thousands of American lives last year. By some estimates, synthetic opioid overdoses, most of them caused by fentanyl, were the number one cause of death in the United States in 2022 for 18 to 45 year olds.

Kalie Shorr: So you throw a rock and you're gonna hit somebody who it's affected.

[MUSIC SHIFTS]

Kalie Shorr: My sister, she was the oldest sibling I had. I'm the youngest of seven. She was always looking out for me and introduced me to TLC and the Chicks and all these bands that I fell in love with. She loved children so when my mom got pregnant with me and she was 13, she was so excited and would always dress me up in little outfits like a little doll.

Peter Bergen: Is there a song that you've written about her?

Kalie Shorr: There is, yeah, there's several. There's a song called The World Keeps Spinning, and I wrote that about the day she died and just finding out and realizing that nobody around me knew what was going on and my world felt like it was ending. And I drove by a wedding on the way to her funeral and that inspired the song. Just realizing the kind of dissonance between those two things and the mourning process in a world where it doesn't stop just because, you know, you're going through something.

Peter Bergen: How does that song go?

Kalie Shorr: Like, do you want me to sing it?

Peter Bergen: I mean, if that's not an imposition

Kalie Shorr: No. Let me sing my, my favorite part. [SINGING:] I got a drive through coffee, wrote a song like I always do. It was probably about some stupid boy. I wasn't thinking of you. I got a phone call from our dad. Thought he was just checking in, but as soon as I heard his voice, I knew that wasn't it. And it was just another day until it wasn't.

[RECORDING OF SONG SHIFTS TO PROFESSIONALLY PUBLISHED VERSION]

ARCHIVAL Kalie Shorr: [SINGING:] The sky didn't even have the decency to cry / and that damn sun still found a way to shine / when the heartache's hitting, I think it's kinda cruel that the world keeps spinning.

Peter Bergen: So what happened with your sister?

Kalie Shorr: Like many people, she was in college and went to a party and somebody offered her an Oxycontin. And a lot of people were doing that casually. And, and some people, it didn't trigger an opioid addiction in them, but for her addiction runs in her family. So she just tried it casually, not thinking anything would happen. And then one thing led to another, and by the time I was in middle school, she'd been in prison twice. But she always looked on the bright side of things. And she got sober several times in her life, for extended periods of time. If it hadn't been for addiction, I think she would've just been the best mom to her kids. And at moments she was. And I think that's what made losing her so hard is the kids remembered those moments and couldn't understand why she was so different when she was using drugs.

The final time that she relapsed, she was at a Narcotics Anonymous meeting and a girl had asked for a ride home and my sister said yes, and she was really actively pursuing sobriety. And when she got the girl to her house, the girl's like, ‘Oh, do you wanna come in and hang out?’ My sister said, yes, she's a big extrovert. And, um, she went in and the girl offered her drugs and from then on until her life ended, she was fully relapsed. She died of an accidental fentanyl overdose.

Today: a different kind of national security threat. One that may have already taken a relative or a friend or a neighbor in your life. Maybe someone who struggled with addiction for a while. Or maybe someone who wasn't much into recreational drugs but was unlucky enough, one time, to take a pill contaminated with fentanyl. How at risk are you and the people you care about? And what’s being done about all this?

I'm Peter Bergen, and this is In the Room.

[THEME MUSIC]

Perhaps no one understands the diabolical, catastrophic nature of the fentanyl crisis better than Sam Quinones, who has written two exhaustively reported books about opioids. The first, published in 2015, was called Dreamland: The True Tale of America's Opioid Epidemic. Six years later he published The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth, which tells the story of the rapid transformation of the opioid crisis, from Oxycontin, which is derived from opium, to much more powerful and easily produced fentanyl and meth. Quinones never imagined himself spending decades on the opioid beat.

Sam Quinones: Well initially, I was just fascinated by a story that I had come upon one town, a village in Mexico where everybody came here to the United States to sell heroin — black tar heroin — retail.

Quinones realized he was missing a critical piece of the story: the why. Why was there such a high demand for heroin in the first place?

Sam Quinones: And then I began to understand that I was onto the small story. The much bigger story was the opioid revolution in pain management in American medicine that held that opioids for pain patients were not addictive and you could prescribe them in huge quantities.

His book about opioids, Dreamland, was a surprise success. The title is taken from a swimming pool in a middle-class Ohio town that Quinones describes at the beginning of the book. Dreamland covers a part of the story that you probably already know: how opioid addiction mushroomed into an epidemic that spread across the United States.

Sam Quinones: Portsmouth, Ohio was a big industrial town. Had steel mill, had shoe factories, a very employed town, vibrant downtown. Shopping. And on the outskirts of town, they had an enormous swimming pool, the grounds were about the size of a football field, and they called it Dreamland.

[AS HE SPEAKS, DREAMY MUSIC AND THE SOUNDS OF SPLASHING, KIDS LAUGHING TRANSITIONING TO MORE SOMBER MUSIC THROUGHOUT THE NEXT PARAGRAPH]

Sam Quinones: And it was a place where everybody kind of grew up, it was where community was formed and shaped. And where you grew to feel kind of a part of something that was larger than yourself. And in the 1980s, all that began to change. The factories began to close, people began to leave looking for jobs elsewhere. Main street really hollowed out and became a shell. And then they had to dig up and destroy Dreamland. People lost this place where they could be with each other. A lot of real estate was abandoned in Portsmouth in those years. Now, the only place you really saw anybody was at Walmart.

And then, Portsmouth, Ohio became home to a "pill mill," many pill mills actually. These sketchy clinics prescribed pain pills in exchange for cash.

Sam Quinones: No insurance. And so people would line up all day to get their prescriptions filling your waiting room. These clinics are just packed with people all day long. People from all over. An entire generation got addicted this way. This is a supply story. It's not about demand. People are not out there saying, I really wanna be addicted to opioid painkillers. This is about supply. Overwhelming, relentless, very potent supply. First prescription pain pills. Later, heroin, and then after that, fentanyl and methamphetamine. But it's all kind of creating, as it goes, its own demand.

Quinones didn't expect his book to sell. The subject matter was depressing and there was still a lot of stigma around addiction. But after the book came out, Quinones was invited all over the U.S. to speak. At libraries and schools and community centers, people told him their stories of how they had been touched by addiction and overdose. As he reported his first book, Quinones tracked the changing nature of opioid use: when regulations changed and doctors cut patients off from their Oxycontin supply, users replaced Oxycontin with heroin. Then, after his book came out, the story changed again.

Sam Quinones: Methamphetamine, fentanyl, taking over. Synthetic drugs, taking over, no plant-based drugs anymore.

Peter Bergen: You said something quite striking in your book about how anyone can become a drug kingpin with fentanyl. Tell us what you mean by that.

Sam Quinones: What I mean is that these are now able to be produced in Mexico, given the corruption down there and the access to the ports that the trafficking world has, that allows them to get almost unlimited ingredients from the rest of the world, from China, from India, but other chemical ingredients, they can make these drugs in quantities that are simply mind boggling we've never seen… before. If you are a drug trafficker, you no longer need land. You no longer need irrigation, water, sunlight, farmers, you could do it all in a little hut or a lab away from the prying eyes of helicopters. It's most of the time with meth and fentanyl as well as some other synthetics, very easy to make these drugs. And that means, low level drug addicts, low level schmos in wherever you happen to be, can all of a sudden be… selling or dealing in quantities that only kingpins would've dealt with 5, 10, 15 years ago. Multi-kilo loads of fentanyl or methamphetamine or whatever. It's the supplies coming outta Mexico in such staggering quantities that allow almost anybody to sell kingpin level quantities of dope in America today.

Peter Bergen: And so how much stronger is a synthetic, like fentanyl than just regular heroin?

Sam Quinones: Fentanyl is much stronger than heroin or morphine. It was designed that way when it was invented by Paul Janssen and Janssen Pharmaceutica in Belgium. Became one of the world's great drugs. I've had fentanyl in a surgical setting. It's a wonderful drug, revolutionary drug.

Peter Bergen: You had a heart attack in 2017…

Sam Quinones: They gave me, as part of that surgery, fentanyl. And it was a magnificent drug and was very, very helpful. And it has helped many people, millions of people every year, all across America, and I'm sure the world. One reason… that it is so… effective is it's so potent and it can be easily manipulated, in and out of anesthesia.They say synthetic drugs change everything. One of the things they change is that I believe the era of risk-free recreational drug use is over in America.

[MUSIC BRIEFLY INTENSIFIES]

And if the era of risk free recreational drug use is indeed over, so is the possibility of managing a low-grade addiction.

Sam Quinones: I think that fentanyl tends to make it almost impossible for you to be what's known as a functioning drug addict. Your entire life is devoted to fentanyl at that point. And with heroin, I've known people to kind of more or less function.

Peter Bergen: You can function for decades… on heroin.

Sam Quinones: There's lots of people who, you know, who were able to do it. It's not a good way to live, I don't

Peter Bergen: No, it's not recommended, but the point is it's possible.

Sam Quinones: Yeah, it is. And with fentanyl, I don't actually believe it's possible. I know, people might say, oh no, I know somebody. Okay, fine. I think by and large though, as soon as you're addicted to fentanyl, it's such a towering tolerance that, that you build up. You are so dominated by your entire life is devoted to, to finding and using it.

Perhaps you haven't thought of fentanyl, or opioids in general, as falling under the rubric of national security. But to Deputy Homeland Security Advisor Joshua Geltzer, who advises President Biden on this issue, it's that and so much more.

Josh Geltzer: We think about fentanyl as a national security problem, a homeland security problem, a public health problem, a diplomacy problem. All of those. We don't get to choose because if it is causing the number of deaths that it is causing…

ARCHIVAL Newscaster 1: … in a home in Stanford, a woman was found in the basement, dead from an apparent fentanyl overdose. First responders found more people dead in the kitchen. 

ARCHIVAL Newscaster 2: A new form of fentanyl has contributed to the deaths of 75 people so far this year in Allegheny County.

ARCHIVAL Newscaster 3: Fentanyl was identified in more than 1600 overdose deaths of Kentuckians.

ARCHIVAL Newscaster 4: Nearly 108,000 Americans died from overdoses last year. Overdoses involved fentanyl and other synthetic opioids topped 71,000.

Josh Geltzer: When you think about horrific terrorist attacks and think about a certain number of lethalities, or you think about horrific acts of extreme weather, you think about some number of lethalities. And then if you think about the fentanyl crisis, you need to add a bunch of zeros to that. The last 12 month period for which we have good data shows 107,000 Americans perishing in drug related deaths. And we think the vast majority of those being fentanyl specifically. That sort of number dwarfs what you see when you're thinking about terrorism lethality, or you're thinking about extreme weather and it requires a response from the federal government that takes seriously what this is doing to Americans and American communities.

Peter Bergen: So when did fentanyl become a subject of conversation for you and your team and across the government,

Josh Geltzer: In thinking about the answer to that, I've thought of how Hemingway described how a person goes into bankruptcy, which is gradually then suddenly, and I think this is how fentanyl has felt, at least to me. It has been years of seeing some headlines, some stories, some horrific accounts of the way in which fentanyl and related substances have surged in not just their availability, but in the deaths that they have caused.

I wanted to know why the United States is ground zero for the fentanyl epidemic. To answer that question, you have to begin with the supply chain.

Josh Geltzer: It does begin with what I understand to be factories, some big, some small, in different parts of China in which these precursor chemicals are made.

These precursor chemicals typically are made in China specifically to supply the illegal fentanyl market in Mexico where the final product is typically manufactured.

Josh Geltzer: That then gets shipped out in various forms of shipping containers. And so it moves through European ports, and other ports. I don't think there's any single route as to how it reaches Mexico, but it does in very, very large proportion then get to the cartels in Mexico. They use what are often relatively unsophisticated, as I understand it, laboratories to turn that into the powder. Sometimes the powder then enters the United States and it is pressed into pills here, but more often it is made into pills still by the cartels in Mexico. Those pills are then moved into the United States, and frankly we've seen them moved just about any way you could imagine. Probably some ways you couldn't, but the cartels have. Sometimes brought in, in just passenger traffic. We've seen them flown in via drones and we've seen them shipped in using, exploiting, abusing very legitimate services, carriers who have no desire to see their shipping services abused in this way.At that point, it reaches dealers in the United States, which utilize their local networks and often online reach to potential consumers to sell it, and the money is then moved back in various ways, including, being laundered back to the cartels and others who profit from this whole supply chain.

Peter Bergen: As I understand it, just a few tons of fentanyl is enough to like, ruin a lot, hundreds of thousands of people's lives.

Josh Geltzer: It's a brutally tough problem. DEA assesses that right now 60% of the pills making it to Americans are at least potentially lethal. Whether it's lethal depends a little bit on a particular person, their health, their height, their weight, their status. But 60% are potentially lethal. So DEA has what it calls its ‘one pill can kill’ public awareness campaign,

ARCHIVAL DEA PSA video: Counterfeit prescription pills laced with fentanyl are deadly. Be their protector. Be informed.

Josh Geltzer: And it is quite literally true. One pill can kill. That is brutal. The scale of it is brutal. If you zoom way out, the quantity of pills and powder combined seized by U.S. law enforcement at our border last year, just what they seized was enough to kill every single American, potentially with a few pills left over. So that, of course, doesn't even count the pills that were not seized and that did reach Americans and indeed killed far, far too many of them. So it is a distinctive problem in how quickly, how brutally it can be lethal and in just the enormity of the supply right now.

According to Geltzer, the People’s Republic of China — the PRC — isn’t willing to do much to stop the flow of these chemicals to Mexico. While the PRC did designate fentanyl as a controlled substance a few years ago, that hasn't stopped the chemicals that are used to manufacture fentanyl from making their way to Mexico.

Josh Geltzer: In a sense, the supply just shifted in how it emerged from the PRC, shifted to emerging as one step earlier, those precursor chemicals, we think the the natural next step would be for the PRC to evolve and to tackle the sale of those, precursor chemicals as they become this deadly drug. So we are eager to have, uh, a dialogue with the PRC about this and to work collaboratively. It is one that thus far and regrettably their leadership has resisted. But, as we continue to work with other governments around the world and really to ratchet up the level of attention governments pay to this problem and do so collaboratively, uh, we're eager to do that with the Chinese as well.

In April, the U.S. Justice Department announced charges against a Mexican criminal organization called the Sinaloa Cartel. It was once headed by the notorious drug lord El Chapo Guzmán, who is now in a U.S. prison for his crimes. The cartel has since been taken over by his sons. El Chapo means “shorty,” and his sons, called “Los Chapitos,” are the little shorties whose stature in the drug world could not loom larger.

Here's Anne Milgram, head of the U.S. Drug Enforcement Administration, announcing the indictment in April.

ARCHIVAL Anne Milgram: To dominate the fentanyl supply chain, the Chapitos kill, kidnap and torture anyone who gets in the way. In Mexico, they fed their enemies alive to tigers, electrocuted them, waterboarded them, and shot them at close range with a 50 caliber machine gun. To drive addiction, the Chapitos hide fentanyl in pills that look like Oxycodone, Xanax, or Percocet.

To be clear, this is counterfeit Xanax and Percocet, not the stuff you get at a U.S. pharmacy. And, for whatever you think their word is worth, the Chapitos have denied the DEA’s allegations.

ARCHIVALAnne Milgram: They mix fentanyl in with cocaine, heroin, and methamphetamine, all to induce Americans to take fentanyl without knowing it and to get hooked on it.

Peter Bergen: The indictment talks about El Chapo's sons as sort of dominating this fentanyl market in Mexico. I was struck by how well armed these guys are. They have rocket propelled grenades, they have grenade launchers, they have armored vehicles. They have .50 cal machine guns mounted to these armored trucks. I mean, this is like a small military.

Josh Geltzer: That's right. These cartels while profiting — primarily, not exclusively — primarily off selling these types of dangerous drugs, they represent something even bigger as a threat, including very much within Mexico. They are extremely, heavily armed. They use brutal, absolutely brutal violence to intimidate or in some cases actually eliminate those whom they see as a challenge. And they wreak havoc on some areas against civilian populations.

That is a challenge for the Mexican people and the Mexican government. And it is a challenge more broadly because that violence is not confined to the Mexican side of the border. And it's why we treat this as a shared challenge with the Mexican government to deal with because, the, the violence that that goes along with it accrues in the course of trying to generate these drugs, move these drugs, profit off these drugs, it's enormous. And the Mexican government I think is doing what it can to try to reduce those sorts of areas where these entities operate. They of course, like us, have no interest in seeing that sort of violence and that sort of especially appalling effect on, on civilians, but it's very hard.

Peter Bergen: One thing Mexico suffers from is we, the United States, are exporting hundreds of thousands of semi-automatic weapons, which are clearly contributing to the violence. And so is there a deal where the United States gets a better handle on AR-15s and other similar weapons leaving this country, and they do a better job on preventing fentanyl crossing the border?

Josh Geltzer: Look, I think each of us, I mean the United States and, and Mexico is committed to stepping up our game when it comes to dangerous things moving in one direction or the other illicitly. The Justice Department periodically announces quite significant charges for those it is able to hold responsible for the illicit movement of firearms across the border. That work will continue because we are committed to trying to protect the border from illicit movement of firearms, of drugs, of anything that shouldn't be moved along it in either direction.

[MUSIC SHIFTS]

Peter Bergen: Have you ever reflected on… it’s kind of an interesting business model because fentanyl is so dangerous that you're in danger of killing a bunch of your customer base, so why would they go down that route?

Josh Geltzer: For years the kind of inherited wisdom on drug sales was that drug dealers, at least at that level, wanted their clients hooked, but not dead. Because once they were dead, they wouldn't, you know, keep making sales to them. That really has been up-ended by the fentanyl business model in which it is so cheap to produce, and in which the lethality is so high when it's made as cheaply, indiscriminately as it's being made that, those going all the way to the kind of local dealers but going all the way back to the cartels do not seem to abide by that mantra.

They seem to think that there are enough potential other buyers out there that if 60% of the fentanyl on the market is potentially lethal, so be it. And if they lose some users, they'll sell to others. That, I mean, that has just an unbelievable disregard to human life attached to it. But that seems to be the operating principle.

To me, this is the most baffling part of the fentanyl issue: Drug dealers are killing off their customer base. In the past we might have talked about drug users “overdosing” on their drugs. But when it comes to fentanyl, the more appropriate frame is often a poisoning. While plenty of people use fentanyl on purpose, many have no idea they’re consuming fentanyl. For instance, a college student trying out a counterfeit pill, or someone taking cocaine at a party.

So, why would drug dealers want to kill the very people they are selling to? Part of the answer has to do with what Geltzer said. There are enough potential buyers out there that even if they lose some — or even many — there are still plenty of others who will become the customers of tomorrow.

Recently, an appalling new trend has arisen, showing just how powerful the grip of fentanyl is: the addition of Xylazine, known as tranq, to the fentanyl supply in many parts of the United States.

ARCHIVAL Newscaster: Xylazine has been prominent in the east coast, especially Pennsylvania, where it's estimated tranq is in 90% of Philadelphia's dope supply.

It’s a horse tranquilizer that has the grotesque effect of causing severe wounds in users.

ARCHIVAL Philadelphian: You can just walk out into Kensington Avenue and you can smell the rotting flesh. It's awful.

The DEA says that about a quarter of fentanyl powder that was seized in the U.S. in 2022 contained tranq. When you hear that people continue to chase a drug even as it eats away at their limbs, it makes you wonder if we have to throw out the whole playbook on treating drug addiction and write a new one. Sam Quinones is skeptical of whether “harm reduction” measures like clean injection sites and shelters can solve this problem.

Sam Quinones: Fentanyl is unforgiving. It won't allow you to do those really effectively. You could say, yes, here's treatment… and a bed and a place for you to go to get away from the street, and people will not take them. The problem is that that would've worked in another era. The era of fentanyl means that that person is very likely going to die soon because nobody lives on fentanyl.

Peter Bergen: So I'm sure it's hard to kind of come up with an average, but I mean, is it like a two year process?

Sam Quinones: Talking to people on the street, talking to people, outreach workers, and so on. It's about two years. Because even though you may have developed enormous tolerance to fentanyl, which is the natural process, if you survive it, you can never trust the mix to be what you're looking for. It, it always will be off.

Peter Bergen: Right.

Sam Quinones: And, and so you've got people hitting mixes that, that will kill 'em. No matter what their tolerance is.

Peter Bergen: What about harsher penalties for people who are dealing in fentanyl?

Sam Quinones: I believe there need to be consequences without a doubt. Nothing could be clearer than the fact that selling something with fentanyl in it is akin to firing a gun into a crowd. You know you're gonna hurt somebody, you know you might well kill somebody. It's clear there's no lack of knowledge to hide behind anymore. and there's no getting around the idea that almost everything has fentanyl

[MUSIC SHIFTS]

There are lots of myths swirling around when it comes to fentanyl. Last year, panicked headlines about fentanyl disguised as candy made the rounds ahead of Halloween — but that turned out to be unfounded hysteria. While it’s true that some cartels have added color to their fentanyl product, there’s no evidence that anyone has been disguising the drug as candy and attempting to give it to children.

Another myth common enough to pop up in news coverage: fentanyl can be absorbed through the skin, or the powder can be inhaled accidentally. Experts say this isn’t true: fentanyl doesn’t get into the body all that easily, which is why people often smoke its vapor or inject it.

But the myth persists. Until recently, the DEA even warned first responders about these so-called risks on their website. According to experts, this information is inaccurate and even dangerous: If first responders are afraid to touch overdosing patients, they might hesitate to provide care — and when someone is overdosing, even a minute’s delay can mean the difference between life and death. When we contacted the DEA about an erroneous fact-sheet on their website for first responders, they said it would be moved to their archive.

As a parent, I wanted to know, what advice can I give my kids that will actually keep them safe? Sure, you can tell your kids, "just say no," but as Kalie Shorr reminded me… when it comes to teenagers, defiance is part of the gig. When the stakes are life or death, we might have to change the way we think about talking to our kids about doing drugs.

Kalie Shorr: Kids are gonna do whatever they want. I mean, they don't have fully developed prefrontal cortexes. How are you expecting them to weigh all the risks and rewards of this situation? It, to me, feels similar to like sex ed in schools where if you teach abstinence only, I mean, I went to an abstinence only school and I was one of three girls in my class who had not been pregnant by senior year. I mean, I'm not even exaggerating. Small school, but still crazy numbers. You don't have to approve of it in order to give your kids the resources. I think that the best thing you can do is to just relieve yourself of the judgment and realize that maybe if your kids aren't gonna use them, their friends will. I've also started carrying Narcan in my purse as well, which is very small, I mean it's smaller than a case of AirPods.

Peter Bergen: What is Narcan?

Kalie Shorr: Narcan is, uh, it's also known as Naloxone. It's an opioid overdose reversal drug. It's a nasal spray. It really just targets the opioids in your system if you are overdosing and can save your life.

It’s no wonder Kalie Shorr is so dedicated to stopping the next overdose death. She lost her sister to fentanyl in 2019, and then in 2022, she lost one of her close friends as well.

Kalie Shorr: A little over a year ago, my high school best friend, she had struggled on and off with addiction and had gone to rehab. I mean, I believe, you could count on two hands how many times she'd gone. It was, it was definitely like her family tried so hard and, and had the resources to get her that help. And she had been sober for six months. And was living with her family and they helped her get into an apartment. And the first night she was in her new apartment, she did what she thought was two lines of cocaine and she had no idea that the cocaine she did was laced with fentanyl and, yeah, she passed away.

Peter Bergen: Very sorry to hear that. What is her name?

Kalie Shorr: Her name's Casey Bouchard. She was an incredible person and I think that that's the biggest thing I want to, you know, get out there, is I think that if you haven't lost someone…to addiction, there's still this kind of notion that it's a junkie in a trailer and these are people whose lives were just gonna go there anyways.

[MUSIC SHIFTS]

Casey Bouchard worked with autistic children. She spent much of her time fundraising for an orphanage in Zimbabwe. She had planned a visit there… but she overdosed, or rather she was poisoned, by fentanyl.

Kalie Shorr: I don't believe everything happens for a reason. I think that I never should have lost Casey and Ashley, but if I was going to, it's my responsibility to make something good come of that. And if they had had somebody at a party passing those out to them, they would still be here.

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If you’d like to learn more, we recommend Dreamland: The True Tale of America’s Opioid Epidemic and The Least of Us: True Tales of America and Hope in a Time of Fentanyl and Meth. Also, we recommend checking out more of Kalie Shorr’s music. You can find her on Youtube and on Instagram @kalieshorr, that’s k-a-l-i-e-s-h-o-r-r.

Special thanks to the toxicologists we spoke to for this episode, Dr. Lewis Nelson and Dr. Ashraf Mozayani.

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