One Pill Can Kill

Conversations on an out-of-control fentanyl crisis. The killer drug that is sweeping across America has made its way south and the fight is on to save ourselves from this overdose epidemic that has taken so many innocent lives.

Fake pills disguised as prescription medications are driving the overdose crisis killing people like Johnathan Millwood.

When South took on the task of covering the escalating opioid and fentanyl crisis, what began as a Q&A took a personal turn through two very different sets of eyes – those on the frontlines of law and policy, and those on the frontlines of love and loss with families affected by addiction.

Johnathan Millwood was a young professional in San Diego, just 28 years old, working as a district sales manager, in a happy relationship, supported by a loving family who gave him a memorable childhood. He wasn’t what you’d describe as a drug addict. He had a prescription for Xanax. That’s it. Seeking access to the drug in a pandemic year led him to an unregulated dose unknowingly laced with fentanyl. Taking a single pill – one he believed to be the same as the prescribed medication he’d taken many times before – would this time, instantly take his life.

It’s one story of hundreds of thousands shocking families and loved ones, and not seen coming by the person taking the medication. “He thought he was just taking a pill,” says his sister Whitney Millwood. “If he had known the risks, if we had known, I believe it would have been different. That’s why even though it’s hard to talk about, it’s so important to let others know. We wish we would have known.”

That’s the common thread among everyone from loved ones to law enforcement to leadership in the fight against the opioid crisis like TJ Ward, the North Florida Director of Advocacy for Project Opioid at Jax Chamber. “Unfortunately,” TJ shares, “stories like Jonathan Millwood’s have become all too common. Bootleg versions of the synthetic opioid, fentanyl, are being laced in everyone’s drug of choice, and fake pills disguised as prescription medications are driving the overdose crisis. That’s why Project Opioid is partnering with family members of lost loved ones, courageous people like Whitney and her husband Brock, who are willing to leverage their loss to help bring awareness to the newest narrative of the overdose crisis that claimed more than 108,000 lives last year.”

Assistant Special Agent in Charge of the DEA Jacksonville District Office, Mike Dubet brings to life how unfathomably lethal and undetectable a drug we’re dealing with. Speaking of a nearly microscopic amount being fatal, Dubet describes, “This product is fifty times more potent than heroine, and one hundred times more than morphine.”

But we’re not talking about traditional street drugs or even known risks. Fentanyl is the “ghost drug” being found in familiar over-the-counter doses of Adderall, Xanax, and Oxy – pills kids have been known to share, “try” once, or frighteningly even dose each other with as a joke. That joke can turn into two lives lost when one is killed and the other prosecuted.

“It didn’t used to be like this,” says Millwood. “Kids used to experiment with pharmaceuticals, and though not good, they survived and you could deal with the problem once you knew. Now, you only get one chance – or, you don’t even get that, you get zero chances, and families don’t know this.”

Asked what one thing she wanted others to know, Millwood shared the same urgent message you’ll hear from everyone who has seen this crisis from the inside:

“Unless a pill comes directly from your doctor, you are risking your entire life. Not just parents, everyone, please talk about this, make sure others know. I keep thinking, if I say something to someone who doesn’t know this, maybe it will make them hesitate just enough to not do it.”

A single message to change a life. Pass it on.

More People, More Lethal

“In 2021,” reports Josephson, “we saw the highest number of deaths ever and the highest increase in adolescent drug use as well. But this is not necessarily attributed to the equivalent rise in the number of people using drugs, but the potency of drugs themselves. Drugs are not more prevalent – they’re more deadly. It’s not more people, it’s more lethal.”

In three consecutive years, according to the CDC, drug overdose deaths in the United States in a one-year period rose from 56,064 to 78,056 to 100,306, and as Josephson explained, this doesn’t mean an astronomical increase in drug use, but an increase in fatalities from an only slightly higher number of individuals. More than ever, these drugs are laced with fentanyl, which the DEA calls “the deadliest drug threat facing the country, and up to 100 times more potent than morphine.”

That is a state of emergency, and it’s the quietest one ever, rolling almost fully under the radar of awareness especially where it’s needed most – in schools and families of teens and young adults – and proliferating at a rate where our response is not matching pace on any level.

Mercy Johnson knows this first-hand saying, “When it comes to drug addiction within the United States there are some really important questions and realizations that are making their way through society too slowly.”

Drug addiction is not what it was 15 years ago.

Matteo And Mercy Johnson

In the past you hear a lot more about overcoming addiction than you do now. “Fentanyl addiction is not that,” says Johnson, “The strength of brain chemistry alteration initiated by fentanyl is far more lethal and it only takes overdosing on fentanyl once to kill you. Now, most stories involving fentanyl include several overdose and resuscitation instances, but without immediate and exasperated care, overdose usually results in death.”

The drug rehab industry is not equipped to deal with complex drug addiction situations.

“Social progress in this area is moving very slowly and distribution of fentanyl is increasing more rapidly. Because fentanyl takes such a strong hold of the addict’s brain, the determination of the patients to return to drug use is stronger than traditional drug counseling has been previously trained to handle,” says Johnson.

The legal system is not caught up to the present issues.

Johnson’s research focuses on the “necessary legal measures that can be taken to empower people to protect their loved ones from self-destruction. The medical industry has created a huge loophole by declaring drug addiction a disease. This opens an opportunity to evaluate patients using competency and informed consent testing. If medical professionals can demonstrate a compromised decision-making ability, power of attorney can transfer to family members who are better equipped to make life saving decisions for patients compromised by drug addiction, and with safeguards in place requiring agreement of two adult relatives.”

Matteo Johnson San Diego

“I want to help people move through these things and return to authentic joy, and remind people, you’re not alone. Some days will be hard, others will be good. Be brave: Tell someone what you need. Reach out. It’s worth it. They might not know what to say, but they’ll be present with you.” – Marcy Johnson on losing her brother, Matteo Johnson.

Undetectably Deadly

This year, the South Carolina Department of Drug and Alcohol Abuse reported that fentanyl was “found in more than half of the fake pills tested.” Addictions.com puts that in perspective saying, “Ninety-one Americans die from an opioid overdose every day … and while many of these opiate overdoses are due to people knowingly taking fentanyl, an increasing number of other drugs are being laced with fentanyl and sold to people who don’t realize what they’re getting.”

This is an area of abject focus for Josephson and the Savannah US Attorney’s office where he serves as Opioid Coordinator, a position now required by the Attorney General in every US Attorney’s office to serve as POC on issues surrounding the crisis including outreach and education.

“Most would be amazed with how real synthetics can look, but they’re fakes. They’re not mixed with precision, not regulated, not “safe” as users would expect of a prescribed drug. Oxy, Xanax, Adderall – these are all being knocked off by pill mills, where there’s no oversight to proper production, drugs are not pharmaceutical grade, and no way to know what you’re taking. This means we’re fighting US pill mills the same as we are the drug cartels, where there’s no oversight to proper production and you cannot know what you’re taking, which is the real danger of drug use today.”

An Every-Person Crisis

Add to this unorthodox and imprecise battle of chasing fakes, the war has moved to unorthodox channels, going online, deep into social media, and into the chat of any kid with a phone. You aren’t dealing with seedy, street corner deals. You aren’t telling your kids to stay out of a certain part of town. “This is your brain on drugs,” has been retired by a raging fatality rate changing the drug war slogan to, “One pill can kill.” We’ve lost our buffer of the second chance.

Somberly, Josephson says, “It doesn’t take much for tragedy to strike. It’s an every-person crisis.” It can be a first-time experience for your teenager – or younger – who thinks they’re popping their friend’s Adderall poolside out of sheer curiosity. It can be buried in your kids DMs and snaps. Josephson says with exasperation yet determination, “You can see a line of emojis – and it’s a drug deal.”

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Here is where Josephson touches on a point that is at once inspiring and devastating: “It isn’t just dying from the drugs, it’s all the hopes and dreams that get sidetracked when you start going down the road of addiction. You see it all the time in our kids – they have dreams and goals in life and those dreams are not compatible with drug use.”

So What Do We Do?

“The starting point,” says Josephson, “is for the community to realize that this is a crisis that affects everyone, and everyone needs to be involved in the solution. We need to help families to talk about these issues early, and make sure it’s not seen as taboo or something you can’t talk about until something terrible happens. Then you have to provide the resources. A lot of parents want to talk about these issues and want to prepare kids, but don’t know how to start the conversation, what to say, or how to say it.”

The common thread among those in the fallout of crisis is a selfless passion to hit the alert button, wave the flag of warning, share a story that could change a direction or save a life.

Johnson shares from experience, “I want to help people move through these things and return to authentic joy, and remind people, you’re not alone. Some days will be hard, others will be good. Be brave: Tell someone what you need. Reach out. It’s worth it. They might not know what to say, but they’ll be present with you.”

“Get involved in a solution,” says Josephson in the same chorus. “Talk. They hear you. Increase family engagement. Bring attention to the subject. Talk early and know how to start the conversation at any point, remembering that yes, it can happen to anyone.”

As is his aim of his office, Josephson encourages families or individuals to find and use the tools created to help in these areas and provides a list of links to use as a springboard.

“There is no magic formula, no guarantee,” he says, “but education and communication can give you the best chance.”

As much as one pill can kill, one word might make a way, and on a good day, that might be all someone will need, to live.

Savannah’s Assistant US Attorney Matthew Josephson

THE FIGHT FROM SAVANNAH: WHAT’S BEING DONE BY THE CHATHAM-SAVANNAH COUNTER NARCOTICS TEAM (CNT)

“CNT has formulated a multi-pronged approach to the opioid epidemic, in an attempt impact each phase of the epidemic; before, during and after i.e. education, enforcement and recovery. CNT has partnered with the community to help establish early prevention education and training as well as a “Healing Hearts Family Support Group.”

In order to help educate the community CNT has partnered with the Board of Education, as well as other partners, to help teach the dangers as well as the early signs of fentanyl use to students, parents and the community. These efforts include:

Re-rocking is the process of diluting drugs and re-forming the drug into the final pills with a hydraulic press.

Working with several Chatham County partners to establish a local call center to direct Chatham County residents to specific opioid related resources.

Over the course of the last two years, aggressively investigating any individual distributing fentanyl, dedicating personnel and resources to respond to and investigate overdose deaths that occur within the entire Lowcountry area, with the ultimate goal of prosecuting the distributor of the fatal dose.

In an attempt to help those who have lost a love on to an Opioid Death, partnering with the recovery center in Savannah Georgia, a qualified Recovery Center counselor oversees the Healing Hearts monthly meetings. Re-rocking is the process of diluting drugs and re-forming the drug into the final pills with a hydraulic press.

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