When Keisha, a drug dealer based in British Columbia, Canada, first told me she considered fentanyl “safe,” I scoffed in disbelief.
Fentanyl—an opioid up to 50 times stronger than heroin—is the main driver of drug deaths in the U.S. and Canada, where it’s been linked to at least 250,000 fatal overdoses in the past decade.
But a lot of drug users and experts working in harm reduction and addictions that I spoke with shared Keisha’s view. While fentanyl is by no means safe, worse drugs are now hitting the street supply.
“Eventually, there's not going to be anything to do with heroin and fentanyl. It's going to be all chemical, all from the dark web, all just something people have thrown in a bowl and sold as fent or heroin,” Keisha said.
VICE News spent the past six months investigating this latest—and deadliest—wave of North America’s overdose crisis. We found an increasingly volatile and toxic drug supply, cut with legal synthetic chemicals that can be easily purchased online. The sheer variety of substances being combined means this era can no longer accurately be called an opioid crisis—it’s more accurately a polysubstance overdose crisis.
For the people taking these drugs—essentially human guinea pigs—the effects have been devastating. Even with harm reduction gaining momentum, 2021 was another record-breaking year for overdoses in the U.S., with more than 107,000 deaths. Since 1999, more than 1 million Americans have died from drugs.
As part of the VICE News Tonight documentary “Beyond Fentanyl,” we embedded with Keisha as she cooked and sold fentanyl, offering it to people who are hooked on “benzo dope,” a deadly cocktail of synthetic benzodiazepines (sedatives) and fentanyl. In March, benzodiazepines were found in a third of fatal overdoses in British Columbia, according to the Coroners Service. Drug users in Abbotsford, B.C., a city an hour’s drive from Vancouver, described being robbed or assaulted, or getting into car crashes, while knocked out on benzo dope, and having “amnesia” when they finally woke up.
“The benzos are going to kill a lot of people... It’s already started, and everything is cut with it,” Keisha said.
She said when benzos first contaminated the fentanyl supply, nobody knew it was happening—they just knew there was super strong dope on the market. But people quickly became addicted.
Meanwhile, in Philadelphia, the animal tranquilizer xylazine is being found in nearly all of the illicit fentanyl and heroin samples and being sold as “tranq” or “tranq dope” on the street. Users are reporting severe skin abscesses they believe are caused by the tranq, including in parts of their bodies where they aren’t shooting up. In some cases, they’ve needed fingers or toes amputated.
“Brown dope [heroin], you're hardly getting sick from that. That was like nothing. Fentanyl was a little bit worse. But this tranq is intense,” said Sam Brennan, a tranq user in Philadelphia's Kensington neighborhood. “You feel like you're literally going to die.”
While it’s hard to know for sure where the chemicals being cut into the supply are coming from without talking to wholesalers, we did identify one easy pathway: via chemical companies based in China.
Nicole Cook, a narcotics analyst for the Center for Advanced Defense Studies, a nonprofit based in Washington, D.C., that tracks online drug suppliers, showed VICE News 109 xylazine sellers, most of them based in China, on a single website.
President Donald Trump’s administration successfully pressured China to ban fentanyl and its analogs in 2019, which resulted in a drop in shipments to the U.S. of finished fentanyl. But then Mexican cartels began synthesizing fentanyl using precursors bought from China, and other drugs, including xylazine, which aren’t scheduled in the U.S., have become more common.
Trying to keep up with clandestine chemists is like a game of whack-a-mole: Manufacturers need only tweak a compound slightly to make a new substance that’s technically legal.
“The producers are always going to be one step ahead,” Cook said. “You can’t just control every single chemical that ever existed.”
While President Joe Biden’s drug control budget included a historic $85 million specified for harm reduction, it focused on treatment and $18 billion for law enforcement measures to disrupt the supply. His administration’s drug strategy did not mention safe supply—providing pharmaceutical alternatives to street drugs, or making safe drug consumption sites legal federally. Those are the measures drug users told VICE News are most urgently needed to save lives.
For Keisha, the matter is so urgent that she was willing to risk being arrested by appearing undisguised in “Beyond Fentanyl.”
“I have an extensive record and I’m not wearing a mask and I could have consequences from other people that I deal with. It could probably potentially make or break me,” she said.
But she said using and selling drugs in the shadows of society is also driving deaths.
“I want people to stop hiding.”
Follow Manisha Krishnan on Twitter.