'There's no demographic that's safe' as fentanyl use increases across North Dakota

Dec. 2—GRAND FORKS — There were 131 drug overdose deaths in North Dakota last year. That's more than the state's 101 traffic deaths in 2021.

The 2021 total of overdose deaths is up from 76 in 2019 and approximately 116 in 2020.

"There's no demographic that's safe," said Col. Brandon Solberg of the North Dakota Highway Patrol. "There are middle-schoolers, for example, who have experienced an overdose."

Opioids and amphetamines were the most common drugs in 2021 overdose deaths, according to Highway Patrol press release. The NDHP has been organizing opioid roundtable discussions in response to the increase of drug overdose deaths. The department brings together public health and public safety agencies across the state to explore the depth of the issue as well as potential solutions. Overdose statistics provided at the opioid roundtable discussion in Grand Forks were collected by the Department of Health and Human Services.

However, the number of overdoses is likely much higher than statistics show because many overdose deaths are not reported, according to Northeast Central Judicial District Presiding Judge Donald Hager.

"We have a lot of unreported overdoses in this community, and we see them as judges," Hager said.

When the cause of someone's death is undetermined, judges may sign warrants for drug tests, blood tests and other related searches. Of the overdose deaths Hager has seen in recent years, "all of them, pretty much, are fentanyl-related."

"I call it the drug of death," Hager said.

Though fentanyl (a synthetic opioid) has been "prevalent" in North Dakota "for a number of years now," Grand Forks County State's Attorney Haley Wamstad said "it has become much more accessible."

In Grand Forks County, overdose deaths are rising as well, from six in 2019 to 12 in 2021.

Fentanyl is a powder and can be injected intravenously. However, the drug is commonly manufactured into a pill that resembles M30s (oxycodone). The pills make ingesting fentanyl much easier.

"They don't need needles or, you know, anything like that," Wamstad said.

Counterfeit M30 pills have become commonplace in recent years and, thus, law enforcement can typically identify the pills as fentanyl. However, counterfeits often went undetected when fentanyl pills were new to the drug market.

Recently, "rainbow fentanyl" — fentanyl pills of various colors — has been found in North Dakota.

"Enough time has passed where individuals realize that most of these pills are counterfeit, so now [manufacturers are] starting to get into the business of mixing up their variety and options and colors," Solberg said.

"They're starting to make them look like Smarties," said Hager, referring to a type of candy. "It's kind of dangerous for kids, if these get passed along."

Recently, fentanyl has also been found laced into marijuana.

"That's a scary part," said Hager, "and an argument, I guess, for people who want [marijuana] legalized and controlled."

A major concern with counterfeit M30 pills is users' inability to determine the quantity of fentanyl in any pill they come across. The U.S. Drug Enforcement Administration considers two milligrams of fentanyl to be a potentially lethal dose — for someone who has not built up a tolerance to the drug.

"In order to put that into perspective," said Solberg, "I usually share that a sugar packet weighs four grams, so the residue left behind after dumping out the sugar crystals could be two milligrams."

According to Solberg, the absence of quality control in the manufacture of counterfeit M30s results in vastly different fentanyl doses per pill. The process does not take place "in multimillion dollar controlled lab facilities" such as prescription pills tend to, Solberg said.

"These might be individuals ... using a bullet to mix up, and so one pill might have an extremely potent amount of fentanyl, and one pill might be light," Solberg said.

"They're just taking a chance, whether they know it or not," said Hager. "It's like playing Russian Roulette."

A significant contributor to fentanyl's increasing presence in North Dakota is the substantial amount of money to be made by selling drugs in smaller communities.

Hager and Solberg both said one fentanyl pill can be sold for $80 (or even $90, Hager said) on Native American reservations in North Dakota, where the supply of fentanyl and other illicit drugs is minimal.

The market value of fentanyl in Grand Forks, though not as high as on reservations, is significant compared to large metropolitan areas.

As a judge, Hager sees many defendants from out of state who have no ties to Grand Forks County — professional or personal.

"There's a lot of people that don't have jobs that come through court, but they have large amounts of cash on them, and that's from selling drugs," Hager said.

"There's disposable income in our state," said Solberg, "heavy ag, heavy energy — and the criminal element is just responding to that. They're trying to meet that demand and provide an adequate supply."