Warning: This story contains descriptions of drug-taking from the start and discusses suicide The few grains of fentanyl sit in the silver foil as a straw, held between Mike's lips, hovers above; a cigarette lighter below. The 48-year-old army veteran is crouched low in an alleyway in Columbus, Ohio's Linden neighbourhood. "This drug will damn near make you do anything, unfortunately," he says.
The hit he's smoking cost three or four dollars. "You can snort too much and you can't take it back. Can't call the bullet back," he says.
He burns the foil and inhales. As the opioid takes hold, he grips the fence behind him. He sways as a low moan comes from deep in his throat; he could be humming a tune.
We've spent a few days with Mike - he's been our guide through the neighbourhood's back streets. Everyone seems to know him and he's regarded fondly. He helps out at a local pawn shop and gas station, and that's how he feeds his 20-year-old opioid addiction.
Synthetic opioids are more powerful and in plentiful supply, and they have transformed the drugs landscape. Fentanyl, which is entirely man-made, is 50 to 100 times more powerful than heroin, which is cultivated from poppies. It is now often cut with synthetic tranquillisers, which make reviving overdose victims more difficult.
These are homemade threats, where cocktails of synthetics can be made in American basements and bathtubs. We have Naloxone (brand name Narcan) in our pockets, in case anyone on our team comes into contact with fentanyl or anyone around us overdoses. It's a nasal spray that immediately reverses opioid overdoses and its widespread adoption has transformed the number of fatal overdoses in the United States.
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