Confused, distressed experts and media confabulate: that against all evidence and daily news reports, drug users have no idea the illicit drugs they buy and use might include fentanyl

by Clark Miller

Published April 25, 2022

Fentanyl, in news headlines every day,

could easily be imagined to be perceived and understood by American consumers of American Media as much more than a psychoactive chemical powder, instead as some threatening thing, some force, with agency, malevolent intent, a terrorist organization, a foreign enemy.

Because, clearly, fentanyl is Harming America, is causing, is the explanation for something that wasn’t supposed to happen. Fentanyl is causing sustained, unrelenting – pre-pandemic, during, now post-pandemic – multiplying overdoses, more and more deaths. Its victims, as typically portrayed, are passive, uninvolved, inexplicably found to have had fentanyl enter their bloodstreams, with tragic effects. By some media accounts, the overdose victims have been poisoned, but by whom and why is not clear. By the suppliers of illicit drugs whose income depends on living consumers? 

None of that of course makes sense, no more than any of the necessary deceptions American Media have been fabricating in collusion with American Medicine, beginning with those that created the opioid crisis.

This fiction is particularly off, contrived, nonsensical, disingenuous. But necessary. Because without some fabricated cover story, some manufactured rationalization, we are left to face the truth that we’ll explore below and as reported consistently over past years – opioid users are continuing to use street opioids with known risk of fentanyl involved, and are actively seeking out fentanyl, aware of the risks.

We have known for years now that fentanyl is desired, sought out and used on the street, or used by opioid users having been added to other opioids, at known risk of that presence.

As reported in St. Louis, Missouri, in 2019 on the street, the risk commonly understood  – 

A decade ago, the state’s opioid crisis was fueled by prescription pills, and largely affected rural, mostly-white communities. But in the last five years, the crisis entered a new phase — one dominated by fentanyl, and focused in urban areas.

When it hit St. Louis, Morris Lockett saw the change first-hand. Lockett used drugs for most of his life, and ended up spending 17 years in prison. When he returned home in 2019, he found the scene had transformed.

“The drugs that was normally on the street wasn’t on the street,” Lockett said. “And the drugs that was on the street was pretty much laced with fentanyl.”

Fentanyl is the new heroin. 

That’s a big problem and explains the desperately constructed cover stories.  

Because how could that be? When we know –

have it on authority of America’s top, trusted medical and public health experts with consistent assurances in American Media – that there is a widely available cure for opioid dependence that works really well, a proven medical cure that eliminates the risk of using dangerous opioids on the street, eliminates high-risk use.

Provision of that cure, medication assisted treatment (MAT) with the substitute opioids methadone and Suboxone, has increased steadily over past decades and as described in this recent post is widely available on the street, no prescription needed. The inexpensive, DIY street form, available everywhere, is used as an effective cure for problem opioid use, just as it would be if prescribed by a medical professional, we are assured by America’s addiction treatment and public health experts.

So that is a problem, isn’t it? Because the fentanyl phenomenon, representing continuously elevating levels of high-risk illicit opioid use – with daily risk of death – then becomes direct invalidation of MAT. Treatment or no, if you can procure illicit opioids, you can find Suboxone, “subs” on the street too. It’s everywhere.  If MAT, available to every opioid user, prescribed or DIY, works to cure high-risk opioid use, – just by using it daily as a proven medication – to offer users escape from compulsion to regularly risk death by use of street opioids including fentanyl, then the relentlessly mounting, lethal fentanyl phenomenon gives the lie to MAT.

Fentanyl exposes the established lethal lie of MAT.

No wonder they have to keep making this stuff up! Who can blame them? There’s just too much at stake.

We’ve known about the real role of fentanyl on the street for at least a couple of years –

New research from the B.C. Centre for Disease Control that suggests people are knowingly using fentanyl in B.C. is not surprising news for the president of the Vancouver Area Network of Drug Users.

Lorna Bird, who is in recovery from a heroin addiction, said the reason behind drug users’ preference for the potent synthetic opioid is simple: the high is better than heroin.

“A lot of people don’t even want the heroin anymore, they’d rather have the fentanyl — they get higher,” Bird told the Courier by telephone Monday from the VANDU office on East Hastings.

Bird then passed the phone to a 39-year-old woman named Delilah, a heroin user for 16 years, who said she continues to buy heroin but knows it can be laced with fentanyl.

“It’s stronger, and it helps,” she said, adding that she’s overdosed a couple of times, but believes she’s developed a tolerance for the drugs.

“It’s dangerous, but [the dealers] usually let us know. We just do a little amount of it, that’s all.”

Delilah’s experience and the findings of the new research is in contrast to government, health agency and police campaigns that say fentanyl the size of a grain of salt can kill a person.


Delilah’s insight about tolerance and Bird’s assessment about preference are in line with some of the study’s findings, with another factor being the drug’s widespread availability in the street drug supply.

The study’s lead author, Mohammad Karamouzian, a PhD student at the University of B.C.’s School of Population and Public Health, said he was shocked by the number of users saying they knowingly used fentanyl.

“Before we got the results, we honestly didn’t expect this,” Karamouzian said.

“The general narrative is that most exposure to fentanyl is unintentional, people don’t know what’s in their drugs. All of our public education campaigns and messaging has been ‘be careful, there’s fentanyl out there.’”


The study drew on data collected from 303 drug users recruited from 27 harm reduction sites in B.C., including Vancouver. Each participant completed a brief survey and provided a urine sample that researchers tested for fentanyl and other substances.

Sixty per cent of users had fentanyl detected in their urine. Of those people, 64 per cent knew they had taken fentanyl. 


Significant that all respondents were involved in “harm reduction sites”, although we don’t know what that means. At the very least, it likely means that in addition to needle exchange and/or other harm reduction supports, these clients would have also been receiving or repeatedly offered MAT. 

That relationship is consistent with more recent findings from the U.S. that link harm reduction involvement (MAT) with urine screens positive for illicit fentanyl and with pandemic period overdoses. 

The direct evidence for the intentional use and role of fentanyl in street economies of opioid use is longstanding and described, for example, here

Dr. Jane Buxton, an epidemiologist and harm reduction lead at the B.C. Centre for Disease Control, said in a news release last week that making users aware of the presence of fentanyl in the drug supply “isn’t enough.”

“We need harm reduction services, substance use treatment, overdose prevention resources and pharmaceutical alternatives to the toxic drug supply to reduce the devastating impact of fentanyl and its analogues on our communities,” she said.

Dr. Buxton is putting a great face on this, really. 

The problem is that her medical interventions for the entirely non-medical problem of compulsive substance use have had a decades-long trial run, in the U.S. funded with $billions in public healthcare funds.

The outcomes are clear:  illness, death, and epidemic predictably worsening over those decades. 

cityscape, St. Louis, Missouri

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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