For Christmas vacation in 2014, Bailey Henke went on a road trip, driving west across the snowy plains of North Dakota. The recent high school graduate departed his apartment in Grand Forks with his roommate, Kain Schwandt. They passed the University of North Dakota, the lumber store, and the town landfill, before the city gave way to farmland. The sky began to open up.
Henke, who wore a chinstrap beard, put U2 on the stereo and watched the scenery speed by. He had a way of putting others at ease, of putting on a brave face no matter how he felt inside. He and Schwandt knew that what lay ahead of them on this trip, that it wouldn’t be easy, but they felt optimistic. They weren’t just visiting family members for the holiday. They were traveling with a specific purpose: to get well.
The two eighteen-year-old friends had developed opioid addictions. In addition to nasty heroin habits, they had recently become consumed by an even more potent and destructive drug called fentanyl.
Most people, if they knew of fentanyl at all back then, knew of it as a medicine. Doctors had used it for decades, during surgeries, in epidurals for women during childbirth, and to help cancer patients and others in great pain. But around the time Henke and Schwandt started using it, fentanyl abuse was becoming increasingly common. Like heroin, fentanyl is a derivative of morphine, capable of producing both great pleasure and great suffering—except it can be fifty times stronger than heroin. Even a tiny amount can overwhelm the respiratory system, causing users to stop breathing.
Henke and Schwandt initially got their fentanyl from medical patches, bought on the black market. The prescription-grade patches were intended to be stuck onto one’s chest or upper arm, to relieve pain, but Henke and Schwandt didn’t use them that way. Instead, they cut them open with a knife and squeezed out the fentanyl gel onto tin foil, and smoked it through a tube. (They didn’t shoot it up because they didn’t like needles.) Later Henke acquired fentanyl in a white powder form that was made illicitly.
Fentanyl gave an incredibly powerful high—unlike anything the teens or their friends had ever experienced.
“I’d never tried it until Bailey brought some over one day,” Henke’s friend Tanner Gerszewski said. “He showed me a tiny little bit and said, ‘That’s $150 worth.’ ” Gerszewski thought it was a rip-off until they smoked some together. “I barely even got any smoke, but I was just blown away. I was sweating. I got a call, but couldn’t see the phone well enough to answer it. Heroin is strong stuff, but fentanyl is just completely on another level.”
Even though Henke had been smoking heroin for some time, fentanyl raised the stakes. He was experiencing a rough patch in his life. Not long before, he had split with his girlfriend after going through her text messages and discovering she was seeing someone else. And though he dreamed of becoming a cop, he had recently dropped out of community college in nearby Devil’s Lake and started working at a local car dealership. Their drug habits were dragging them down, and so he and his close friend Schwandt resolved to get clean, to go through withdrawal on this road trip together, far away from their drug suppliers and their corrosive influences.
Opioid withdrawal is notoriously difficult, but the two young men had help in the form of Suboxone—a medication designed to help people beat these types of addictions. Perhaps just as important, they had each other.
Still, they expected roadblocks and soon encountered a literal one in the form of a massive blizzard. Before they could reach Minot, the western North Dakota town to which Bailey’s parents had moved, the roads became almost impassable. Finally a local police officer, taking pity on the travelers, turned on his lights and led a caravan of cars slowly down the highway, and they safely arrived at their destination. While in Minot, they hung out with Henke’s parents, went to the mall, and laughed a lot.
“We had a really nice Christmas,” said Bailey’s mom, Laura Henke.
Henke and Schwandt did their best to hide their withdrawal symptoms, which were beginning to kick in. “It was really uncomfortable,” Schwandt said. After Henke’s parents went to bed, they would stay up late and play video games, pilfering some beers or vodka from the liquor cabinet. The booze helped him sleep, Schwandt said, and Henke’s parents were none the wiser.
In fact, Laura Henke didn’t notice anything out of the ordinary. “As far as I knew, they weren’t using,” she said. The truth is, she had absolutely no idea what her son was up against. She had never even heard of fentanyl.
“I was clueless,” she told me.
Laura Henke wasn’t alone. As recently as 2015, very few Americans were familiar with fentanyl.
After the heroin and prescription pill crisis took off in the 1990s and reached epidemic levels in the following decades, heartbreaking reports increasingly appeared about decimated communities, about young victims cut down in their prime.
Yet while civic leaders, law enforcement, and politicians struggled to find answers, fentanyl was quietly creating a brand-new drug epidemic, one that quickly outstripped the previous one and has become more destructive than any drug crisis in American history: worse than crack in the 1980s, worse than meth in the first decade of the 2000s, worse than heroin and prescription pills in the 2010s. “Fentanyl is the deadliest drug in America, CDC confirms,” read a December 2018 CNN headline.
Because of its incredible potency, fentanyl is extremely difficult to dose properly. It can be lethal at only two milligrams, an amount barely visible to the eye and far smaller than a dose of heroin. Traffickers “cut” fentanyl into other drugs to give them more kick, unbeknownst to users. Thus, many fentanyl victims think they are taking heroin, cocaine, meth, or prescription pills. But when too much fentanyl is in the mix, it kills almost instantly.
Driven by fentanyl, overdose drug deaths are, by the time of this book’s publication, for the first time killing more Americans under fifty-five than anything else—more than gun homicides and more than even AIDS during the peak years of the crisis. As of 2017, Americans were statistically more likely to die from an opioid overdose than a car accident. More than sixty-eight thousand Americans died from drug overdoses in 2018 (the most recent year for which statistics were available), and synthetic opioids (mainly fentanyl and its analogues) were responsible for the greatest number of these deaths, more than thirty-two thousand, compared to about fifteen thousand deaths from heroin overdose and about thirteen thousand from natural and semi-synthetic opioids, including OxyContin (which contains the drug oxycodone). Compared to the previous year, the heroin and prescription opioid numbers declined, while synthetic-opioid deaths continued rising. Overdose death rates among African Americans, middle-aged women, and young people continue to accelerate at alarming rates. Fentanyl has been cut into heroin for years, but now is often mixed into meth, cocaine, and fake prescription pills, a troubling development, considering that Americans are much more likely to try those drugs than heroin.
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