The flow of fentanyl and other synthetic opioids into Wyoming continues to swell, according to data presented to state lawmakers last week.
From 2017 to 2021, Wyoming lost 410 people to drug overdoses with a growing share of deaths due to fentanyl.
Between 2018 and 2021, the number of deaths caused by man-made opioids like fentanyl increased from 10 to 42 in Wyoming, according to the Wyoming Vital Statistics Service.
While final death counts from 2022 are still being tallied, the amount of fentanyl seized by law enforcement continues to soar. The Wyoming Division of Criminal Investigation seized about 1,600 “dosage units” of fentanyl in 2020 compared to nearly 13,500 in just the first three quarters of 2022.
Regional and national seizures show similar trends. Over the same time frame, seizures reported by the Rocky Mountain High Intensity Drug Trafficking Area — including Montana, Colorado, Utah and Wyoming — increased from nearly 111,000 units to 1.8 million.
And enough fentanyl was seized nationally in 2022 to kill every American, according to the U.S. Drug Enforcement Administration.
“It clearly shows that fentanyl is very readily available for those people who want to use it,” Wyoming DCI interim director Forrest Williams told Joint Judiciary Committee members on Friday.
The same could be said of those who don’t want to use it, as drug traffickers mix fentanyl in with other illicit substances.
Fentanyl is used and carefully monitored in medical settings to treat pain, but it’s so potent that any deviation in dosage can be deadly. When sold in illicit pills on the street, the drug’s chemical structure and dose varies but can be up to 50 times more potent than heroin.
Much of the illegal fentanyl coming into the U.S. started as chemicals in China, which are shipped to cartels in Mexico, and smuggled into the U.S. via foot, car, plane, boat and mail, according to the DEA.
The cartels often press it into blue pills that look like oxycodone to cash in on addictions left over from an era of overprescriptions. It’s also a cheap, synthetic replacement for drugs like black-tar heroin, which is harder to manufacture from actual poppy plants.
Illegal fentanyl has also been found in powders, mixed with other drugs or made to look like other kinds of prescription pills, like Percocet and Xanax.
In Wyoming, the trouble really settled in a few years ago.
“Around 2017 and 2018, synthetic opioids found in fatal overdoses in Wyoming started to increase, with no signs of slowing,” said Casey Patterson, Wyoming’s drug intelligence officer for the Rocky Mountain HIDTA.
Staffers in the state crime lab saw the phenomenon firsthand. According to information provided by DCI, the number of “observed fentanyl items” — pills and powders — that went to the lab increased from 12 in 2017 to 289 in 2022. Laramie and Natrona counties sent the most items in 2022 with 86 and 63, respectively.
Once samples reach the lab, technicians do presumptive screens for fentanyl, according to State Crime Lab Deputy Director Scott McWilliams. He added that they sometimes have to test dozens of pills from a large batch to make sure it’s all fentanyl, and each pill can take around an hour to process.
If DCI agents want absolute confirmation that it was fentanyl, though, he says they have to ship samples overnight to another lab.
That means “getting results two weeks later, with some kind of confirmation result and quantitative result that shows how much of that was in the blood. It would show the exact compound whether it’s fluorofentanyl or regular fentanyl or some other isomer. And then I would get a bill for $495,” he said.
He hopes to be able to perform such tests in-house some day, but the lab has limited personnel. There are only four people in the lab’s toxicology unit, for example, two of which are in training.
“Absolutely staff is the hardest thing,” McWilliams said. “When someone decides to take a higher-paying job at another lab, that just kills you. We generally have a hard time finding qualified applicants, and so we have to hire at the entry level and then do a lot of training here.”
It takes two years to fully qualify someone for certain roles, he added, and it still sometimes ends with them leaving.
There are a total of 24 people working through all units of the lab, including managers, he said.
Meanwhile, the facility continues to eat away at a substantial case backlog. At the end of 2021, the chemistry unit had a backlog of more than 1,000 cases, while the toxicology unit had around 700. Now it’s down to 424 and 189 backlogged cases, respectively.
That’s partially thanks to recent hires and new, more efficient equipment.
The state needs a statute that equips prosecutors to go after fentanyl dealers whose products kill someone, according to Williams at DCI.
That statute is available at the federal level and carries a mandatory minimum sentence of 20 years and a maximum of life behind bars. Prosecutors say they’ve used that possible penalty as bargaining leverage to reach higher-up dealers.
But knowing how variable fentanyl substances can be, and how they’re often mixed with other drugs, Williams wasn’t sure what exactly that state statute should look like.
“I mean, that’s a huge question,” he said. ”One of the issues is the fact that people that suffer from overdose deaths use multiple types of various controlled and non-controlled substances.”
That makes investigations challenging because “you have to wait for the toxicology results to come back to be able to identify what substance possibly led to that person’s death,” Williams said.
Wyoming isn’t the only state grappling with how to prosecute those who have or deal fentanyl.
In a contentious move, Colorado decided last year to make possession of between 1 and 4 grams of a fentanyl compound a felony that comes with up to 180 days in jail and up to two years of probation. That sentence could be reduced to a misdemeanor if the convicted person goes into treatment.
That legislation was also paired with a $40 million investment in overdose prevention.
Some praised the move as a way to punish drug dealers and protect children, but others were concerned it was a continuation of an ineffective drug war tactic that incarcerated a disproportionate amount of poor people and people of color.
Wyoming Rep. Ember Oakley (R-Riverton), a Fremont County prosecutor, is sponsoring House Bill 111 — Endangering children-fentanyl. That bill proposes to add “fentanyl to the list of controlled substances that qualify as a child endangerment offense.”
Taking a different stance, Senate File 79 — Plan of safe care-newborns would require plans to be made to support new mothers who are addicted to substances, including fentanyl.
In the last six months, new Wyoming mothers have tested positive for fentanyl, according to Jan. 18 testimony by Erin McKinney, director of Women and Children Services at Cheyenne Regional Hospital.
Even more recently, Cheyenne Regional Doctor April Kranz testified that she’s started to see babies born addicted to the drug there.
“I’ve never seen babies require this high [of] doses of morphine as they are requiring just to control their withdrawal symptoms,” she said.
Health providers testified in that hearing they expect fentanyl to continue replacing drugs like methamphetamine and backed the legislation meant to provide care plans for new mothers with addiction instead of criminalizing them. Penalties, they feared, would lead women to avoid seeking help or prenatal care and could separate families instead of helping those with mental health challenges.
“It’s great to see something come up that’s not criminalizing our women,” McKinney said.
A bipartisan federal study found that arrests and drug seizures alone cannot stop this crisis, but should be paired with addiction treatment programs, harm reduction tools like naloxone and education.
The state is set to receive millions of dollars that could help with that from legal settlements with companies that allegedly exacerbated the opioid crisis.
According to the Wyoming Attorney General’s office, the first few settlements will provide about $3.55 million to the Department of Health for statewide use and another $5.87 million to participating local governments. More will go to the Northern Arapaho and Eastern Shoshone tribes.
Several other settlements are either pending or expected to come over the next few years.