Fentanyl: What I Got Wrong

Timothy McMahan King
7 min readJun 11, 2021

In celebration of the 2-year anniversary of the publication of Addiction Nation: What the Opioid Crisis Reveals About Us (Herald, 2019), I’m diving into a series of things that I got wrong. Or, in some cases, things I would have written about differently if I knew what I know now.

I recently had the chance to sit down and record an audio version of the book. And it is a humbling experience to wince at some of your own words as you hear yourself read them out loud. Luckily, I also have the power to change those words and was able to revise that version of the book.

The first big thing I got wrong is how I wrote about the drug fentanyl.

Photo by © Shutterstock/Sherry Yates Young

What I Wrote

In 2015 I read about a man a few miles away from my home in New Hampshire who had been found dead with two fentanyl patches in his stomach. I was shocked. I had been on fentanyl patches. They had seemed so safe and innocuous in their box by my bedside. I wrote:

New Hampshire, often tied with Ohio for the second highest drug overdose rates per capita (West Virginia is number one), rose to the top when it came to fentanyl overdoses while I was writing this book. Hillsborough County, where I grew up, is the epicenter. In the time between my release from the hospital and my return to New Hampshire, a period of six years, fentanyl overdoses increased 1,600 percent.

Fentanyl is a synthetic opioid. It is the latest force pushing up overdose rates to new record highs across the United States and Canada. Unlike heroin, you don’t need access to a base of opium to make it; you just need the right ingredients. This powerful substance is fifty to one hundred times the strength of heroin; it can be created in a lab by anyone with a basic knowledge of chemistry.

It is so strong that law enforcement officers have nearly died from overdoses through accidental contact and inhalation while making drug arrests. When forty-five kilos were seized from the trunk of a car, experts estimated it was enough to give a fatal dose to every resident of New York City and New Jersey combined. A quarter of a milligram — just a few granules — can be fatal.

Each of these statements were sourced, footnoted and fact checked. Some of it holds up and but other parts I now see are inaccurate and…

Timothy McMahan King

Author of Addiction Nation: What the Opioid Crisis Reveals About Us and Senior Fellow at Clergy for a New Drug Policy.