Crisis Next Door: The Fentanyl Epidemic
Introduction
Crisis Next Door examines North Carolina's fentanyl epidemic, revealing the devastating toll fentanyl has taken on thousands of lives across the state. The documentary explores both the state's response to this growing crisis and the urgent actions still needed to save lives.
It explains the dangers of illicitly manufactured fentanyl, which is far more potent than pharmaceutical fentanyl and is often mixed into other drugs, placing unsuspecting users at extreme risk. In many cases, fentanyl is 50 times stronger than heroin, and even a tiny dose can be lethal. Families, communities, and frontline workers across North Carolina continue to face the harsh realities of the fentanyl epidemic.
The documentary also highlights confusion surrounding fentanyl, which has contributed to misunderstanding and a lack of empathy toward those affected by addiction. Crisis Next Door emphasizes the need for urgent education, prevention, and support initiatives, showing how immediate action is necessary to address this crisis and prevent further loss of life.
North Carolina's Fentanyl Epidemic
Governor Josh Stein "North Carolina continues to set the standard for fighting the opioid epidemic with transparency and accountability…making sure North Carolinians know how their counties and municipalities are investing these funds to save lives and build safer, healthier communities."
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Quotes
"Fentanyl is an opioid, and what that means is it's a painkiller. In its pharmaceutical forms, when it's produced by pharmaceutical companies and approved by the FDA, it's used for acute and chronic pain. Unfortunately, when we're talking about fentanyl from an overdose perspective, we're mostly talking about illicit fentanyl … produced by drug cartels and used for money making purposes, not for healthcare."
"If you can put in a tiny amount of something and produce a big high, then you can make a lot more money. So obviously, if the dealer has the strongest stuff on the streets, that's what these drug users are going to look for."
"A little over 75% of drug overdoses in North Carolina involve fentanyl in some way. Unfortunately, in 2021, we lost the most North Carolinians we've ever lost to drug overdoses, and that was 4,041 individuals."1
"We had five boys. William was the oldest, and Parker was out middle son. I just absolutely loved every moment of being able to be called their mother ... we all had hoped that 'wow, now William's finally gotta wake up. Losing a brother has to have him wake up from this terrible disease.' Unfortunately, it did not."
"There was marijuana – people were not addicted and dying over it. Then cocaine came out and people were addicted to it, but they probably weren't dying of it. Then crack came out, which is a whole lot more addictive, but it wasn't killing them instantly. Now you have heroin that is laced with fentanyl and opioids. It's killing people instantly."
"Originally, we were seeing fentanyl flown in from China – that's where a lot of the component chemicals are manufactured. But more recently, the fentanyl components are being sent to Mexico where they're being manufactured there and driven across the border through border checkpoints. And those drugs are coming all across this country, and they're absolutely devastating people's lives."2
"We initially decided to charge Mr. Windham with second degree murder ... What we elected to do with the support of the family was to offer Mr. Windham a plea to involuntary manslaughter."
"There were three waves of this opioid epidemic. The first wave from 2000-2010/2012 had to do with prescription pills. The drug companies were aggressively promoting these pills to prescribers, asserting that they were effective at treating pain and they were not addictive – it turns out neither of those things are true. So, millions of Americans got hooked on these pills while these companies were making billions and billions of dollars. When the pills became less available, folks started transitioning to using heroin, buying it on the street, because heroin was cheaper than the prescription pills. And now this third wave has to be with fentanyl which is even cheaper than heroin. And that's what's killing people because it's incredibly potent."3,4
"We are making them [pharmaceutical companies] pay over $50 billion. North Carolina's share is going to be about $1.4 billion. It has to go to prevention, harm reduction, treatment or recovery services."5
"Harm reduction is a safe space for people to come and get clean sterile supplies, Narcan, fentanyl test strips, basically anything a drug user needs to stay safe."
"I [Erica Minton] am the harm reductionist here for Wilkes Recovery Revolution ... I came here to put his picture on the Somebody's Someone wall, and it just so happened that those events led up to, they needed a harm reductionist. Every day when I come into work I touch his picture, and I feel him, I just know he's working with me."
"They [fentanyl test strips] can test that substance so that they can make a better choice for themselves and know what is in that supply. I used to say that people overdosed. I now say that people are being poisoned because people don't even know what they're getting."
1 Although overdose deaths in North Carolina have declined in recent years, fentanyl remained involved in approximately 69% of overdose deaths in the state in 2025. Health officials also reported that fentanyl is increasingly being detected alongside other substances, most commonly cocaine and methamphetamine.
2 Illicit fentanyl supply chains are complex and have evolved over time. While China has historically been a major source of precursor chemicals used to manufacture fentanyl, production has increasingly shifted to domestic laboratories in Canada and transnational networks involving multiple countries, including Mexico and India.
3 Opioid pharmaceutical marketing, led by Purdue Pharma's 1996 launch of OxyContin, aggressively promoted long-acting opioids for chronic non-cancer pain, shifting from strict, short-term usage paradigms. Misleading tactics—including overstating safety, downplaying addiction risks, and funding biased educational materials—drove widespread prescribing, fueling a major public health crisis, resulting in exponential overdose increases, and leading to billions in corporate settlements.
4 Researchers have increasingly described a “fourth wave” of the overdose crisis marked by rising deaths involving stimulants such as cocaine and methamphetamine used in combination with synthetic opioids like fentanyl. Public health experts have also raised concerns about emerging adulterants, including xylazine, entering the illicit drug supply.
5 North Carolina's opioid settlement funds are required to be used for opioid remediation efforts, including evidence-based addiction treatment, recovery support services, naloxone distribution, syringe service programs, diversion programs, youth intervention initiatives, and reentry support for individuals leaving incarceration.
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Brenda H.
BA Psych, Grad. Cert. Addictions & Mental Health
Driven by a deep personal connection to these topics, I created AMH Resources to bridge the gap between academic knowledge and everyday support. I watch, read, and summarize a wide range of free resources to help you navigate the overwhelming amount of information available and find what resonates with your journey.