Crisis Next Door: The Fentanyl Epidemic

Crisis Next Door examines North Carolina’s fentanyl epidemic through the experiences of families who have lost loved ones, harm-reduction workers, and experts responding to the crisis. It explores the rise of illicitly manufactured fentanyl, its role in overdose deaths across the state, and the devastating impact the crisis has had on families and communities.

The documentary also looks at how the opioid crisis evolved from prescription medications to heroin and fentanyl, as well as the changing drug supply and efforts to hold pharmaceutical companies accountable. Alongside these issues, Crisis Next Door highlights harm reduction, including naloxone and fentanyl test strips, and the importance of reducing stigma and helping people stay alive.

North Carolina

"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."^x

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"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

"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."