Exploring the profound impact of Fentanyl and the proactive measures being taken to combat the opioid epidemic across the USA and in North Carolina.
Written by Dustin Diaz - Political Journalist and Edited by Jessica Diaz - Marketing Journalist
Saturday, October 19, 2024

Fentanyl, Death by Distribution.
Photo produced by Ai.
Fentanyl is an extremely potent synthetic painkiller, or opioid, that has wreaked havoc on untold millions, killing thousands and addicting many more. Non-pharmaceutical fentanyl use surpassed prescription drugs and heroin and as the leading case of drug overdose deaths in 2016, which is considered the third wave of the American opioid crisis, according to the Congressional Research Service, or CRS. CRS writes that "between 1999 and 2020, 565,000 Americans died of opioid-related overdoses". As stronger narcotic opioids become available via both prescription and the black market, the crisis has deepened, and the government has scrambled to respond.
"fentanyl and other synthetic opioids now contribute to nearly 70 percent of overdose deaths, including nearly 74,000 in 2022, a 4% rise from 2021."
Fentanyl Kills More
Fentanyl surpassing the death toll of both prescription drugs and heroin and the accompanying death toll is considered the third wave of the American opioid crisis, following other developments deepening the crisis in stages since the turn of the century. According to the Congressional Research Service, prescription opioid sales in the United States quadrupled from 1999 to 2010 and the rate of opioid-involved overdose deaths in the United States doubled from 2.9 to 6.8 deaths per 100,000 people. This represented the first wave, and the second wave came in 2010 to 2016 while heroin surpassed prescription abuse as the leading opioid involved in overdose deaths. After heroin became the leading cause of opioid-related deaths in 2015, synthetic opioids including fentanyl followed in 2016. According to the Center for Disease Control, or CDC, fentanyl and other synthetic opioids now contribute to nearly 70 percent of overdose deaths, including nearly 74,000 in 2022, a 4% rise from 2021.
What is IMF?
The CDC website states pharmaceutical fentanyl is approved for treating severe pain including terminal cancer pain and is 50 to 100 times stronger than morphine. Illegally made fentanyl, or IMF, is available on the drug market in different forms like liquid and powder, and often mixed with other drugs like methamphetamine and heroin. It is also sold in pill form disguised as other substances. This is often done without the drug user’s knowledge and can cause greater dependence on opioids and/or kill the user. The Congressional Research Service writes IMF is made with chemical agents, or precursors, from China, processed by drug dealers in Mexico.
Harm Reduction
The Biden-Harris administration and members of Congress have advocated a strategy of harm reduction for users, including availability of mental health services and substance abuse treatment. To their credit, the two branches have worked together on anti-IMF efforts, and the federal government has provided a lot of money for the States. While harm reduction is a noble effort and worth funding, I feel a more effective and direct method for dealing with the problem is prosecuting the people who distribute fatal drugs to helplessly addicted users.
"a more effective and direct method for dealing with the problem is prosecuting the people who distribute fatal drugs to helplessly addicted users."
California Rep. Tom Harder advocates federal legislation to give law enforcement more authority to crack down on fentanyl (Harder, 2024). The bipartisan Disrupt Fentanyl Pill Production Act would require serial numbers for all machines that mass-produce pills, but has not yet been voted on. “These drug dealers make lethal pills by using imported or illegally obtained pill presses – this bill cuts off that supply and makes it easier for law enforcement to catch these heartless criminals,” Harder said in a press release. “Simply put: less supply means thousands of lives saved.”
Hopefully Harder’s bill will pass, and the federal government’s resources will be helpful in dealing with the epidemic, but Harder stresses that his law is also part of his ongoing effort to protect his local constituents in San Joaquin County, California, from IMF. State governments also play an important role in addressing the opioid epidemic, such as law enforcement at their level and convicting offenders. In any case, the legislative branch at both levels proves the most effective in giving prosecutors and Attorneys General the resources and authority they need to pursue and effectively punish offenders.
Death by Distribution in North Carolina

In this State, the North Carolina General Assembly passed the 2019 Death By Distribution (DBD) Law creating the new offense of DBD of certain controlled substances (Denning, 2019). This offense is distinct from murder in that malice is not necessary to convict a person of the crime of unlawfully selling a substance that a person ingests, causing their death. “The General Assembly finds that the opioid crisis is overwhelming medical providers engaged in the lawful distribution of controlled substances and is straining prevention and treatment efforts,” the law reads. “Therefore, the General Assembly enacts this law to encourage effective intervention by the criminal justice system to hold illegal drug dealers accountable for criminal conduct that results in death.” A death by distribution charge is equivalent to a second degree murder charge, even if the criminal act of distribution was not done with malice. This law can be the cornerstone of a legislative agenda for other States to emulate.

North Carolina Attorney General Josh Stein met with Vice President Kamala Harris in 2023 to discuss their shared strategy of fighting the fentanyl epidemic, and his accomplishments include winning $56 billion from pharmaceutical companies who addicted users for treatment, harm reduction and recovery and working with federal and state legislators to fund large-scale fentanyl trafficking cases. Stein’s stated mission is pursuing and prosecuting drug dealers under the death by distribution statute and the 2017 Stop Counterfeit Pill (STOP) Act, which updates North Carolina law to address the growing threat of counterfeit pills containing fentanyl, methamphetamine, or other dangerous drugs. Implementing Stein’s strategies nationwide could make a big difference in reducing distribution of IMF and the resulting deaths.
More Powerful NC
More Powerful NC is an interest group comprising government officials, government agencies and private organizations that collaborates to fight the opioid epidemic in North Carolina. More Powerful NC has used its influence to help pass anti-fentanyl legislation and fight the opioid epidemic in North Carolina communities. AT&T, the Carolina Hurricanes hockey team, Duke Energy, and other private organizations collaborate with Stein’s Department of Justice, the North Carolina Department of Health and Human Services, and many others to form a coalition helping create, fund, and provide resources for this interest group.
"five people die from opioid overdoses every day and the number of unintentional overdose death in 2017 was nearly 17 times higher than in 1999."

Josh Stein
According to Stein’s website, five people die from opioid overdoses every day and the number of unintentional overdose death in 2017 was nearly 17 times higher than in 1999. One of Stein’s responses to the North Carolina opioid epidemic was to draft several recent laws with Representatives Greg Murphy and Craig Horn, Senators Jim Davis and Tom McInnis, and other members of the North Carolina General Assembly.
According to Stein’s website, the STOP Act requires electronic prescription of opioids to reduce prescription fraud and takes other measures to prevent addiction. As mentioned earlier, the STOP Act helps law enforcement authorities pursue fentanyl traffickers by ensuring that all fentanyl and opioid derivatives are classified as controlled substances under North Carolina law. The 2018 Heroin and Opioid Prevention and Enforcement (HOPE) Act strengthens laws against theft of drugs by first responders and healthcare workers and gives law enforcement authorities tools for addressing the opioid epidemic. The DBD law has taken dealers off the streets.
"...Attorney General Josh Stein’s courtroom wins include a $26 billion settlement in 2021 with manufacturer Johnson & Johnson and the three largest drug distributors."
Stein has also aggressively sued opioid manufacturers and distributors. According to the More Powerful NC website, Attorney General Josh Stein’s courtroom wins include a $26 billion settlement in 2021 with manufacturer Johnson & Johnson and the three largest drug distributors. Stein and More Powerful NC succeeded in passing anti-fentanyl legislation because they brought together multiple government entities, government officials and private organizations. Attorney General Josh Stein has worked across state and party lines to hold corporations accountable for their role in creating and fueling the opioid epidemic and to bring much-needed resources to North Carolina communities to combat the opioid crisis.
North Carolina Representative Greg Murphy
My representative in Congress, Republican Greg Murphy of North Carolina’s 3rd District, has wisely worked with Stein on the State’s agenda. Unfortunately, it seems to be in name only; a perusal of his website does not list fentanyl as an area of concern, as he instead spends his time voting for partisan measures like House Resolution 1371 (to condemn the Biden Harris Administration and Border Czar Kamala Harris for failing to secure America's borders) and issuing divisive statements instead of pursuing a constructive response to the fentanyl epidemic in Congress. Murphy’s seat is safe, as he only ran against a Libertarian candidate in 2024, so it is unlikely he will do anything risky like sponsor a federal DBD statute or other controversial new legislation. The best one can hope for is that he’d vote in favor of good laws proposed by others.
North Carolina Senators Thom Tillis and Ted Budd
Meanwhile, North Carolina Senators Thom Tillis and Ted Budd, are demonstrably engaged with the issue. In October 2023, they wrote a joint letter to the Administrator of the U.S. Drug Enforcement Administration (DEA) and to the Secretary of the Department of Homeland Security (DHS) about the flow of fentanyl into North Carolina. Tillis and Budd wanted answers about what DHS and DEA has done to work with local and State law enforcement to track and dismantle drug networks, as well as how the organizations have worked with social media platforms to prevent sale of illicit narcotics and recruitment by drug cartels. They wrote, “We urge the DHS and DEA to use all the tools at your disposal to dismantle the drug cartels and halt the incursion of drugs flowing into our country.” Tillis also cosponsored the FEND Off Fentanyl Act, which was signed into law this year. This law uses economic national security tools to choke off profits from the IMF trade. Tillis and Budd appear more aware and engaged on the fentanyl issue and would serve as better advocates of the DBD statute than Congressman Murphy.
The Argument Against Aggressive Dealer Prosecution

One argument against aggressive prosecution against dealers and distributors, including the DBD law, is that users are to blame and should be punished harshly for drug-related offenses. According to Jennifer Murphy, a scholar writing for California State University, Sacramento, in 2012, Americans feel drug addicts should be both punished and treated. A 2006 US Today survey showed that a majority of Americans view drug addiction as a disease, while a substantial minority perceives addicts to be weak-willed and immoral. Murphy says this has given rise to drug courts, special courts that deal with drug addicts and their offenses. She adds that people come out of these courts less than other people, ineligible for federal benefits and prohibited from voting. Addicts have to go through a process of “reintegrative shaming” that is unhelpful and can lead to reoffending.
My response to those who want harsher punishments for users is that drug addicts suffer enough already - from loss of benefits, from time in prison, from damaged relationships and job prospects - and it’s more productive to focus on the people providing the drugs that kill them to break the cycle of addiction. Taking aim at IMF dealers and distributors means fewer addicts will be created, fewer punishments will be meted out to common criminals, and fewer people will suffer. Passing death by distribution laws will put the dealers away and addictive narcotics out of the user’s hands, giving them a chance at treatment and rehabilitation.
"Passing death by distribution laws will put the dealers away and addictive narcotics out of the user’s hands, giving them a chance at treatment and rehabilitation."

A drug dealer in Hickory, North Carolina, who sold fentanyl to a woman and caused her fatal overdose in 2022, was convicted the following year and sentenced to 6-to-8 years in prison for death by distribution. Scott Reilly, district attorney for North Carolina’s 36th district, said the Catawba County Sheriff’s Office (where the woman’s overdose occurred) has seen more overdose deaths because of IMF and the DBD Act gives attorneys general like him the ability to prosecute offenders appropriately (News-Topic, 2023). Another criminal was charged in DBD in 2023 when 21-year-old Sergei Ndinga Momo died of a drug overdose and an investigation determined he was to blame for selling the drug that killed Ndinga Momo. The dealer, Jerimiah Hargrove, is in jail under an $80,000 bond and unable to sell more deadly drugs while he awaits trial (Town of Carrboro, 2024). The high bond amounts for DBD offenders alone help to save lives that way and make their arrests more valuable than targeting users. Dealers heartlessly promote recidivism and continued suffering in addicts to line their own pockets and are the ones who deserve prosecution and imprisonment.
"Dealers heartlessly promote recidivism and continued suffering in addicts to line their own pockets and are the ones who deserve prosecution and imprisonment."
Journalists with nonprofit news organization, The Appeal, wrote an article in 2018 arguing against DBD, or charging dealers with homicide, as they put it. Beletsky and Siegel say threats or harsh punishments do not deter drug dealers and prevent overdose deaths, but can make the drug trade deadlier and expose family members of addicts to legal jeopardy. This is a philosophical argument about the nature of punishment; dealers must be punished for their part in killing others whether or not they are afraid of the law - and if they are selling or using opioids, we know that they are not. The illicit trade becoming more dangerous is not the concern of the law. The point is to take dealers off the streets, not the safety of criminals.
Harm reduction programs exist for dealers and offenders who are afraid to stop using without assistance. A threat of punishment is necessary for the dealers, who are guiltier than the users they hook. Interest groups like More Powerful NC could be duplicated in other States to achieve similar results. A team of legislators, prosecutors, health care and other organizations can provide the visibility and resources to lobby for anti-fentanyl laws like the STOP Act and DBD Law. Harder and Tillis working directly on legislation to stop IMF in the Senate and Murphy in the House of Representatives have access to their colleagues in other States and can tell their counterparts what works in their States and what doesn’t. State legislators can learn from one another and other States can learn about North Carolina’s anti-IMF bills, including the DBD Law, from Murphy and Tillis to pass along to their State officials for possible enactment. Another group like More Powerful NC can bring together people at all levels of government to spread awareness of their unique policies and address challenges unique to their State.
I believe public opinion will be receptive to any efforts at collaboration, particularly bipartisan ones, and anti fentanyl legislation such as the FEND Off Fentanyl Act is usually bipartisan in nature. In today’s polarized political climate, the public will be likelier to support any bipartisan efforts, especially a law like DBD that can make them and their families safer. With thoughtful implementation and as part of a package of laws like the STOP Act and HOPE Act, prosecuting dealers and distributors under DBD laws in all states could prove to be a valuable tool in fighting IMF and the opioid epidemic. Public opinion and time is ripe for State legislatures to pass DBD laws.

Dustin Q Diaz - Political Journalist
Dustin hails from Massapequa, New York, and recently relocated to the area after meeting Jessica at a half marathon in Virginia Beach. A disabled Combat Camera Veteran with the U.S. Navy, Dustin brings decades of experience in camera operation, news production, and editing to his work. As a recognized military journalist and editor, he has a knack for storytelling and a way with words. With his deep, smooth baritone voice, Dustin’s narration enhances any video project. His brilliant interview skills create a comfortable atmosphere, allowing authentic voices to shine on camera. Dustin is currently studying Political Science with a minor in Economics at SNHU.
References
Attorney General Josh Stein. (2023). Attorney General Josh Stein Continues Fighting the
Fentanyl Crisis - NCDOJ
Attorney General Josh Stein. (2024) Opioid Crisis.
Beletsky, L., & Siegel, Z. (2018). Charging “dealers" with homicide: Explained.
Center for Disease Control. (2024). Fentanyl. Fentanyl | Overdose Prevention | CDC
Congressional Research Service. (2024). China Primer: Illicit Fentanyl and China’s Role.
IF10890 (congress.gov)
Congressional Research Service. (2022). The Opioid Crisis in the United States: A Brief History. IF12260 (congress.gov)
Denning, S. (2019). General Assembly Creates New Crime of Death by Distribution – North
Carolina Criminal Law (unc.edu)
Murphy, G. (2024). How We Can Help You. https://murphy.house.gov/
News-Topic. (2023). Hickory man convicted in death by distribution case. News-Topic. Paxton
Media Group LLC. https://link.gale.com/apps/doc/A766435207/STND?
North Carolina General Assembly. (2019). Death by Distribution.
North Carolina General Assembly. (2023). Senate Bill 189.
Palamar, J. J. (2024). Illicitly manufactured fentanyl use among individuals in the US,
2022. American Journal of Preventive Medicine, 67(2), 285–
Representative Josh Harder. (2024) Harder Takes on Fentanyl Epidemic and Counterfeit Pills
with New Legislation | Representative Josh Harder (house.gov)
Town of Carrboro. (2024) Death by Distribution Charge in Overdose Death.
Tillis, T. (2023). Tillis, Budd Demand Answers on Flow of Fentanyl Into North Carolina
Tillis, T. (2024). Tillis Legislation to Crack Down on Fentanyl Trade, Expose Iranian Assets
Worley, J. (2017). A Primer on Heroin and Fentanyl. Journal of Psychosocial Nursing & Mental
Health Services, 55(6), 16-20.https://doi.org/10.3928/02793695-20170519-02
Comments