WASHINGTON, April 16 (Reuters) – China is directly subsidizing production of illicit fentanyl precursors for sale abroad and fueling the U.S. opioid crisis, a U.S. congressional committee said on Tuesday, releasing findings from an investigation it said unveiled Beijing’s incentives for the deadly chemicals.
China continues to provide subsidies in the form of value-added tax rebates to its companies that manufacture fentanyl analogues, precursors and other synthetic narcotics, so long as they sell them outside of China, the House of Representatives’ select committee on China said in a report.
“The PRC (People’s Republic of China) scheduled all fentanyl analogues as controlled substances in 2019, meaning that it currently subsidizes the export of drugs that are illegal under both U.S. and PRC law,” the report said, adding that some of the substances “have no known legal use worldwide.”
The report cited data from the Chinese government’s State Taxation Administration website, which listed certain chemicals for rebates up to 13%. It additionally currently subsidizes two fentanyl precursors used by drug cartels – NPP and ANPP, it said.
According to the Chinese government website, the subsidies remain in place as of April, the report said.
China’s embassy in Washington said China was sincere in drug control cooperation with U.S. authorities and had a special campaign underway to control fentanyl and precursor chemicals and crack down on illegal smuggling, manufacturing, and trafficking activities.
“It is very clear that there is no fentanyl problem in China, and the fentanyl crisis in the United States is not caused by the Chinese side, and blindly blaming China cannot solve the U.S.’ own problem,” embassy spokesperson Liu Pengyu said in an email.
The U.S. State Department did not respond to a request for comment.
Mike Gallagher, the Republican chair of the bipartisan select committee, told a hearing on the issue on Tuesday that China’s incentives suggest Beijing wants more fentanyl entering the U.S.
“It wants the chaos and devastation that has resulted from this epidemic,” Gallagher said.
Fentanyl is a leading cause of drug overdoses in the United States. The U.S. has said that China is the primary source of the precursor chemicals synthesized into fentanyl by drug cartels in Mexico. Mexico’s government also has asked China to do more to control shipments of fentanyl.
China denies the allegation, and says the U.S. government must do more to reduce domestic demand.
The U.S. and China launched a joint counter-narcotics working group in January, following an agreement between U.S. President Joe Biden and Chinese leader Xi Jinping in November to work to curb fentanyl production and export.
U.S. officials have described the initial talks as substantive, but have said much more needs to be done to stem the flow of the chemicals.
The committee also said in its report that it found no evidence of new criminal enforcement actions by Beijing.
Ray Donovan, a former senior Drug Enforcement Administration official, told the hearing that the November agreement had not changed China’s support for the illicit chemical industry’s supply to the Western hemisphere.
HARNETT COUNTY – A Harnett County man with a history of law enforcement interaction for the past 20 years has been indicted by a grand jury for distributing fentanyl that killed four people on the morning of March 28, 2020.
The jury returned a true bill of indictment on Feb. 26 charging Gerard LaSalle McLean, 37, of 446 Raynor McLamb Road, Bunnlevel, with four counts each of death by distribution and aggravated death by distribution.
“There were two scenes,” explained Harnett County Sheriff’s Office Maj. Aaron Meredith. The first victim, Shannon Lynette McLean, was located at 112 Blake St. in Lillington at 12:49 a.m. Three other victims were found dead in a car located at 242 Nutgrass Road in Bunnlevel at 7:37 a.m.
There were others who overdosed at both locations and survived,” Meredith shared.
The indictment alleges Gerard McLean sold fentanyl to a person identified as Courtney McLean. Investigators say this substance was ingested by Shannon McLean and she died as a result.
While looking into this indictment, the Record learned that Gerard McLean has three other related indictments stemming from his alleged distribution of fentanyl in March 2020.
Lt. R.S. Jackson, of the Harnett County Sheriff’s Office and a homicide detective in the criminal investigation division, charged Gerard McLean with three counts of death by distribution on March 28, 2020. He was arrested on May 6, 2020. He has been held under a $600,000 secured bond since that time. Based on this arrest and a prior drug conviction in Cumberland County, the jury agreed on charges of aggravated death by distribution in the deaths of Shannon McLean, Ervin Bass Jr., Laketa Vinson and Brittany Shaw.
The last three indictments were returned on July 6 and served on Gerard McLean in the Harnett County Detention Center the following day.
The indictments allege that the fentanyl was purchased from Gerard McLean by Brittany Shaw and ingested by Bass, Vinson and Shaw, resulting in their deaths.
All four of Gerard McLean’s alleged victims died on March 28, 2020.
During the traffic stop, narcotics agents discovered a liquid fentanyl mixture, marijuana, and fentanyl that was individually wrapped in Brandon Currie’s wallet.
A man was arrested for carrying a pound of liquid fentanyl in Sanford on Monday.
The Lee County Sheriff’s Office arrested Brandon Currie during a traffic stop on Third Street in Sanford.
During the traffic stop, narcotics agents discovered a liquid fentanyl mixture, marijuana, and fentanyl that was individually wrapped in Currie’s wallet.
The fentanyl mixture weighed over 500 grams, a little more than one pound.
Currie, 39, was arrested and charged with:
Trafficking opioid by transport
Trafficking opioid by possession
Possession of controlled substance within 1000 feet of a school
Simple possession schedule VI controlled substance
Maintaining a vehicle for sale of controlled substance
Possession of drug paraphernalia
Possession of marijuana paraphernalia
Currie was issued a $100,000 bond on Tuesday by judge.
by Jennifer Fernandez, North Carolina Health News March 4, 2024
By Jennifer Fernandez
LEXINGTON — On a recent Saturday, family members gathered in a circle at a church here to share stories of loved ones lost to fentanyl.
“Our whole world is turned upside down,” said Michelle, a Forsyth County mother who lost her 19-year-old son to fentanyl poisoning. She didn’t want to use her full name for this story or go into details about his death, as authorities are still investigating.
She doesn’t think her son knew he had taken fentanyl, which has become more common as drug dealers add it to everything from heroin to fake prescription medications.
Just a few grains of the highly potent opioid — about 2 milligrams, an amount that’s barely enough to cover the date on a penny — can be fatal. In 2021, fentanyl was involved in 83 percent of fatal medication or drug overdoses in the state, according to N.C. Department of Health and Human Services.
“If this can happen to him, this can happen to anybody,” said Michelle, who has made it her mission to help educate other parents about the dangers of fentanyl.
She’s not alone in her fight.
Barbara Walsh, whose Fentanyl Victims Network of North Carolina organized the recent Lexington meeting, is pushing for North Carolina to require that the opioid reversal drug naloxone be available in all schools. Her 24-year-old daughter died from fentanyl poisoning in 2021 after unknowingly drinking a bottle of water laced with the drug.
The North Carolina Child Fatality Task Force also is looking into the role fentanyl has played in the deaths of not only teens, but young children who likely are getting exposed through trash from illegal substance use left within reach.
“We were floored when we started seeing the deaths of the infants and the toddlers, and that’s really what started our prevention efforts,” said Sandra Bishop-Freeman, the state’s chief toxicologist who works in the Office of the Chief Medical Examiner.
In North Carolina, fentanyl contributed to the deaths of 10 children age 5 or younger in 2022. Just seven years prior, the state recorded only one death in that age group.
For children ages 13 to 17, fentanyl deaths increased from four to 25 in that same time period, according to data shared with Child Fatality Task Force members.
“Having one child or infant death related to fentanyl or other drugs is …, is too much,” Michelle Aurelius, North Carolina’s chief medical examiner, told task force members in November.
During that meeting, Bishop-Freeman read from investigators’ notes about child deaths due to fentanyl poisoning.
The decedent’s mother reported seeing the deceased pick up a baggie and put it in her mouth.
During the autopsy, a small piece of folded paper was recovered from the baby’s stomach.
Law enforcement stated there was a plastic bag and loose pills on top of a 4-year-old brother’s bed.
Another report focused on 22 cases in 2021 where a single substance was linked to the child’s death. Pathologists determined that fentanyl was the single substance in 15 of the fatalities. Only one other single substance killed multiple children that year — carbon monoxide, which killed two children. Also that year, fentanyl was one of the substances attributed in six out of seven deaths where pathologists determined more than one substance caused the death.
“These are startling stories to hear. They’re awful stories to hear, but we need to talk about them so we can prevent them,” Aurelius said. “I don’t want to have to do another autopsy on an 8-year-old who … died of (a) fentanyl overdose with (a) fentanyl patch on her skin after she was left alone.”
Counterfeit pills
For older children, fake pills laced with fentanyl are a rising concern.
In 2021, authorities seized 77,000 counterfeit pills in North Carolina alone. Eight in 10 pills contained some fentanyl.
Data from the U.S. Drug Enforcement Administration shows that of the fake pills tested by the agency, seven out of 10 contained potentially lethal doses of fentanyl.
Many fake pills are made to look like prescription opioids such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®).
The fake pills have become easier to obtain, with sales taking place online and on social media.
Further evidence of the impact of these fake pills comes from a recent study by the North Carolina Office of the Chief Medical Examiner. Officials looked at a sample of 75 toxicology reports from deaths between 2020 and 2022 and compared results to what investigators learned about the deaths.
The study showed that 50.7 percent of those who died thought they were taking Xanax (an anxiety/depression medication), and 54.7 percent thought they were taking a form of oxycodone (a pain reliever). However, the toxicology reports were most often positive for fentanyl with no traceable amounts of the medications the victims thought they were getting.
Last year, the DEA seized more than 79.4 million fentanyl-laced fake pills in the country, according to a tracker on the agency’s homepage. So far this year, more than 19.8 million pills have been seized nationwide, which is on pace to be one and a half times last year’s number.
Barb Walsh is executive director of the nonprofit Fentanyl Victims Network of North Carolina.Two women hug while sharing stories of loved ones lost to fentanyl poisoning at a meeting of the Fentanyl Victims Network in Lexington, N.C., on Feb. 10, 2024.Information on fentanyl poisonings in North Carolina sits on a table at a Lexington church that hosted a meeting for families of fentanyl victims on Feb. 10, 2024. A woman shows support for another woman who broke down while telling the story of how she lost a loved one to fentanyl at a meeting of the Fentanyl Victims Network in Lexington, N.C., on Feb. 10, 2024.
Finding solutions
Walsh says the opioid reversal medication naloxone, also known by the brand name Narcan, should be available in every school. It should be treated like any other emergency item that schools stock, like epinephrine pens for allergic reactions or automated external defibrillators to shock a heart back into rhythm.
Some North Carolina school systems are starting to do that.
Charlotte-Mecklenburg Schools is adding naloxone to its first aid kits at every school. Nurses and at least two first responders at each school are to be trained in how to use it.
Wake County Schools, which already allows school resource officers to carry naloxone, may soon follow Charlotte’s lead. District officials plan to recommend that naloxone be placed in every school and a policy be created for staff on training and using it, WRAL-TV reported last week.
Last school year, school nurses, staff or SROs administered naloxone 21 times on school grounds in the state, according to the annual School Health Services Report Brochure. The year before, it was used 14 times. According to the report, 84 school districts last school year reported having the opioid reversal drug available on school grounds through SROs and 22 through a districtwide program.
As of September last year, eight states have passed laws requiring all public high schools to keep naloxone on site in case of overdoses at the school or a school-sponsored event, according to data compiled by the Legislative Analysis and Public Policy Association.
“Studies show that naloxone access can reduce overdose death rates, that its availability does not lead to increases in youth drug use, and that it causes no harm if used on a person who is not overdosing on opioids,” Gupta and Cardona said in the letter.
They also noted that most states have Good Samaritan Laws that protect bystanders who help someone who is overdosing. North Carolina passed a limited Good Samaritan law in 2013 that permits people who are “acting in good faith” to seek medical help for someone who is overdosing without fear of being prosecuted for possessing small amounts of drugs or drug paraphernalia.
“Our schools are on the frontlines of this epidemic, but our teachers and students can be equipped with tools to save lives,” Gupta and Cardona wrote.
Limited resources
One of the big frustrations that family members expressed at the Lexington meeting was how long it took for them to learn that fentanyl killed their loved one.
“We didn’t know for six months it was fentanyl,” said Michelle, the Forsyth County mother whose 19-year-old died. “They just said, ‘Your son is gone.’”
The Office of the State Medical Examiner has faced an increasing workload due to the rise in opioid-related deaths while struggling to retain new forensic pathologists who can make tens of thousands of dollars more for doing the same job in neighboring states.
Last year, legislators took steps to address that wage disparity in the budget by adding $2 million in recurring funds for each of the next two fiscal years to help increase the state’s autopsy capacity.
Lawmakers also added two toxicology positions, however, those jobs were in response to the expected increase in workload due to the new requirement of comprehensive toxicology on all child deaths investigated by a medical examiner. While those new positions will help address that expanded workload, they do not help with the existing work where the department still needs additional positions, the Office of the State Medical Examiner said in an email to NC Health News. The two new jobs have not yet been posted.
One strain on the office is that 45 percent of the workforce is made up of temporary or time-limited employees, “which creates a very unstable workforce,” according to the medical examiner’s office.
The toxicology lab performs more than 36,000 analytical tests each year, performing analysis on 90 percent of medical examiner cases, the office said. On average, the toxicology lab issues reports on about 15,000 cases every year.
That work won’t let up any time soon, as the number of overdose deaths continues at a steady clip in the state.
In January, the medical examiner’s office identified 332 suspected overdose deaths, down from 368 in January 2023. While some will be classified as non-poisoning deaths after further investigation, most will end up being confirmed overdoses, the medical examiner’s office said.
At last week’s meeting of the Child Fatality Task Force, members talked about the difficulty of seeing so many child deaths from overdoses.
Pediatrician Martin McCaffrey told the task force that the child fatality review committee he is on just reviewed three infant/toddler fentanyl overdoses. Jill Scott, president and CEO of Communities in Schools North Carolina, shared that a 17-year-old had died not too long ago.
“He got a hold of something,” she said. “He didn’t know what it was.”
They are part of a much larger picture of the toll that the opioid crisis has had.
In Arlington, Va., pictures line the walls at the DEA’s offices as a memorial to those who have died from fentanyl. There are so many victims, they ran out of wall space for photos, Michelle, the Forsyth County mom said.
“It kind of takes your breath away,” she said, “when you see face after face after face.”
Move will allow school employees to administer overdose rescue drug
In a unanimous vote at its May 8 meeting, the Dare County Board of Education passed a new policy allowing school personnel to administer Naloxone. The so-called rescue drug that can reverse the effects of an opioid overdose, Naloxone has become an important tool in the battle against the opioid epidemic.
Dare County School Board Member Matt Brauer asked if school nurses and school resource officers should be the primary administrator of Naloxone.
School personnel are not required to train to use Naloxone, but the policy establishes guidelines for the storage, procurement, administration and other details related to Naloxone on campus. Students and parents or guardians will be notified annually of the policy.
According to the draft policy text in the meeting agenda packet, Naloxone will be stored in the school nurse’s office or another location designated by the school nurse or superintendent, and it “shall be made available to those trained to administer it in the event of a suspected drug-related overdose.”
The school nurse will ensure that all trained staff are aware of the Naloxone’s storage location and will periodically check the expiration date, notifying administration prior to its expiration, according to the policy.
Lists of school district employees who have completed Naloxone administration training will be maintained in the school district’s administrative office and in the head nurse supervisor’s office. Anyone who administers Naloxone “in accordance with North Carolina law is immune from any civil or criminal liability,” the policy notes.
“The Dare County Board of Education makes no representation regarding the availability of Naloxone in the school system at any given time,” the policy states.
The policy also says law enforcement will be notified of the possession or use of illegal substances and that students using illegal substances will be disciplined in accordance with board policies.
Other district policies that were revised or added at the May 8 meeting were done so at the recommendation of the North Carolina School Boards Association, according to Dare County Board of Education Attorney Rachel Hitch.
“But this is one [policy] that came up in conjunction with your local health department,” Hitch said, adding that Assistant Superintendent Steve Blackstock worked on the draft policy in conjunction with school nurses before it was brought to the board for adoption.
During a roughly 10-minute discussion on the topic, School Board Member Matt Brauer asked several questions, including whether the policy came from a standing order from the state. The standing order since August 2017, signed by the North Carolina State Health Director, allows anyone at risk of experiencing an overdose, anyone who may be able to assist someone experiencing an overdose, or anyone who requests naloxone, to receive the medication.
“The standing order from the state removes hurdles for you to have the medicine in the school system if you need it…so that you may [have this policy],” Hitch responded.
“Why wouldn’t we just…lay it off on the school nurse, who is a healthcare provider, or even the school resource officer, who’s a first responder? Shouldn’t they be the primary person to administer” Naloxone? Brauer asked.
Dare County Schools Superintendent Steve Basnight responded that the goal is to make Naloxone available where it’s needed, in accessible locations. Blackstock agreed, adding that many activities take place in school buildings after school hours when the school nurse is not onsite.
The Dare County Department of Health and Human Services distributes Naloxone at no cost to community members, so Hitch noted that teachers and students may already have the medication on hand.
“We figured if it’s in your schools, then we need to make sure that we’re telling people how it needs to be handled,” Hitch said.
In response to Brauer’s question about potential civil litigation, she said that she’d learned from a Dare County Health Department presentation that if someone were not overdosing and received Naloxone, “there are no implications,” meaning they wouldn’t suffer harm.
“The idea was: The administration is easy, the risk is very minimal…and the possibility that the issue finds its way to your schools is unfortunately very high; so that was the thinking behind the policy,” Hitch said.
Board Member Mary Ellon Ballance said that some teachers and substitutes are also trained first responders or volunteer first responders who may have used Naloxone in that role to treat overdoses. “I know that Hatteras has several that are also members of the rescue squad and work at the rescue squad in the summer, so they would have access [to Naloxone].”
Board Member David Twiddy asked about what might happen if a student experienced an overdose while on an activity bus away from campus and no one there had the medication.
Basnight said that the policy doesn’t require Naloxone to be available in “every aspect of school life. What we’re saying is, if it’s going to be in the building, here’s where we want it.”
“It’s similar to the AEDs [Automated external defibrillators], Hitch added. “We don’t have them everywhere, but we know that if we have them somewhere, that we have a chance of helping a kid.”
