“You can get it anywhere,” says 35-year-old Jamie Ethridge, but he typically went to downtown Denver’s Civic Center Park to find fentanyl. Blue tablets, orange pills, pink powder: It was a smorgasbord of fixes, all available from a handful of dealers. Ethridge, a local musician, hasn’t chased the euphoric high of the potent synthetic opioid for more than a year now, though, making him one of the lucky ones who can say they played an often fatal game of chance and lived. In 2020 and 2021, roughly 1,450 Coloradans—and more than 127,500 other Americans—were not so fortunate.

Although experts point to 2013 as the beginning of what is now being called the third wave of the nation’s opioid epidemic, law enforcement and health care professionals in the Centennial State say it wasn’t until about 2018 that they began seeing the effects of the drug on everyday Coloradans. “Patients were coming into our facility in opioid withdrawal,” says Dr. David Mendez, an addiction medicine specialist at UCHealth’s Center for Dependency, Addiction, and Rehabilitation, “but they weren’t responding to treatment. We realized this wasn’t oxycodone. It was something else.”

It was fentanyl. But it wasn’t the pharmaceutical-grade IV drug long used in hospital operating rooms and as a painkiller for cancer patients. This was a bastardized version, one that was cooked up using chemicals (usually imported from China) and pressed into tablets by drug traffickers (often in Mexico) who had realized how much easier and cheaper it was to make and how much more lucrative it was to sell in the States—often passing it off as pilfered prescription meds—compared with heroin.

In Denver, one pill can sell for anywhere from $5 to $25. Those who are struggling with addiction often use between five and 20 pills a day.

According to some local law enforcement officials, a 2019 state law may have turned 2018’s trickle of illicit fentanyl into a torrent by 2020. That statute made possession of up to four grams of almost all drugs for personal use a misdemeanor. The problem? Four grams of fentanyl-laced pills equals, conservatively, 40 fatal doses. And while a 2022 law changed possession limits for fentanyl specifically, not everyone believes the legislation went far enough. “Drug dealers are savvy,” says Denver Police Department Commander Paul Jimenez. “When state law allows possession of certain drugs to be misdemeanors, drug dealers know how much to carry so they fly under the radar. Because of its location, population, and drug laws, the metro area is a major trafficking hub for all drugs, including fentanyl.”

The 2022 threat assessment from the Rocky Mountain High Intensity Drug Trafficking Area (RMHIDTA) program supports that claim. For the first time, the annual report from RMHIDTA—which facilitates coordination between federal, state, local, and tribal law enforcement in Wyoming, Utah, Montana, and Colorado to disrupt drug trafficking—listed fentanyl as the most significant drug threat facing the region.

According to Keith Weis, executive director of RMHIDTA, fentanyl is a menace for several reasons, but mostly because it’s so deadly. “Remember,” he says, “one [pill] can cause a fatal overdose.” Roughly 50 times more potent than heroin, fentanyl is a poor excuse for a street drug because it often kills repeat clients. “Dealers just don’t care,” says Steve Kotecki, a Denver-based public information officer for the Drug Enforcement Administration (DEA). “There’s always another customer.”

Users can simply ingest the pills, but snorting fentanyl powder and smoking it—by crushing the pills, adding water, and heating the resulting mixture with a flame—are also common methods of use.

There is never, however, another family member or friend. And with Colorado’s associated death toll rising faster than any other state’s save Alaska’s, too many loved ones here are learning that in the most awful way possible—whether that’s because a group of five friends thought they were doing cocaine at a party in Commerce City but instead took a lethal dose of fentanyl or because a curious 13-year-old in Aurora swallowed a pill he’d gotten from a friend and died in his bathroom.

Ethridge knows his family nearly experienced that agony. He overdosed on four occasions. “Whether you’re thinking you’ll just experiment one time or you’re an addict, think about it first,” Ethridge says. “Dying from this stuff can happen to anyone.”

The Effects of Fentanyl

First produced in 1959, fentanyl is a synthetic opioid—which means it’s made in a lab rather than from an actual poppy plant. Typically, it’s used under a doctor’s supervision to curb chronic pain or pain after surgery. Used appropriately, it’s a wonder drug; deployed recreationally, it can ravage the body. Here, a look at some of its effects.

Often called “blues,” the small, often light blue tablets are made to look like oxycodone M30 pills. Other bogus versions can be manufactured to imitate Percocet, Adderall, and Xanax. Photo by Joni Schrantz

Euphoria and relaxation: When fentanyl enters the body, the neurotransmitter dopamine increases in the reward areas of the brain, which elicits the stereotypical exhilaration and serenity associated with being high. After frequent opioid use, though, the brain develops a tolerance for the substance, making it difficult to feel pleasure from the drug—or anything else.

Pain relief: Fentanyl works by binding to the body’s opioid receptors, which are localized in areas of the brain that manage pain. The analgesic effects of fentanyl are greater than morphine and are generally relegated to use in the operating room and for uncontrolled pain, typically in patients with late-stage cancer.

Cyanosis: Because fentanyl depresses breathing, the body doesn’t receive the oxygen it needs. This can lead to a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood.

Drowsiness: Fentanyl, like most opioids, makes people drowsy. This can be an upside for those who need to rest after surgery. Fentanyl misuse, however, can interfere with a person’s ability to work, drive safely, and manage daily life.

Pupillary constriction: One symptom of opioid overdose is pinpoint pupils that don’t respond to changes in light.

Respiratory failure: At high doses, fentanyl depresses respiration, making breathing slower and shallower and decreasing the amount of oxygen a person takes in. This side effect is generally responsible for fentanyl’s overdose deaths, but it can also lead to hypoxia-induced coma and brain damage for those who survive a fentanyl overdose.

GI tract issues: Up to 85 percent of people who use prescription opioids experience constipation. Unlike some other side effects of opioids, these gastrointestinal disturbances—which are often accompanied by nausea, vomiting, and abdominal pain—do not dissipate as a person becomes more tolerant to opioids.

Addiction and withdrawal: When the brain’s opioid receptors don’t receive the fentanyl they’re used to, they panic and cause a variety of unpleasant symptoms. Most addiction specialists and people who misuse fentanyl liken fentanyl withdrawal to the worst flu imaginable. Symptoms of withdrawal can include yawning, watery eyes, goose bumps, diarrhea, nausea, vomiting, sensitivity to light, body aches, muscle spasms, insomnia, and sweating.

Dangerous Lines

The statistics are going in the wrong direction when it comes to fentanyl’s impact in Colorado.

*A dosage unit is a single-use amount—usually a pill, but it can be powder—that would be consumed by one person
**Through August
Sources: Colorado Department of Public Health & Environment; Rocky Mountain High Intensity Drug Trafficking Area

The History—and Future—of the Opioid Epidemic

The history of human opioid use is long and (mostly) nonlinear, but it’s easy to connect the crests and troughs of the country’s most recent opioid crisis. What’s not as easy? Predicting what will come next.

Photo by Joni Schrantz

Wave 1

Although some experts suggest the opioid epidemic began after the New England Journal of Medicine published a letter in 1980 that said the development of addiction to narcotics was rare in patients with no history of dependence, most lay blame for the current opioid epidemic on the American Pain Society. In the mid-1990s, the society (which closed in 2019 after allegations it had colluded with opioid manufacturers) called for pain to be considered the “fifth vital sign.” Paired with the journal information that opioids might not be as addictive as physicians thought, doctors began relieving patients’ suffering with opioids such as OxyContin, which Purdue Pharma released in 1996. Although numerous studies have found that up to 45 percent of chronic-pain patients become addicted, Purdue’s salespeople told doctors for years that fewer than one percent would suffer that fate. OxyContin turned many formerly functioning folks who’d needed pain meds after surgery into pill seekers who went from doctor to doctor to feed their addiction after their scripts ran out. Meanwhile, Purdue’s sales of Oxy-Contin rose from roughly $48 million in 1996 to more than $1 billion in 2000.

Wave 2

In 2007, Purdue Pharma was found guilty of misrepresenting OxyContin’s potential for abuse and paid $600 million in penalties. Three years later, Purdue Pharma released a re-engineered iteration of OxyContin that couldn’t as easily be crushed and injected, which had been the preferred method among those who misused the drug. Around the same time, the American medical establishment collectively pulled back on prescribing narcotics. These changes left those who’d become dependent upon OxyContin with little choice but to find other substances to avoid dope sickness, a slang term for going into withdrawal from opiates. For many, the easiest replacement for OxyContin was heroin, which set off a steep rise in overdose deaths.

Wave 3

Heroin is a high-overhead product. Drug trafficking organizations, often located in Mexico, need acreage to grow poppies; farmers to tend to them; security to guard the crops; workers to harvest them; vehicles for transporting plant materials; a processing facility; and other expensive items common to large agricultural endeavors. According to the DEA’s Kotecki, when cartels realized they could import the ingredients they needed to manufacture illicit fentanyl and other opioids from China, thereby avoiding all that farming overhead, they pivoted. That meant a dip in heroin production that forced Americans to take whatever the drug traffickers were selling—and that was mostly fentanyl. The substance and its variations—called analogs—have caused more annual deaths than any other drug, ever.

Wave 4

Coming soon (if it’s not already here)
Carfentanil. Isofentanyl. Acetylfentanyl. These are just some of fentanyl’s so-called analogs—drugs that are chemically similar to an original substance but are created to be chemically different enough to circumvent existing laws. These analogs have been outlawed by the DEA over the years, but new designer synthetic drugs could be part of the fourth wave. Some of them—such as N-pyrrolidino etonitazene, a synthetic opioid sometimes called Pyro that is circulating in Colorado—are more potent than the original. There are other newcomers, too: The combo of xylazine and fentanyl is known as tranq. Xylazine is a central nervous system depressant that’s combined with fentanyl to make the effects of the opioid last longer; it also causes skin ulcers, drowsiness, amnesia, slow breathing, slow heart rate, and low blood pressure. Benzo dope is the mixture of fentanyl and benzodiazepines, which are sedatives prescribed as anti-anxiety medications. “We’re already seeing it,” says Steve Carleton, executive clinical director for Gallus Medical Detox Centers, which has a Denver location. “The next wave is benzo dope because, from a business standpoint, it’s gold. It’s so addictive. Plus, it doesn’t respond to Narcan. It’s going to be crushing.”

The DEA put out an alert in late August that traffickers are now making so-called rainbow fentanyl. The pills and powder, which have been found in Colorado and are known as Candy or Skittles, come in a variety of colors and shapes and are an effort to drive addiction among adolescents and teens.

Addiction Chronicles

Photo by Joni Schrantz

Playing Pretend

Connie Weinrich is looking for a “before” picture on her iPad—the one where Hannah looks young, vibrant, and healthy. She wants to show that photo first and then the “after” shot, the image where her daughter, in the throes of fentanyl addiction, is nearly unrecognizable. In that photograph, Connie and her husband, Tom (Hannah’s longtime stepdad), can barely see the talkative girl with the dry sense of humor who loved scary movies, wanted to save the honeybees, excelled at styling hair and doing makeup, and always had a vivid imagination. “As a child,” Connie says, “she was good at pretend. And even as she grew older and something would go sideways, she’d say, ‘Let’s pretend that didn’t happen.’ ”

Today, the Weinrichs wish they could pretend a lot of things didn’t happen. For instance, they might pretend that when Hannah was 15 she hadn’t started using cannabis. They might also try to forget about how smoking high-THC pot led Hannah to using meth, which led to heroin, which led to fentanyl. They could try to imagine a world where their 23-year-old daughter hadn’t been homeless for more than a year and hadn’t been breaking into houses to find copper wiring to sell for fentanyl. They might also try to misremember that, since April, Hannah had been working on her sobriety and attending services at Denver’s Free Spiritual Community, which bills itself as a place for “addicts, loved ones of addicts, and spiritual refugees.”

“She seemed to be motivated,” Connie says. “She’d gotten her cosmetology license back, she’d gotten a job.” But on the day she received her first paycheck in late July, Hannah left work early and decided to celebrate.

At the time, the 25-year-old had been staying with her father; he found her, lifeless, in her bedroom the next morning. There was fentanyl in her pocket and in her purse—and ultimately in her autopsy report. Her parents believe she may have neglected to take into account that she had become less tolerant as she had weaned herself off the drug and failed to scale back her dosage. “I went to her dad’s house that day, but I couldn’t go into the room because it was a crime scene,” Connie says. “They brought her down in a body bag—my child. That’s something you never forget.”

Strong Enough To Live

Photo by Joni Schrantz

The first sign of fentanyl withdrawal is the nonstop yawning, says Laura Beth “LB” Burkhalter. Then come the watery eyes and the runny nose. Then sweating, body shakes, heart palpitations, muscle spasms, diarrhea, and vomiting. The symptoms can begin within hours of a person’s last fix. “It was my substance of very little choice for 10 years,” Burkhalter says.

Growing up in Mississippi, Burkhalter says she had mental health struggles and the signs of a predisposition to addiction as a teenager, but it wasn’t until she experienced bone fractures in her legs and feet from athletics that she found the relief of pain meds. “My injuries wouldn’t heal,” she says, “and doctors gave me massive amounts of medication. I was using OxyContin and Vicodin and then fentanyl patches on top of that.”

When her prescriptions ran out, Burkhalter began buying pharmaceutical-grade fentanyl patches from cancer patients she knew who needed money more than pain relief. “The drug stops doing what you need it to do,” she says. “You need more and more to turn your brain off. You need it just to not be sick. I wasn’t strong enough to die or strong enough to live.”

But, tired of being sick and tired, Burkhalter tried to self-detox. She went cold turkey and suffered alone in an apartment in Louisiana for 17 days. When the misery was too much, she got some heroin and did just enough to make the hurt go away. “I was trying to portion control heroin,” she says. “I realized you can’t use heroin like a lady and then went back to my old routine.”

After bearing a son who was addicted to opioids at birth and nearly dying of an overdose, Burkhalter surrendered. Her family found a treatment center for her in Colorado, far away from her life in the South. A year of therapy allowed her to leave the drugs behind, but she didn’t trust herself to leave the recovery community. So, she didn’t. Instead, she found a job working in a treatment center in Lakewood and now also runs a sober-living home for women in Loveland.

Through that work she has learned a lot about how people view addiction. “People are opposed to harm reduction because they see it as enabling,” she says. “My view is that we are enabling them to survive so that they can find recovery. It took me more than 10 years to choose to live, but now I have the gift of recovery and know that life can be beautiful.”

Harm Reduction

In the battle against misused substances, there are often two camps: those who want to fight illicit drug use using the criminal justice system and those who prefer to reduce its consequences by deploying a set of strategies called harm reduction. Located in Denver, the Harm Reduction Action Center (HRAC) helps roughly 150 people who use drugs each day do so more safely. With assistance from HRAC executive director Lisa Raville, we explain what harm reduction looks like—or could look like—when it comes to the fentanyl crisis.

Naloxone (Narcan)

AP Photo/Matt Rourke

Several years ago, when fentanyl was still relatively rare in Colorado, it was often police officers or paramedics who encountered people who were overdosing. “Today, it’s a barista or a bartender who’s finding someone in the bathroom,” Raville says, referring to the dramatic increase in overdose deaths in Colorado. “We need more people to have access to Narcan. I carry it. If someone is going to OD, I want them to OD with me.” Naloxone, often referred to by its brand name Narcan, is a medication—which comes as an injectable and as a nasal spray—that temporarily but rapidly reverses an opioid overdose. HRAC provides access to naloxone for its clients, but other local agencies, businesses, and organizations offer it to the general public.

Supervised Drug Use Sites

In 2018, Denver City Council approved a framework for a pilot program for a government-sanctioned supervised drug use site in the Mile High City. Four years later, the site—which would allow people to use drugs in the presence of medical professionals, rather than risking an overdose alone—has yet to open because the state Legislature hasn’t passed a law needed to enable its launch. “We need to be having conversations about safe use,” Raville says. “If we want to prevent overdose deaths, this is one way to do that.” The country’s first such sites opened in New York City in November 2021. In the first two months of operations, the sites were used 5,975 times by more than 600 people; staff responded to 125 on-site overdoses but saw zero deaths. Governor Jared Polis has stated he is opposed to supervised sites.

Fentanyl Test Strips

Fentanyl has permeated the illicit drug supply in Colorado. The opioid is showing up in what dealers are selling as cocaine, heroin, meth, MDMA, and prescription painkillers, like oxycodone. Those who are addicted to street drugs—or those who want to experiment with these substances—can use test strips to detect the presence of fentanyl before using them. “People do want to know what’s in their drugs,” Raville says. “My clients know the dangers of fentanyl. Are test strips 100 percent effective? No, mostly because of the chocolate-chip-cookie effect, but they’re better than nothing.” (The chocolate-chip-cookie effect refers to the fact that the illicit drug supply is unpredictable; drugs are not always mixed evenly, which means it’s possible to get a false negative if you test a part of the cookie where there is no chocolate chip—aka fentanyl.) “Still,” Raville says, “we hand them out and tell people to test their supplies.”

  • Denver residents can request fentanyl test kits for free from the Denver Department of Public Health & Environment.
  • DanceSafe, a public health nonprofit, sells test strips online ($20 for a 10-pack).

Safe Supply

Controversial and as-yet-unadopted in the United States, safe supply is the idea that there should be a federally regulated, pharmaceutical-grade supply of drugs such as heroin and fentanyl so that people may use them more safely, without worrying about life-threatening adulterants. This would, advocates like Raville suggest, disrupt the toxic drug supply and save thousands of people from fatal overdoses. A number of countries have been exploring and researching safe supply methods; however, the idea is often anathema to Americans who have been consuming This Is Your Brain On Drugs–style campaigns since the 1980s. Advocates make the point that the opioid drugs that started the current crisis were government-regulated—and overdose deaths were lower than they are now.

3 Questions For: John Kellner

The district attorney for the 18th Judicial District—and candidate for Colorado attorney general in this month’s election—was involved in one of the largest fentanyl busts in state history earlier this year. 5280 caught up with Kellner to ask what concerns him most about the state’s synthetic opioid crisis.

5280: A cadre of law enforcement agencies and the 18th Judicial District were involved in busts that, combined, took more than 200,000 fentanyl pills off the streets in early 2022. What did you take away from this case?
John Kellner: There were two big things for me. First, these pills weren’t just the blue tablets we so often see. There were also pink pills, which suggests to us an effort by dealers to differentiate their products. They’re essentially rebranding to catch eyes. We’ve heard they may even be adding flavoring to market to younger Americans. They will be killing younger and younger people.

And the second big thing?
In addition to the fentanyl, we found guns and heroin and cocaine and $60,000 worth of stolen merchandise. In another large fentanyl bust back in December 2021, we found 28 firearms and $450,000 in cash. [Fentanyl] is big business for dealers, and there is tremendous potential for violence because these people will protect that business at all costs.

These sound like the exploits of drug trafficking organizations, but everyday crime in Colorado is up, too. Some experts are suggesting there is a link to the opioid crisis—what’s your take?
There is a nexus between crime and drug activity. Law enforcement officers are finding fentanyl when they catch people stealing cars. They’re finding it on people who are stealing things from Target to resell. FBI agents who investigate bank robberies—which Colorado had the highest number of in 2021—attribute the state’s increase to fentanyl. The rise in crime rates in Colorado can, I think, be put at the foot of the fentanyl crisis.

Legislation & Colorado’s Great Fentanyl Debate

Lisa Raville, Executive Director of the Harm Reduction Action Center, looks at paper faces representing the 1,111 people who died in Colorado in 2018 from overdose. The paper faces were lined up in the grass during a march held by Harm Reduction Action Center and Denver Health for Overdose Awareness Day on Aug. 30, 2019. RJ Sangosti/Media News Group/the Denver Post via Getty Images

House Bill 22-1326, which became the Fentanyl Accountability and Prevention Act, passed the state Legislature in the final minutes of the 2022 session—yet no one seems all that happy about it.

Supporters say HB 1326 didn’t go far enough. Detractors say the law stepped well over the line. Typically, that might mean legislators hit the sweet spot, but the Fentanyl Accountability and Prevention Act, which took effect on July 1, doesn’t seem to have any real friends.

The bill was introduced, in part, to remedy the unintended consequences of a 2019 law that made possession of four grams or less of a controlled Schedule I or II substance, including fentanyl, a level one drug misdemeanor. The aim of that 2019 law was to de-felonize possession for personal use. But at that time, fentanyl was only beginning to show its destructive potential in Colorado. By early this year, Governor Jared Polis, Colorado Attorney General Phil Weiser, and House Speaker Alec Garnett all went on the record to say new legislation was needed to fix a law that was allowing drug dealers to carry dozens of potentially lethal doses of fentanyl without fear of being charged with a felony. HB 1326 passed in late May.

Months later, it’s difficult to find anyone—whether they supported the original intent of HB 1326 or not—who thinks the Fentanyl Accountability and Prevention Act was particularly well constructed. Here’s why.

The Provision

Possession of between one gram and four grams of fentanyl or a fentanyl compound for personal use is a level four drug felony punishable by up to 180 days in jail and up to two years of probation.

Supporter: John Kellner, district attorney for the 18th Judicial District, backed the legislation but believes the new law, which would make drug dealers eligible for probation, was too lenient. “If dealers feel like there’s a strong system of punishment,” he says, “they’d be less willing to do business in Colorado.”

Detractor: “This legislation doubled down on the worst parts of the war on drugs,” says Lisa Raville, executive director of the Harm Reduction Action Center, which advocates for the health of Denverites who use drugs. Raville argues that re-criminalizing possession just means putting people—many of whom take five to 15 fentanyl pills a day, enough to trigger a felony charge, just to stave off dope sickness—back in jail.

The Provision

If defendants charged with fentanyl possession can show evidence they didn’t know that the controlled substance they had in their possession contained fentanyl, the defendant can argue that case to the jury. If the jury agrees, the penalty can be knocked down to a misdemeanor.

Supporter: “This is going to make felony prosecution of anyone found with one to four grams of fentanyl more difficult than any other hard drug,” Kellner says. “Anyone can say they didn’t know. The prosecution doesn’t have to prove someone knew it was cocaine, so why is that the case here?”

The Provision

The act zeroes in on those who have an intent to distribute fentanyl, making penalties stiffer if the drugs originated from outside of Colorado, if the person also possessed a pill press or other manufacturing equipment, or if the distribution leads to a death.

Supporter: “For a number of years, we’ve looked at cases of fentanyl overdose deaths and worked with the DEA or FBI,” DPD Commander Jimenez says, “but there weren’t state charges until now. It’s a good deterrent, but these are labor-intensive cases, and we have to have good information to present to a DA. Sometimes, because there are multiple drugs in a person’s system, the medical examiner can’t say for sure that fentanyl killed them. Sometimes medical examiners don’t even test for fentanyl. That’s a problem for us.”

Supporter: “I hear over and over from families affected by a fentanyl death that the police just don’t reach out,” says Aretta Gallegos, who lost her daughter, Brianna Mullins, to fentanyl in 2021. “Even when they do, they often say there’s nothing they can do because they don’t have definitive information to arrest someone. The law should’ve been stricter and more helpful for investigators.”

Addiction Chronicles

Photo by Joni Schrantz

Those Left Behind

Scotty Mullins laughs a sad little laugh when he admits that Brianna was his boss at his first job at a Sonic Drive-In. He giggles, too, when he says that the woman who would become his wife was funny and caring and a good mom but that she liked to pick arguments. “She liked to fight,” he says. “If she fought with you, she loved you.”

But, Mullins says, Brianna was fighting other battles as well. Sexually assaulted at the age of 18, she had started taking Xanax to help manage anxiety. She used it off and on until she got pregnant, and after giving birth, her family thought she was doing well without the medication. That, however, was not the case. Brianna had started taking Percocet—or what she thought was Percocet—that she got from a friend at work. “She knew she needed to stop using it,” Mullins says. “She had already scheduled an appointment with a therapist looking for that help.”

Instead, on the night of April 14, 2021, Mullins came home from work to find his 25-year-old wife already in bed. “I knew something was wrong the moment I saw her,” he says. “Her face didn’t look good. I tried CPR. I didn’t know what to do. The medic said she had probably been gone for hours.”

The pills Brianna thought were Percocet were laced with illicit fentanyl. “It sucks, because I know who gave her the pills,” Mullins says. “I gave the police that info. But because the fentanyl bill wasn’t a thing then, they said they couldn’t do anything [about her death].”

Mullins believes, as many others in his position do, that his wife was poisoned. “It’s murder,” he says. “She thought it was something else; she didn’t want to die. Our son was everything to her.”

Now, more than a year later, Mullins says he still has to explain over and over to their five-year-old, Aaron, that his mom is not coming home. Too young to understand, Aaron is confused about why she’s not coming back when he misses her so much. “I just tell him that I miss her, too,” Mullins says. “If you haven’t lost someone like I lost her, though, it’s hard to explain—and unexplainable to a child—that really I don’t have any feelings anymore. Everything just got taken away.”

Hindsight Is 20/20

Photo by Joni Schrantz

Coco Peterson looks at her three kids and her niece—all between eight and 13 years old—and wishes she didn’t have to have the conversation she knows she has to have. But maybe more than most people, the 39-year-old Fort Collins resident realizes how critical it is to talk with her children about not taking any pills or medicines that their friends might offer them. “It’s just not something you should have to tell little kids,” she says. “You have to explain, though, that it could be one pill and done.”

That’s how it happened for Peterson’s 37-year-old sister, Kristina Kaufmann, who died in February 2019 after taking what her family believes was a counterfeit oxycodone pill cut with fentanyl. Kaufmann had become dependent on prescription painkillers following a car accident. When her prescriptions ran out, she began getting oxycodone or Percocet from friends who had legal prescriptions. When that became untenable and the neck pain became too great, she turned to less-savory characters, who would sell her black-market pain medications. She was able to do all this and hide it from her family and her boss. “My sister was high-functioning,” Peterson says. “She was smart, had a job in financial investing, and she had a daughter she loved. Only in hindsight did we see how much she was struggling.”

Peterson is devastated by the thought that her older sister—who was funny and a lover of practical jokes—died of loneliness. “Substance abuse is so isolating,” she says. “She wanted to have the appearance of being able to take care of everything. I think the stigma was a big part. She didn’t want to say, ‘I need help.’ ”

Which is why Peterson talks to Kaia (top left), Jett, and Jade—and her sister’s daughter, too—about how it’s OK to not be OK, but that it’s not at all acceptable for them to experiment with pills of unknown origins. “Fentanyl is in things kids might want to try,” she says. “It’s in pills that look like Xanax and Adderall. The problem is they can’t experiment any longer. It’s a death wish.”

Not that she thinks Kaufmann wished to die. She knows she didn’t. “She never intended to die,” Peterson says. “She didn’t intend to take a counterfeit pill. She didn’t want to miss all these life moments with her daughter.”

Coded Language

Smartphone-wielding Gen Zers don’t need to find a dark alley to score drugs. Why? Because dealers, often called “plugs,” can flog their wares—and offer to deliver them, pizza-guy style—to your teens using emojis that, even if you saw your kid’s Snapchats, you might not recognize as sales transactions. With a little help from the DEA, we rounded up some common pictograms and their meanings. Remember: Nearly all of these street drugs can be cut with fentanyl and, when it comes to pills that look like prescription drugs, more than 90 percent of them are counterfeit and can contain fentanyl.

Local Activism

How the death of her child led one woman to create Colorado’s Voices for Awareness.

More than four years after her 32-year-old daughter died, Andrea Thomas is still waiting for the man she holds responsible to be sentenced. Bruce Holder, who was convicted of four counts of fentanyl distribution in April 2021, has been linked to nine deaths and several other nonfatal overdoses on the Western Slope. “My daughter didn’t mean to die that day,” Thomas says. “She was poisoned.”

Andrea Thomas, founder of Voices for Awareness. McKenzie Lange/Courtesy of the Daily Sentinel

A lot of people would agree. Although the Denver-based jury that convicted Holder was only presented with the opportunity to return a guilty verdict (which it did) on one count of distribution resulting in death—for a man who died in Carbondale in 2017—a grand jury had previously indicted the dealer for the death of Thomas’ daughter, Ashley Romero.

Romero, who had chronic pancreatitis exacerbated by alcohol use, would sometimes use legally prescribed pain meds when the condition flared. But in June 2018, she didn’t have anything in her medicine cabinet during an acute attack and instead bummed what she thought was an oxycodone pill from her boyfriend, who had gotten it from a friend. “She took half of the pill,” Thomas says. “Her boyfriend took some, too. They both overdosed on fentanyl.”

Paramedics revived Romero’s boyfriend, but Romero was pronounced dead at the scene. “The next day,” Thomas says, “that young man took his own life.”

At the time, Thomas says, she had no idea how half of a pain pill could kill her daughter. Since then, Thomas has made it her mission to make sure everyone knows that even the smallest amount of fentanyl can kill. In 2019, she founded the Voices for Awareness Foundation, a nonprofit based in Grand Junction that tries to bring attention to counterfeit drugs and illicit fentanyl around the country.

That has meant speaking at town halls, spearheading awareness campaigns, advocating in Washington, D.C., for a federal response, testifying in front of the Colorado Legislature this past May, and organizing rallies for National Fentanyl Awareness and Prevention Day. “I also spend a lot of time with affected families,” Thomas says. “I’m in rooms where everyone has been to a mortuary to pick out a pine or cardboard box for their child.”

She does it in memory of her daughter, but she says it’s become bigger than that. She says she’s had it with the lack of action at the federal level and wants to make enough noise to encourage change. “We need sanctions on other countries that sell these dangerous chemicals,” she says. “We need to stop these terrorist organizations from bringing it into our country from Mexico. And we need people to tell that to the federal government because, trust me: This can happen to your family.”