The Rising Fentanyl Crisis
HIDTA conducts an annual assessment to determine the greatest drug threats
impacting their region. For
calendar year 2022, the most significant drug threats in the Houston HIDTA were
deemed to be opioids/opiates (due to fentanyl) and methamphetamine, followed by
cocaine and marijuana.
18-County Houston HIDTA Region
The Rising Fentanyl
Fentanyl is central to the overdose crisis in the Houston HIDTA as well as throughout Texas and across the nation. In Harris County, the most populous county in Texas, there was an astounding 457% increase in fentanyl-involved deaths over the past four years from 104 in 2019 to 579 in 2022. Reflecting the magnitude of this threat in Harris County, almost half (49%) of the drug and alcohol-related deaths involved this lethal substance in 2022. This death data likely reflects only the tip of the iceberg of this growing problem as aggregate data on non-fatal overdoses is still not yet well-captured.
This is the Houston Investigative Support Center’s
(HISC) analysis of information received from the Harris County Institute of
Forensic Sciences (HCIFS). It is not considered to be official HCIFS data. Data
is preliminary as the HISC does not have the final dataset for 2022.
Drug Deaths by Drug Type
in Harris County
Note: Many deaths involve more than one drug type.
This is the HISC’s analysis of data received from Harris County Institute of
Forensic Sciences. It is not considered to be official HCIFS data.
sharp upward surge in deaths involving fentanyl/fentanyl analogs (designated
with a blue line) in recent years can
be seen in chart above. More deaths have involved this drug than any other
major drug type for the past two years. The number of deaths rose from 104 in
2019, to 296 in 2020, to 483 in 2021 and 579 in 2022.
number of cocaine-involved deaths (designated with a red line) also remains high. There was a fairly steep rise in
the number of cocaine-involved deaths from 283 in 2019 to 401 in 2020, with a
continued increase to 440 deaths in 2021. The number in the preliminary 2022
data appears to have remained fairly constant with 442 deaths. It is important
to note that until 2021 when fentanyl rose to be the drug type involved in the
highest number of toxicity-related deaths in Harris County, more deaths
involved cocaine than any other major singular drug type for years.
number of deaths involving methamphetamine (designated with a green line) has also risen steeply in recent
years, from 205 in 2019, to 343 in 2020, and to 431 in 2021. However, the
preliminary 2022 data shows a slight decline with 417 methamphetamine-involved
deaths identified in the past year.
number of deaths involving heroin (designated with a purple line) in Harris County was incrementally rising from
207 deaths in 2019, to 224 in 2020, and to 237 in 2021. However, there appeared
to be a fairly steep downward trend in the past year. There was a 31% reduction
in deaths involving this drug type from 237 in 2021 to 164 in 2022.
Summary of Drug Threats in the Houston HIDTA
The Threat from Fentanyl in the Houston HIDTA
- A primary reason for the rise in fentanyl-involved deaths is that this deadly substance is being identified more frequently in a broader array of illicit drug types. Counterfeit prescription pills (primarily fake oxycodone) increasingly contain fentanyl and it is also more commonly being identified in the region’s heroin, methamphetamine, and cocaine supply. Another trend is that seized drugs suspected to be heroin or cocaine are more frequently identified as fentanyl instead. Fentanyl has changed the landscape of the drug threat environment to such an extent that the use of almost any illicit drug could potentially expose an individual to this lethal substance.
- Counterfeit prescription pills are more readily available than ever before in the Houston HIDTA due to a rise in local pill pressing operations in addition to the already high level of production and exportation by Mexico-based drug cartels. In 2022, drug investigators reported an increased level of seizures of fake oxycodone tablets made with fentanyl, fake Adderall and ecstasy tablets made with methamphetamine, and fake Xanax often containing non-controlled benzodiazepines or sometimes fentanyl. Because fentanyl has been found to some extent in a variety of types of tablets in recent years, taking any pill purchased illicitly is analogous to playing a game of Russian roulette.
The Threat from Methamphetamine in the Houston HIDTA
- Methamphetamine continues to be consistently ranked by the vast majority of drug investigators as one of the greatest threats in their jurisdiction. Its high availability and relatively low cost have contributed to the ongoing expansion of the use of this stimulant throughout the Houston HIDTA. Methamphetamine was reported to be among the primary drugs being used by adults as well as one of the top drugs rising upward in use. Crystal methamphetamine is the most commonly encountered form of the drug. It is generally smoked or injected. The overall threat from crystal methamphetamine has risen much higher in the past year due to increasing reports of methamphetamine-fentanyl mixtures.
The Threat from Cocaine in the Houston HIDTA
- Although it has become overshadowed by the rapidly rising threats from methamphetamine and opioids/opiates, powder cocaine and crack cocaine continue to be widely used by the adult population in the region. The threat from cocaine has become elevated due to a rise in suspected cocaine seizures found to be cocaine-fentanyl mixtures or to contain solely fentanyl instead of cocaine.
The Threat from Heroin in the Houston HIDTA
- The popularity and high level of availability of opioid pills in the region has likely precluded heroin use from escalating to the extent seen in other areas of the country. However, heroin use by adults (particularly young adults) has been slowly and incrementally rising as more individuals become addicted to opioids/opiates. Both black tar heroin and powder heroin are used in the region. Heroin-fentanyl combinations are increasingly being seized as are seizures of drugs represented as heroin that test positive only for fentanyl.
The Threat from Marijuana in the Houston HIDTA
- Marijuana use continues to soar upward in use as its social acceptance has grown substantially with expanding legalization across the country. Availability and use of highly-potent hydroponic marijuana, marijuana concentrates such as vape cartridges with THC oil as well as THC-infused edible products is high due to an influx from the broadening number of states in which the drug has been legalized. Marijuana is widely used by both adults and adolescents in the region. Vaping of THC by adolescents is reported as rampant. The increasing popularity of high-potency THC products among teens and young adults is a serious concern due to THC’s known detrimental effects on the developing brain. There have been NO instances of seized marijuana, marijuana concentrates, or marijuana edibles testing positive for fentanyl in the region.
The Threat from Other Illicit Drugs in the Houston HIDTA
- Various other types of illicit drugs are considered to be lower-level threats, not because they are not as dangerous, but because they are less widely used in the region. Some of these include synthetic cannabinoid products (often referred to as synthetic marijuana or Kush), synthetic cathinones (bath salts), and synthetic hallucinogens (PCP, LSD, etc). There have been NO instances of seized illicit drugs in this category testing positive for fentanyl in the region.
- Nationally, there has been a revived interest in hallucinogens. In the Houston HIDTA in 2022, there was a noted increase in seizures of psilocybin mushrooms as well as a newly identified drug product: chocolate “magic mushroom” candy bars. Tested seizures of these candy bars in the Houston HIDTA indicated the presence of psilocin.
Emerging Drug Trends in the Houston HIDTA
- A class of synthetic opioids called NITAZENES was newly identified in the Houston HIDTA in 2022. Nitazenes have been found in seized counterfeit oxycodone, hydrocodone, and alprazolam (Xanax) tablets, and in powder form in the greater Houston Metropolitan Area. Some nitazenes are even more potent than fentanyl and multiple doses of naloxone (Narcan) may be needed to reverse a nitazene-involved overdose. The HISC has identified two deaths associated with nitazene toxicity in Harris County to date. Individuals using drugs containing nitazenes are likely unaware of its presence. Fentanyl testing strips do not detect nitazenes.
- XYLAZINE (“Tranq”), a powerful veterinary tranquilizer is being found in the nation’s illicit drug supply, contributing to a worsening of the fentanyl crisis. Xylazine does not respond to Narcan since it’s not an opioid and for this reason, xylazine-fentanyl mixtures are being associated with a rise in deaths nationally. Xylazine use is also linked to serious skin abscesses and skin ulcers. The DEA issued a safety alert in March of 2023 about the sharp increase in the trafficking of fentanyl-xylazine drug mixtures and the heightened risk of fatal drug poisonings associated with their use. In April of 2023, the Director of ONDCP designated fentanyl adulterated with xylazine as a national emerging drug threat. While xylazine-fentanyl mixtures have been identified in the Houston HIDTA, this threat has not become as prominent in the region as in other areas of the country. Fortunately, to date, only a small proportion of seized pills and powders with fentanyl have been found to contain xylazine in the Houston HIDTA.
Drug Transportation Trends in the Houston HIDTA
As can be seen in the map above, Houston is a pivotal point for the importation and exportation of a wide variety of drug types. Noted with red arrows, illicit drugs such as methamphetamine, cocaine, low-grade marijuana, heroin, fentanyl, and fentanyl-laced counterfeit pills are transported in bulk quantities into the Houston HIDTA from Mexico through South Texas. Once arriving in the Houston area, these large drug loads are broken into smaller quantities and delivered to locations throughout the nation. Noted with purple arrows, Mexico-based cartels obtain precursor chemicals from China for the fentanyl and methamphetamine they produce. Although Mexico is the primary source for fentanyl entering the United States, fentanyl and other synthetic opioids also arrive via mail shipments originating from source countries such as China though to a lesser extent than in the past. Noted with green arrows, domestically-produced high-grade marijuana, marijuana concentrates (THC wax and oil) and THC edibles are diverted from a continually growing number of states that have legalized marijuana into Houston HIDTA counties to meet the very high level of demand for these potent marijuana-based products.