The number of deaths from drug overdoses has increased dramatically over the past two years.

What's behind the rising number of deaths, and what can be done to stop it?

That's this week on Nevada Week.

♪♪♪ Support for Nevada Week is provided by Senator William H. Hernstadt and additional supporting sponsors.

(Kipp Ortenburger) Welcome as always to Nevada Week.

Well, the number of people who have died from a drug overdose is staggering.

The Clark County Coroner's Office investigated over 800 drug overdoses last year.

Now, that's a 42% increase from the year before.

One of the biggest culprits is fentanyl.

It is a synthetic opioid that is being pressed into counterfeit pills and sold on the street.

Cristina Perkins knows the problem personally.

Her son Gio died after taking what he thought was a Percocet.

Here's her story.

(Cristina Perkins) So Gio from a baby was always on the go, never sat down in one place.

Auntie's house, uncle's house, friend's house, wherever he could go, he wanted to go.

Just didn't want to be at home.

(laughter) Elementary, he was super into school activities.

Junior high, went into a sports, basketball, football, flag football.

You know, he played in school and then he played at the little leagues, you know, at the other parks.

And then high school, he played a little bit more football, and then-- I mean basketball, sorry.

He played basketball and then from there, he kind of put the sports to the side for a little bit.

And then 11th grade, got him a little job.

He wanted to work and I didn't know why, but he wanted to work.

So he just worked with his friends, and that was it.

The prior day he had asked me if his girlfriend could spend the night because they had Senior Sunrise the following morning, which they were supposed to be there at like 6:30 before the sun, you know, sets and stuff like that.

So it was just easier for her to spend the night and then leave here early in the morning and go straight to Sunset Park.

I just remember the following morning like-- I don't know if it was like 3:00 or 4:00.

It's such a blur as far as the time.

She came running out of his room and was like Gio's not waking up.

And I'm like what do you mean?

It was just-- it didn't make sense.

So of course, you know, I jump up, I fly over there, and he's just laying on his bed on his stomach face down.

I'm just shaking him, trying to wake him up.

He's not waking up.

Cold, you know, and I just have no idea what's wrong.

No idea.

Healthy kid, plays sports, you know, it just didn't make sense to me.

It happened so fast.

I don't know who call 911.

Somehow 911 was on the phone.

I don't know if it was my husband, if it was the girlfriend, but I had 911 on the phone.

They advised us to move his body to the floor on a flat surface and do chest compressions until the paramedics got here, which is what we did.

Obviously the whole time I'm doing it, I'm just thinking in my head like what the heck am I doing?

This is just not helping, like my son's dead, like he's gone.

There's no pulse, there's no-- his body's cold.

It just doesn't make sense to me, you know.

It felt like I was doing chest compressions and CPR for hours and hours, and it was probably literally like five minutes, if that.

I felt like they were in there trying to probably revive him for hours and hours and hours before they came out and just told me.

They pulled me to the side of course and they explained that hey, we tried everything we can.

We couldn't bring him back.

And that was at like 7:25 in the morning when they pronounced him dead.

When we asked his girlfriend what had happened, she just was like I don't know.

I don't know.

And I'm like you have to know.

You were here, like you were in the room with him, you know.

She just was like I don't know, I don't know, you know, and I can understand.

You know, kids are kids.

They're scared because, you know, she probably just-- I get it.

She was scared.

But obviously when the police came and they talked to her and they spoke to her, she admitted to the police that she had handed him a pill that was in an AirPod case in his room, and she advised him that there was another one so there was two total.

So Gio took one and there was another one.

So she told the police where it was and they did a rapid test, and at that point they knew it was fentanyl.

From that point it was just like-- to process what fentanyl was, it took me a while.

You know, I probably didn't go back to work till six, seven months later.

I just sat on the couch and cried, and I probably read every article on fentanyl, every story on fentanyl, and now it's like fentanyl is tattooed behind my eyelids and in my brain, you know, where I don't want it but it is.

It's hard to be their friend and the parent at the same time.

You know, it's like you want to be both, you really do, because you want them to confide in you, and I probably-- I think I thought I knew everything, but it was just that one thing I didn't know.

I didn't know where he went to get it.

I didn't know when he asked for it.

I didn't know how much he paid for it.

I don't know if he paid for it.

I don't know if it was delivered here.

That story I just don't know.

We were very hands-on with Gio.

We were in our kids' lives.

It was not-- you know, Gio had perfect attendance, good grades.

I was not one that, you know, just pushed the kids to the side to live the Vegas life.

It wasn't like that.

And the fact that we didn't live under a rock.

You know, we are aware of our surroundings, but I still didn't know what fentanyl was, you know, which it just catches me off guard.

You know, which means if I don't live under a rock and there's other people that don't live under a rock, they might not know what it is either.

And to the parents that do live under a rock that aren't aware of what's going on, they need to step outside the box and realize it's a pandemic out there.

-Cristina, thank you for telling your story.

Joining us to talk more about the problem and what is being done to address the ongoing issue is Cindy Marx, assistant special agent in charge at the Drug Enforcement Agency, better known as the DEA, and Jessica Johnson, senior health educator at the Southern Nevada Health District.

Thank you so much for joining us.

I mean, it's such an emotional story, and Jessica, I want to start there.

Let's talk about the Cristina Perkins story.

She said at the end of the clip it's a pandemic out there, and of course she's not talking about COVID, she's talking about the fentanyl use.

How common is this story?

(Jessica Johnson) Unfortunately, what we're seeing is that fentanyl is increasing in our community.

Since 2019 we've seen an explosion of fentanyl in our overdose deaths.

Deaths involving fentanyl are impacting younger Nevadans than overdose deaths that don't involve fentanyl.

And listen, I could probably share statistics here all day, but Cristina's story reminds me that these are people in our community.

They're our family, they're our friends, and we really must have all strategies forward to address this.

-Yes, and I do want to throw in some statistics.

I think it is important to know the dramatic increase that we are seeing in these overdoses, 218 overdose deaths from fentanyl in 2021 alone.

That represents a 256% increase since 2019 in just two years, a huge increase.

And per that story, you're right.

It is just one pill that can do this.

We'll talk about that more in a second.

Cindy, I want to come to you.

If we can talk about fentanyl in general here.

This might be a new term for a lot of people.

It's now emerging in the media a lot more because of these overdose deaths, but why are we seeing fentanyl so much more than let's say just street heroin or something else that's an opioid-related substance?

(Cindy Marx) Well, fentanyl is new and it's becoming more prevalent in all of our communities, and it's hitting all our families pretty close.

Obviously we just spoke with Cristina, and I've had the opportunity to meet Cristina and hear her story.

And what we do at DEA, it's unfortunate because it's not the only story that we've heard and we've worked with families, and it's becoming more and more.

It's something that now everybody is becoming aware of fentanyl, but we have to explain now what fentanyl really is doing and how it's getting here and as a family, as a community, how we can combat that problem.

So we're seeing more fentanyl because basically it's more prevalent than your street heroin because it's being masked in counterfeit pills predominantly.

So people in our younger generation are taking pills.

They don't view it as bad as heroin or other street drugs, so they think it's okay to take these pills.

And whether they know it or not, fentanyl is being laced in it and that's what's causing these overdose deaths, which we like to use the term drug-caused deaths instead of overdose because they're not intending to overdose.

-Yes.

And fentanyl, instead of using a more organic form, if that's the right word, of heroin, why is fentanyl then being used in these counterfeit pills instead of something that's just more naturally grown?

-Accessibility; it's being produced.

We see that it's being produced more in China.

China's then shipping it to Mexico, Mexico's making it.

It's easier to make it.

You don't have to have the land accessible to, you know, grow more of a natural drug.

So you don't need that land space anymore, and they're manufacturing it in Mexico and then it's coming across.

I mean, it's elsewhere but that's predominantly what we're seeing is that it's coming across our borders into our communities.

-Does it make it harder to detect production because it's more I'm assuming in some form of laboratory than having, you know, something that's being harvested?

-Yes, and the mode of transportation too when it's coming across the border.

It being, you know, they're pill forms a lot of the time and, you know, you can take 1,000 pills, which you think 1,000 pills is a lot, you know, it's maybe a small bag.

-Yes.

Jessica, I want to come to just where we've been.

Recently on the show, we've talked about opioid addiction quite a bit, the opioid epidemic as it were.

We've seen a lot of policy changes.

We've seen lawsuits.

We've seen a lot more pharmaceutical agencies not producing these products and a lot harder for prescriptions to be had, and yet we're still talking about pills as the number-one form.

I mean, have we seen any change in demand at all from our policy over the last five, ten years?

-Thank you for the question, Kipp.

What we are seeing is this epidemic is evolving.

So I imagine if you brought us on two or three years ago, we'd be talking to you about prescription medications in our communities, and really as Cindy highlighted, this epidemic has evolved to illicitly manufactured fentanyl in pressed pills, and oftentimes individuals taking them don't know that fentanyl is in there; they're nondesirous of fentanyl in these pills.

-And that brings up that this isn't just a trafficking issue.

We're going to get to that in a second.

But this really becomes a lot more of just an educational issue it seems of knowing that this is in some of these illicit pills.

How good of a job are we doing on the educational front?

-You know, we are making strides on the educational front.

I believe that we can always increase.

We can always find new opportunities to have these conversations whether it's with the public here today, in schools, in families, with parents really communicating this and through a variety of media campaigns and other strategies.

So there are many ways that we can be getting the word out on this.

-And there's the preventive side of things, of course, and then there's the emergency service side of things and making sure that first responders know about it.

But then in this case, there's also just the knowledge of what these pills can do and then being able to test these pills.

And of course, I'm going right to fentanyl strips right here as one of the options.

What are some of the other mitigating factors that potentially users can use here?

-I'm really glad that you brought this up because people who use drugs often don't know that fentanyl is in their products.

Fentanyl test strips are a great strategy for detection in these tools.

People can also access our local Syringe Services Program who can help educate them on a variety of services and strategies to help keep themselves safe and link them to treatment if and when they're ready.

Research really shows when people are connected to programs like this, they often can reduce substance use or may even stop altogether.

-And we'll come back to some of those mitigation strategies in just a sec a little bit more.

Cindy, I want to come to you.

Let's talk about the trafficking side of this a little bit more.

First off I mean, we've already talked a little about why fentanyl is more prevalent.

Is there any evidence or are there reasons why we're seeing the increase so much more here in Southern Nevada?

I'm assuming this is nationally widespread.

-It is.

It's nationally widespread.

You know, DEA is taking it like that's our priority right now as far as we have one pill-- you know, we talk about one pill can kill, and that's exactly what it is.

It's as simple as that-- one pill can kill-- so it's a nationwide problem.

We recognize that it's a nationwide problem.

So that's why DEA as a whole is trying to do their best and collaborative efforts with, you know, each area, with each community directly, but it's a nationwide problem.

-Geographically the state of Nevada, maybe some of our industry being gaming and resorts and hospitality, I mean-- and actually the Substance Use Response Working Group, Jessica, you're part of that-- noted in their beginnings of a need assessment, we'll get to that in just a second, saying that Nevada is really target-rich for trafficking.

Do you see that?

I mean, is Nevada more than any other state more target-rich for just the trafficking end of the supply?

-I wouldn't say more than any other state.

Obviously we're right there with everyone else.

But what makes Nevada unique is that, you know, we're closer to California and we're closer to the border.

So when we talk about the access, Nevada is also very, you know, transient in the sense where we have a lot of tourists and a lot of people coming and going from our city.

So what comes along with that is ease of transportation in and out for narcotics.

-Let's talk a little bit about mitigating of the supply here.

I mean, you know, in layperson's terms, you've got obviously international, you've got federal, you've got local, all need to be working together.

Right away I'm thinking there has to be major collaboration coordination going on right here.

What are some of the programs that we have to intercept some of these drugs here in Southern Nevada?

-From an enforcement side, we work very closely with our state and local counterparts on a regular basis with, you know, from an enforcement side of it with our teams, we have dedicated teams that we work specifically with regarding drug-caused deaths.

And, you know, even from a community standpoint and a preventative standpoint, we acknowledge that, you know, in order to combat this problem, we have to work from the preventative strategy as well.

So that's why we work very closely with our community coalitions and even our coroner's office because unfortunately, sometimes we have to work investigations backwards.

So we go to the coroner's office, we have a great working relationship with them as well, and we can kind of then get back and work the investigation that way.

-Yes.

I mean, we could spend a whole show just talking about the forensics in something like this when you're dealing with pills that have multiple different forms of illicit narcotics, and really, really important.

I want to switch to this being another big area, this too.

We talked about geography here, but let's talk about residents.

Are we any more at risk?

And I know this goes beyond just fentanyl use, this is opioid use, this is addiction use.

But are we more at risk to some of these things?

-Here in Southern Nevada, I would echo what Cindy shared, that I think this is a nationwide issue.

It may or may not look differently, boots on the ground in Nevada.

So really what we need are all evidence-based strategies forward approach.

So ways to help people who are in immediate need and then upstream prevention services that look to a long-term sustainability for how we keep Nevadans safe and strategies in our communities to help support people living in long-term recovery to thrive, to continue on living their lives and bringing together a better community.

-I want to talk about our state has done a lot, I should say, a lot of activity related to a local policy here.

First off SB 390 brought the Nevada Fund for a Resilient Nevada.

This is very important because we have settlement money that can be used for some of these strategies, evidence-based strategies you're talking about.

We also have an advisory committee, and as I mentioned before, another bill, AB 374, brought about the Substance Use Response Working Group better known as SURGE.

First off let's talk about SURGE.

Can you kind of hone down on exactly what are the biggest mitigating factors through some of our needs research that we've done?

-Yes.

I'm really glad you asked about SURGE.

SURGE is out of the attorney general's office.

Really the goal of that group is to look at opioids but all substances and how they might be impacting our community.

So one of the roles of that group has been to work with the Advisory Committee for a Resilient Nevada, the ACRN group, to look to establish a needs assessment statewide for how we will be using some of the dollars coming in through the-- what is it, over $285 million.

-As of right now.

-As of right now, as of today, that are being allocated to our state to help with the epidemic.

-Yes.

What's rising to the top there?

I mean, as far as needs assessment goes is there something that's just-- it seems like education and this outreach preventative piece is really the big key here.

-Yes, I'm glad you brought that up.

They're still in draft form, so if folks are interested in following along, they're public meetings in looking at this needs assessment.

In addition to education, a few other key components, medication-assisted treatment or medication for opioid use disorder, increasing access to that, and other types of strategies across the continuum of care.

-Great.

Well, treatment and recovery is a big part of that.

We have a clip that I want to show, but I want to come back.

Stay with me.

We'll have a couple minutes to talk about the treatment and recovery side of this, very important to this.

While the statistics around fentanyl and the larger opioid crisis are grim, as we've discussed today, there is hope.

People can find their way out of addiction and on to healthier lives.

The Nevada Week team talked to a Las Vegas mother and her son about their journey through addiction and into recovery.

-I didn't really know she was abusing drugs, so I just knew that she was gone.

I didn't really know much about it so it was just that she was gone.

It was hard.

Opioid addiction is a destructive force with the power to ruin families.

This young man, who we'll call Jay, has a mother who has struggled with addiction since she was 13 years old.

Heroin use and some accompanying illegal behavior landed her in jail, and she lost physical custody of Jay.

It was Jay's grandmother who cared for him when his mother could not.

What were some of the most difficult things to cope with while your mother was using drugs?

-It's just sadness that she wasn't there.

It wasn't really anger or anything like that.

-Have you received any counseling?

-Yes, I had a lot of counseling.

I had like four different counselors, but it was for different things every time.

I'm definitely still processing.

I don't feel completely healed yet, but I feel like as time goes on, I'll forget about it entirely like it never happened.

Life changed for Jay when his mother checked herself into the Salvation Army Adult Rehabilitation Center and got sober in 2019.

How is your relationship with your mom today?

-Our relationship is like she never left, like I kind of just forgot about it.

-What makes you most proud of your mom today?

-That she was able to find people to help her and that she could wait a long time and go through a whole program just so she can be there for her children.

I feel like as long as she's with this program, as long as she keeps in touch with Salvation Army that she'll be able to keep being stable and won't stray off the path again.

Jay's mom has moved forward on all fronts.

Sober for more than two years, she now works as an intake coordinator for the center.

(Sharira Thomas) The Salvation Army helped save my life, and that's why I love to work for them.

My goals in life are just to help other people discover a way to have a sober life.

When you're in an addiction, especially one as dark as heroin, you don't think that you can ever be anything but what you are-- a junkie, a criminal, a drug addict.

So this place taught me that I could be something different.

Sharira is grateful and optimistic for the future.

I feel like I have joy in my heart.

You know, I have the joy of the Lord in my heart.

You know, I just look forward to enjoying my grandchildren and my son.

Sharira has a message of hope to share with others who are stuck in the cycle of addiction.

Your past does not define you, and addiction doesn't have to be the end of your story.

-Well thank you, Heather.

Jessica, what a great way of ending our clip there.

Addiction doesn't need to define you.

There is the recovery aspect of this, and then there is the recovery aspect of this, getting away from your identity with addiction.

I want to start with the first though.

Treatmentwise, how good of a job are we doing there?

What can we really improve within our more systemic treatment systems?

-I'm glad you asked about this, Kipp.

We have a lot of incredible treatment agencies and resources in Southern Nevada and across the state.

One opportunity that's been identified in the needs assessment within the SURGE working group already is the opportunity to expand medications for opioid use disorder, to look at opportunities for people to get treatment on demand or treatment right in the moments when they need it and to continue with some of the telemedicine and other aspects of treatment that have been expanded during COVID-19 as a way to increase access for individuals.

So just a few of the many strategies we might take.

-And again telemedicine is another thing we could spend a whole show just talking about.

But let's talk about the recovery side, getting away from that identity and then getting back into a normal life.

I bring up the criminal justice system here.

Is our criminal justice system-- I don't want to use the word lenient-- supportive enough of those that have been addicts?

-We have some really fantastic diversion programs across the state that allow people opportunities to engage in treatment maybe instead of the criminal justice system.

But Sharira's story really highlights that people do recover with the right supports, if and when they're ready, and when their environment allows for it.

I think that's just a really fantastic example of the ways that we need to be adapting in our communities and having more resources across the board.

-Well, Jessica and Cindy, thank you so much; we really appreciate it.

Before I close this show, I want to share with you that this will be my last episode hosting and moderating Nevada Week.

Amber Renee Dixon will take over the seat next week, and I can't express enough how thrilled I am to have Amber Renee taking over.

I had the chance to interview Amber Renee on a Nevada Week In Person segment.

To see that interview and to get to know your new host, please visit vegaspbs.org/nevadaweek.

I wish Amber Renee the utmost success, and I equally look forward to becoming one of you, part of our regular Nevada Week viewing audience.

Now, I'm not leaving Vegas PBS by any means, but I'll be behind the scenes more working very hard on bringing more local quality programs to our station.

With that said, I want to thank Vegas PBS for the opportunity to be in this chair for the last three years.

A big thank you to every one of the panelists I've had the wonderful honor of meeting and interviewing, and of course I want to share a very heartfelt thank you to you, our wonderful and very well informed viewers.

I'll miss you very much.

Now, one last time.

For any resources discussed on this show, please visit our website at vegaspbs.org/nevadaweek.

You can also always follow us on Facebook and Twitter at @nevadaweek.

Thanks again.