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Just like in other industries, producers in the illegal drug business look for ways to cut costs. A major cost cutter for opioids is now flooding the market. It's called Fentanyl. It began as medication for chronic pain and it's cheaper to make than heroin and more deadly.
Eve Troeh of member station WWNO reports from one of the many cities facing a Fentanyl epidemic, New Orleans.
EVE TROEH, BYLINE: New Orleans coroner Dr. Jeffrey Rouse knows dead bodies can help save lives. When someone dies of a drug overdose, his office looks at their blood. This year, he's seen a lot more death from Fentanyl, a powerful opioid. Fifteen people overdosed on it just in January.
JEFFREY ROUSE: In that month alone, we already had more Fentanyl deaths than we had in the entirety of 2015.
TROEH: He expects the body count to grow. Fentanyl is up to 30 times more potent than heroine.
ROUSE: And because it's more potent, it's more likely to result in overdose, and it's sending bodies to the back of my office.
TROEH: Most of the victims seem to be regular heroin users, and Rouse thinks they're underestimating the strength of this different drug.
ROUSE: A simple 10 percent error of measurement is enough to kill you.
UNIDENTIFIED MAN: Right. If they don't cut it enough, it's too strong for people, and they do what they normally do and bam. They're gone.
TROEH: This is an addict on day three of his detox from heroin at New Orleans Odyssey House Detox Center. Its 20 beds hold addicts curled up under blue blankets, most of them asleep.
This guy says he's in his mid-30s, that he's used heroin since age 18, half his life. He doesn't want to give his name because he's also sold drugs and doesn't want the police or future employers to know his past. He says he's known about Fentanyl for years, and, yeah, it's on the rise.
UNIDENTIFIED MAN: You could get it just about any street corner in the city
TROEH: He meets with Dr. Arwen Podesta, a psychiatrist who treats addiction. They discuss how Fentanyl's lethal reputation appeals to addicts.
ARWEN PODESTA: I mean, it peaked their interest because it sounded like it was such a stronger product. That is what the person with the addictive brain in their addiction to an opiate is craving. And if it's an opiate times 10 or 100, they're going to want it more, despite the risk of death.
TROEH: And you're nodding.
UNIDENTIFIED MAN: Oh, yeah. If there's a dope out there that's killing people, everybody wants it. I want that. That's the killer dope. That's the strongest out there.
TROEH: He says he was spending $2,000 a week on his habit. Sometimes he'd buy heroin mixed with Fentanyl or even straight Fentanyl. He'd use less since it's stronger. It turns out the dealers make the same amount of money regardless.
UNIDENTIFIED MAN: It doesn't hit the street cheaper, but it's probably cheaper for the dealer.
TROEH: And it's the same people selling it as they're selling heroin.
UNIDENTIFIED MAN: Right.
TROEH: This fits with what the Drug Enforcement Agency knows about why more Fentanyl has hit the streets. It's the same cartels adding a new cost-effective product.
CRAIG WILES: If you're the Mexican drug-trafficking organization, you're getting your Fentanyl from China and then you're moving it along the same pass and through the same smuggling routes as your heroin trafficking organizations.
TROEH: Craig Wiles is associate special agent in charge for the DEA in New Orleans. He says Fentanyl can be made anywhere from chemicals. That knocks out several steps in the supply chain, no crops of opium to grow, harvest and transport.
WILES: A kilogram of heroin may in fact return a profit of about $80,000. A kilogram of Fentanyl may in fact return a profit of $1 million.
TROEH: Faster profit for the cartels and faster overdose. With Fentanyl, there's a much shorter window of time to save someone's life. Opioid blockers have to be given within minutes. Dr. Arwen Podesta says that's just one factor to consider in the need for education, resources and health care as this more potent opioid sweeps New Orleans and the nation.
PODESTA: We're really, I mean - we're far, far behind the tidal wave.
TROEH: With Fentanyl, it's a faster, stronger wave than before. For NPR News, I'm Eve Troeh in New Orleans. Transcript provided by NPR, Copyright NPR.