Montana state health officials are reporting a troubling increase in fentanyl-related mortality in 2020, with no signs of a decline in 2021.

Since October, federal agents have recovered more fentanyl along the US-Mexico border in Arizona and California than they did for the whole fiscal year 2020.

Fentanyl was involved in roughly 90,000 fatal overdoses reported in the United States last year, according to CDC data.

According to notMYkid.org, in Maricopa County, there were 1,752 overdose deaths in 2020, with another 550 under investigation, nearly double the number in 2019.

According to Shane Watson, public information officer, and prevention specialist at notMYkid.org, the spike in fentanyl was due to supply and demand, reports the Washington Examiner.

As a result of the higher unemployment rates caused by the COVID-19 pandemic, Watson believed that more people are becoming involved in drug trafficking out of desperation.

Fentanyl is a powerful opioid used as a pain medication and together with other medications for anesthesia.

It is also used as a recreational drug, sometimes mixed with heroin, methamphetamine, or cocaine. It has a rapid onset and its effects generally last under two hours.

Fentanyl works primarily by activating μ-opioid receptors. It is around 100 times stronger than morphine, about 50 times stronger than heroin. Some fentanyl analogues such as carfentanil are up to ~10,000 times stronger than morphine.

Common side effects include nausea or vomiting, constipation, sedation, confusion, and injuries related to poor coordination.

Serious side effects may include decreased respiratory rate (respiratory depression), serotonin syndrome, low blood pressure, or development of an opioid use disorder.

Watson claimed that cartels can import bulk fentanyl from China or Europe and utilize a pill press to create pills that look like a range of other medications.

More than 90% of those overdosing on fentanyl think they are buying something else.

Officials with the Department of Justice think that fentanyl is being offered as a substitute for heroin, either in the form of counterfeit tablets or as an injectable substance.

The Department of Justice warned that counterfeit pills posing as lawfully prescribed opioids but containing fentanyl have been discovered in the state, reported the Washington Examiner.

“This is an ongoing investigation, but we know that counterfeit pills laced with fentanyl are manufactured overseas and smuggled across the border before coming to Montana. The federal government must secure the border and stop the flow of drugs into our country,” Attorney General Knudsen said. “Even a small amount of fentanyl is enough to be fatal. No one should take pills that were not prescribed to them and parents need to talk to their kids about the dangers of ingesting unknown substances.”

“This is critically important,” Bryan Lockerby of the DOJ Division of Criminal Investigation said in the release. “It’s crucial that Montanans— especially youth—understand how dangerous these pills can be, especially when you take into account the pills have likely been tampered with and can contain highly potent fentanyl.”

Further DPHHS Director Adam Meier said in the release, “Do not take pills that you can’t prove came from a pharmacy and only take pills prescribed to you. Remember that street drugs may look like prescription pills, but may be counterfeit. Do not rely on markings, size, or lettering.”