Fentanyl Crisis

Combatting the Fentanyl Crisis in North Carolina

The opioid crisis has devastated North Carolina. From 2000 to 2022, more than 37,000 North Carolinians died from drug overdoses. The first wave of the crisis was prescription opioid pills, the second wave was heroin, and now North Carolina and the nation are facing the third and deadliest wave – fentanyl overdoses. Nine North Carolinians on average die daily from fentanyl overdoses.

Attorney General Josh Stein has been leading statewide efforts to address the deadly rise in fentanyl trafficking and fentanyl overdose deaths.

Attorney General Stein is holding accountable the companies that created and fueled this crisis. He secured more than $50 billion in national settlements with these companies.

North Carolina has begun receiving its share, which will total nearly $1.5 billion.

Of the nearly $1.5 billion coming to North Carolina, 15 percent goes directly to the state and 85 percent goes directly to local governments, all to help people struggling with substance misuse.

North Carolina governments can fund effective, evidence-based solutions that help prevent drug misuse or help people get and stay well.

North Carolina is prioritizing transparency, so the public knows how these investments are being used through CORE-NC, the Community Opioid Resources Engine for North Carolina, (www.ncopioidsettlement.org).

Attorney General Stein is working to prevent fentanyl from crossing the border and helping law enforcement break up drug trafficking rings.

Attorney General Stein and the Department of Justice:

Successfully asked Congress to give U.S. Customs and Border Protection (CBP) $300 million to install equipment it already had to detect fentanyl in vehicles entering the United States.

- The funding was included in the March 2024 appropriations bill and will enable CBP to dramatically increase the number of cars and trucks it x-rays using screeners at the border to prevent the illegal import of fentanyl.

Convened a statewide Fentanyl Task Force with local, state, and federal law enforcement leaders to improve collaboration and make legislative and policy recommendations to tackle the fentanyl crisis.

Conduct wiretaps to help law enforcement investigate trafficking rings. DOJ’s Special Prosecutions Section has instigated more than 670 wiretaps since 2017 to help law enforcement break up trafficking rings and assist district attorneys in prosecutions.

Analyze evidence for law enforcement investigations at the State Crime Lab. The lab has found fentanyl in nearly a quarter of all case submissions, making it the second highest controlled substance and the top opioid identified in fiscal year 2022-2023.

- Attorney General Stein also worked with the legislature to obtain a nearly $5 million investment to update the lab’s Drug Chemistry and Toxicology with newer technology.

Investigate and prosecute Medicaid fraud through the Medicaid Investigations Division to hold accountable providers who waste taxpayer resources.

The Medicaid Investigations Division won cases including a $500,000 settlement against a provider who allegedly wrote unauthorized prescriptions for controlled substances and a $1.25 million settlement with a Wilmington doctor who allegedly submitted false claims for addiction treatment to the North Carolina Medicaid program.

Attorney General Stein is also working to update our state’s laws and secure resources to combat trafficking.

Attorney General Stein and the Department of Justice:

Drafted and championed the Stop Counterfeit Pill Act (S206), which became law in May 2023, to address the growing threat of counterfeit pills containing fentanyl, methamphetamine, and other dangerous drugs. The bill was sponsored by Sen. Tom McInnis.

- The law makes it a felony to possess equipment used to make counterfeit pills, to prevent criminal drug networks from mass producing and marketing pills that may contain lethal substances.

- The Drug Enforcement Administration (DEA) has seized these pills in North Carolina and other states in unprecedented quantities, and many of the pills contain a lethal dose of fentanyl.

Helped draft and supported legislation to ban money laundering (H495), which became law in July 2024. Because money laundering is now a felony, law enforcement and prosecutors now have more legal tools to go after drug traffickers and dealers.

Drafted and championed the Synthetic Opioid Control Act, which became law in 2017, and helps law enforcement authorities in North Carolina go after fentanyl traffickers by ensuring that all derivatives of this deadly drug are classified as controlled substances under state law.

Drafted and championed the Heroin and Opioid Prevention and Enforcement (HOPE) Act, which became law in 2018, to ensure that North Carolina’s drug trafficking laws cover fentanyl trafficking and give law enforcement faster access to information they need to investigate the diversion of prescription drugs from legal to illegal uses.

Drafted the Novel Opioid Control Act (H258) to protect North Carolinians from the next fentanyl – nitazines, an evolving class of opioids that can be up to 40 times more powerful than fentanyl and less responsive to naloxone, the overdose reversal drug.

- The bill was sponsored by Reps. Hugh Blackwell, Dean Arp, Donny Lambeth, and Wayne Sasser. It passed the House of Representatives unanimously in March 2023 and is currently in the Senate.

Sought funding from the legislature to create a Fentanyl Control Unit. The unit would be housed within the North Carolina Department of Justice’s Special Prosecutions and Law Enforcement Section to help local district attorneys handle large-scale fentanyl trafficking, wiretap, and overdose cases.

Urged Congressional leadership to pass the Combating Illicit Xylazine Act (H.R.1839/S.939) to combat the widespread illicit use and trafficking of xylazine, a potent veterinary medication that has been widely mixed with opioids like fentanyl and is easy to get online.

- The DEA has noted a dramatic increase in xylazine-related overdose deaths across the United States between 2020 and 2021, with an increase of 1,127 percent in the southern United States. And in 2022, approximately 23 percent of fentanyl powder and seven percent of fentanyl pills seized by the DEA contained xylazine.

- The legislation has been introduced in both the U.S. House and Senate and would classify illicit xylazine as a Schedule II drug and allow the DEA to track the manufacturing and sale of the drug.

Called for Congress to permanently classify fentanyl-related substances as Schedule I drugs, which will allow law enforcement to bring stronger criminal actions against those who manufacture or distribute fentanyl-containing substances. The legislation has been introduced in the U.S. Senate.

Drafted and championed the Strengthen Opioid Misuse Prevention (STOP) Act, which became law in 2017 and sets prescribing limits for opioid pills to address acute pain and puts in place measures to cut down on prescription fraud.

Led bipartisan attorneys general efforts to urge the federal government to make it easier for health care providers to prescribe opioid treatment medication through telehealth and increase the availability of treatment for people who are incarcerated.