An influx of fentanyl into Alaska in the last two years has vexed law enforcement, overwhelmed health systems and deeply affected struggling Native communities.
In 2020 and 2021, the synthetic opioid was a major contributor in a spike in overdoses – the nation's largest, according to Alaska's public health department. In 2021, overdose deaths jumped by 74% in one year, with fentanyl deaths spiking by 150%, the report said.
Drug traffickers have carved out a lucrative market for synthetic drugs like methamphetamine and fentanyl in Alaska, since they can extract higher profit margins in a remote region.
Fentanyl has become a national crisis in recent years, but Alaska faces unique challenges due to its location, size and limited law enforcement resources, Alaska's High Intensity Drug Trafficking Area program said in its annual report to Congress.
In the summer of 2022, Alaska law enforcement seized nearly 2.5 million doses of fentanyl, HIDTA said.
Alaska has the country's largest proportion of its population which identifies as American Indian and Alaska Native at 19.6 percent. And it is these groups – who have long struggled with systemic lack of resources, trauma and substance abuse — that are being hit the hardest by the fentanyl scourge: For Alaska Natives and American Indians, the 2021 overdose rate was 77.7 per 100,000 people, compared to a 2021 rate of 28.8 for White Alaskans.
Alaska officials struggle with intercepting shipments of fentanyl – which is mostly produced in Mexico – since large swathes of the state are only accessible by smaller boats and airplanes that help the drug reach destinations undetected.
And while an opioid pill can cost $2 in Arizona and many other parts of the contiguous U.S., the same pill can sell for $40 in Alaska. Prices can vary widely even within the state, depending on the location: in Anchorage, one dosage unit of fentanyl costs $15, while in Bethel, the hub for 56 villages in the Yukon-Kuskokwim Delta, (400 miles away from Anchorage) one dose can cost $100, according to the 2022 Alaska Annual Drug Report released in January.
"We're the most flying state in the union," Lt. Paul Wegrzyn, deputy commander of the Alaska State Troopers' drug enforcement unit, told CBS News. "People think nothing of hopping on a plane. There is air travel happening all hours and all day and night. It creates a challenge to track drugs coming into these villages."
The Biden administration has stepped up federal efforts to disrupt the flow of fentanyl into the country. But even as law enforcement efforts increase, government agencies have identified racial and class disparities in prevention and addiction treatment services.
In Alaska, the effects of fentanyl on the Native population are being felt across the state. During the pandemic from 2019-2020, overdose deaths increased by more than 40% for Native Alaskans, according to CDC data.
"Most people who died by overdose had no evidence of substance use treatment before their deaths," according to a CDC report. "In fact, a lower proportion of people from racial and ethnic minority groups received treatment, compared with White people."
Stevi Rae Angasan, 38, was born and raised in Naknek, a fishing village on the northeast side of Bristol Bay. Just in the past year, she has seen two overdose deaths in her community of fewer than 800 people spread among three tribal villages: Naknek, South Naknekand King Salmon.
Angasan, a member of the Naknek Tribe, said she has struggled with addiction since high school. She married at 18, had a daughter at 19, and worked in the fishing industry. After the season ended, Angasan would spend all her money on heroin until there was nothing left.
Angasan, who now works as an administrative assistant at the Naknek Native Village Council and has been sober for five years, said she was grateful fentanyl wasn't around when she was hooked on drugs.
Today, she sees "nothing but accessibility." She said the problem is compounded by a lack of resources to fight back. Alaskan tribal courts have prosecuted drug dealers selling fentanyl and other opioids, but most communities rely on law enforcement hundreds of miles from their homes.
And there are no suboxone or methadone clinics to treat addiction in her area, Angasan said.
There are only seven treatment clinics in Alaska, according to a spokeswoman at the State Opioid Treatment Authority. There are three clinics in Anchorage, one in Fairbanks, one in Wasilla, one in Juneau, and one in Sitka. She added that there are plans to open one in the fall of 2023 on Prince of Wales Island.
The Biden administration says it is investingin overdose and addiction efforts; $1.5 billion is being distributed throughout all states for opioid and addiction issues, with $104 million to expand substance abuse prevention in rural communities. In 2021, the CDC invested $13 millionto assist in drug overdose prevention in tribal communities.
Angasan says the resources are urgently needed.
"The community is at a standstill," she said. "We ask 'what are we going to do?'"
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