Health and society in New Orleans: A varied lens on overdose deaths in New Orleans: Why they’re happening and how to stop them

Image of Bourbon St., New Orleans

The problem:

As home to Bourbon Street, Drive Thru Daiquiris, and over 130 festivals, New Orleans has solidified its recurring position on various “best cities to spend a weekend” lists, including the likes of Forbes and Travel + Leisure. Such a reputation brought 19.75 million visitors to the city in 2019. That year, the famous Jazz & Heritage Festival alone brought in 475,000 people, staying for a short period of revelry only to return to the mundane world a few days later. Locals and tourists alike partake in the celebratory culture. Such an environment can often lead to individuals breaking from their usual restrictions, and exhibiting behaviors that are otherwise perceived as deviant or transgressions of social norms. Among these behaviors is accelerated experimentation with drugs and illicit substances. In a sobering reality, between 1999 and 2014, drug and alcohol-related deaths accounted for 75% of all non-traumatic festival deaths. 

Festivals and tourism continue to repopulate New Orleans after their year-long covid hiatus, and with this lively resurgence comes an increase in accidental overdoses in the city. According to studies, music festivals may serve a function as ‘backspaces’ where drug use is increased, normalizing drug use and making it more common. While this ongoing and serious health concern has plagued the city for decades, an alarming recent spike in overdose deaths in New Orleans links to an entirely different and more deadly trend: the accidental consumption of fentanyl. A WNGO headline released in late April of 2022 reads, “New Orleans officials warn of an uptick of fatal fentanyl overdoses ahead of French Quarter Fest.” The article, featuring testimony from Mayor Latoya Cantrell, responds to the 2021 New Orleans Coroner’s drug report, which states that accidental overdose claimed 492 lives in the city. That is more than five times the number of deaths in 2015. 94% of the deaths tested in a lab report link fentanyl to the cause of death, loudly hinting that the Third Wave of the opioid crisis has arrived in New Orleans.

The Third Wave began in 2013 and is defined by drug traffickers mixing doses of fentanyl into other substances. The synthetic opioid contains up to 100 times more potency than morphine, and up to 50 times more potency than heroin, making a lethal dose less than 3 mg. 

Medical professionals reserve prescribing pharmaceutical fentanyl for patients suffering acute postoperative pain. Doctors diligently screen the patient for opioid tolerance and family drug history and calculate the lowest dosage necessary to mitigate the pain. They also limit the treatment to three days to avoid dependency.

Lethal dose of fentanyl compared to a coin.

Traffickers of illicitly manufactured fentanyl (IMF), brought into the United States from laboratories primarily in China and Mexico, lack the tools, let alone the interest, to take such precautions. They see the drug as “less work and less investment and more profit.” With such a high potency, one Kilogram of IMF costs $32,000 to produce and sells for $20 million in the form of 1 million pills. Traffickers create counterfeit pills, filled with addiction-triggering, if not lethal, doses of fentanyl, and sell them as Xanax, Adderall, MDMA, or essentially any pill attractive to people who use drugs (PWUD).

Fentanyl has well-documented lethality that makes it undesirable for PWUD. Testimonials from family members of overdose victims overwhelmingly affirm that they didn’t want to die. People attending festivals in New Orleans are purchasing stimulant and psychedelic drugs to enhance their celebratory experience, not recognizing the high likelihood that their drug might be laced with IMF. The New Orleans Coroner compares using street drugs today to “playing Russian roulette,” as the odorless and tasteless substance is impossible to detect without the proper testing. 

While the Third Wave has plagued every city where individuals experiment with drugs, New Orleans’ revolving door of festivals provides an idyllic opportunity for individuals to indulge more than usual. UNO student Ciaya Whetstone was dropped off at a hospital in eastern New Orleans on morning of February 19, after attending one of the first Mardi Gras parades of the season that evening. Health officials declared her dead moments later, due to an accidental fentanyl overdose. While the festival culture of New Orleans is one of its most revered characteristics, the onset of fentanyl and increased overdoses pose an imminent health threat to those who are here to experience it.

The solution: 

Being that fentanyl marks the Third Wave of the Opioid Epidemic, and recreational drug use has posed an imminent health crisis for decades, government officials have issued fleets of drug combatting initiatives, beginning in the 70s. President Nixon’s War on Drugs in 1971, followed by President Reagan’s Just Say No campaign in 1980, attempted to mitigate drug use by increasing punishment and encouraging young people to say no to drugs. Intensified punishment led to a massive increase in incarcerations for nonviolent drug crimes. Not only did the initiatives fail to reduce drug use, but they were carried out in a way to disproportionately condemned the Black community. The controversial movements did very little to serve the public or solve the health crisis. 

Where past initiatives relied on criminalization, the Third Wave requires an approach with roots in education and risk prevention. Individuals dying from fentanyl overdoses were most likely never looking for an opioid in the first place. While no recreational drug should be considered safe to use, teaching PWUD how to confidently identify the substance they plan to consume can prevent unnecessary overdose from IMF. 

Hoping to drive socio-cultural, and eventually, legislative change, Adam Auctor founded The Bunk Police. Auctor grew up homeschooled and felt socially isolated to the point where he experimented with psychedelics. He found that substances intensely subsided his anxiety, and firmly believed in their healing power. While he acknowledges that using drugs is never a risk-free activity, he asserts that anyone who chooses to use drugs should have the ability to do so as safely as possible. Thus began The Bunk Police: the first substance kit company in the United States to provide accurate, research-based drug testing that will detect underlying substances in a recreational drug. Founded in 2011, the company offers a wide range of testing kits that will detect various substances, including fentanyl. The company claims their fentkits can identify 1/1,000,000th of a gram of the synthetic opioid. The company also offers four tiers of substance testing, with varying prices, to increase their accessibility. 

Drug testing approaches a legal gray area, leading ‘Adam Auctor’ to be a pseudonym for the founder and CEO. While they are federally legal, state regulations can vary. Bunkpolice.com readily serves PWUD at any time, however, to make a greater impact, Auctor began developing a discrete presence at music festivals. They freely established themselves at the Bonnaroo Festival in Manchester, TN for years, but had negative experiences with police at the 2015 event. While they could legally distribute drug testing kits, police shut down the operation, citing technicalities such as not having a vendor permit. 500 of their kits were confiscated that day. Festival organizers hesitate to support test kit organizations due to fear of the RAVE Act. In 2003, then-Senator Joe Biden piloted the Reducing Americans’ Vulnerability to Ecstasy (RAVE) Act, which enacts greater liability on event owners and promoters in the case of injury at a rave or festival. Under these rulings, festival owners grew weary of allowing test kit distribution, because allowing them into the festival would acknowledge the drug use taking place. Such fear of legal implications led Auctor to the development of Bunkbot. By texting “Safety” to 1-888-NOT-BUNK, customers can receive text updates about Bunk’s whereabouts at festivals, notifications about if the company gets shut down, and information about adulterated substances that the kits have detected. 

The legal loopholes that the Bunk Police jump through prove to be worth it, as their impact continues to grow among the PWUD community. The team has tested over 2,500 substances, finding that nearly 100% of samples contain more than one substance. A survey unrelated to the Bunk Police investigated the effectiveness of testing strips among PWUD. Researchers asked drug users in Baltimore and Delaware how they felt about using fentanyl testing strips (FTS). In a survey, 23% and 69%, respectively, indicated interest in prolonged risk reduction behaviors. Such behaviors include using less and testing their drugs before use. 

In addition to readily accessible test kits, placing drug information in casual settings can readily educate people who’ve already made up their minds to take drugs. The Brooklyn Cabaret House of Yes, among dozens of other bars in New York, partnered with the Brooklyn Health Department in 2019 to start putting fentanyl safety information on their drink coasters. The brief safety tips remind patrons to only use in the presence of others,

Cocktail sign at bar

start by using a small dose, and always know how to easily access the overdose rescue drug naloxone. The bottom of the coaster includes the emergency number to access naloxone, and the number to a treatment plan for those seeking help with addiction. The club also trained their staff on how to respond to an overdose, and doses of naloxone are available behind the bar. They approach the Third Wave realistically, recently posting to Instagram: “COCAINE. Let’s talk about it. No shade, no shame, just information.” While the nuanced initiative poses challenges in measurability of success, the Health Department tapped bars and nightclubs because of the high concentration of young adults, a target audience for laced drugs. 

Bringing the Solution to New Orleans:

While entertainment, and inevitably recreational drug use, can be found anywhere in New Orleans, implementing risk prevention initiatives in key locations will drastically mitigate the predicted rise in accidental overdose. Additionally, shifting the drug deterrent culture to emphasize the priority of harm prevention will encourage PWUDs to use drugs responsibly. Making test kits readily accessible, especially during festival season, would make the New Orleans celebrations exponentially safer. Spreading awareness about fentanyl through bars and nightclubs around downtown New Orleans would quickly spread lifesaving overdose information. 

First, implementing testing kits during Festival Season would greatly increase the safety of the celebrations. Louisiana Law still considers test kits drug paraphernalia, however, House Bill 212 is under consideration, which would remove test kits from the criminalized list. The Bunk Police actively seeks out Street Team members, or volunteers to help distribute kits. Forming a community of volunteers could develop into an entire New Orleans sector of the company, and create a stable presence at festivals. During Mardi Gras, there should be designated stations along the parade routes particularly in the French Quarter, where PWUD can discreetly test the substances they plan to take. The Street Team should be present at Jazzfest, Voodoo Fest, and other high-profile music festivals. 

Festivals bring an increased amount of tourists from February- April, however, people flock to Bourbon St. and Frenchman St. consistently. Health officials should partner with bars and nightclubs along the infamous streets to cleverly implement drug and overdose information in their establishments. They should have quick drug facts, emphasizing the danger of fentanyl, on drink coasters. They should also have signs in the bathrooms and on the walls that clearly state drug information. 

Finally, it should become common practice in New Orleans for bars to keep naloxone available, in case a patron suddenly experiences an overdose. If all other initiatives fail, the life-saving reversal drug can block the opioid from getting to the brain, stopping negative effects from taking over the body. 

These initiatives emphasize that they are not aiming to promote drug use, acknowledging that using illicit drugs should never be considered safe. Brooklyn’s House of Yes director summarizes the initiative’s goal, expressing “We’re not trying to scare them. We just want to save a few lives.” Drug use is a much greater, underlying issue in the United States and one that has caused millions of families to witness loved ones succumbing to addiction. This particular problem, where PWUDs lack the resources to definitively identify what they are consuming, can be prevented by implementing harm reduction initiatives around the city. 

Works Cited

Centers for Disease Control and Prevention. (2022, February 23). Fentanyl facts. Centers for Disease Control and Prevention. Retrieved May 7, 2022, from https://www.cdc.gov/stopoverdose/fentanyl/index.html

Hesse, M., et al. “The Use of Tobacco and Cannabis at an International Music Festival.” European Addiction Research, vol. 16, no. 4, 2010, pp. 208–12, https://www.jstor.org/stable/26790520. Accessed 7 May 2022.

IMB Micromedex. (n.d.). Fentanyl: Adult Dosing. Micromedex products: Please Login. Retrieved May 7, 2022, from https://www.micromedexsolutions.com/micromedex2/librarian/CS/DBEC52/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/4190CA/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.DoIntegratedSearch?SearchTerm=Fentanyl&fromInterSaltBase=true&UserMdxSearchTerm=%24userMdxSearchTerm&false=null&=null# 

Los Angeles Times. (2019, September 1). Death, made in Mexico: Traffickers embrace fentanyl. Los Angeles Times. Retrieved May 7, 2022, from https://www.latimes.com/world/mexico-americas/la-fg-mexico-drugs-20190706-story.html 

MacLean, J. (2020, March 23). Music festivals should be doing more to prevent deaths, study says. Cantech Letter. Retrieved May 7, 2022, from https://www.cantechletter.com/2016/12/music-festivals-prevent-deaths-study-says/#