Drug death

But although “poisoning” offers many families a buffer from stigma, others whose loved ones died from taking illegal street drugs find it problematic. Using “poisoning” to distinguish certain deaths while letting others be labeled “overdose” creates a judgmental hierarchy of drug-related fatalities, they say.

Fay Martin said her son, Ryan, a commercial electrician, was prescribed opioid painkillers for a work injury. When he grew dependent on them, a doctor cut off his prescription. Ryan turned to heroin. Eventually, he went into treatment and stayed sober for a time. But, ashamed of his history of addiction, he kept to himself and gradually began to use drugs again. Believing he was buying Xanax, he died from taking a fentanyl-tainted pill in 2021.

Although he, like thousands of victims, died from a counterfeit pill, his mourning mother feels as if others look at her askance.

“When my son died, I felt that stigma from people, that there was personal responsibility involved because he had been using illicit drugs,” said Martin, who lives in Corpus Christi, Texas. “But he didn’t get what he bargained for. He didn’t ask for the amount of fentanyl that was in his system. He wasn’t trying to die. He was trying to get high.”

To a growing number of prosecutors, if someone was poisoned by fentanyl, then the person who sold the drug was a poisoner — someone who knew or should have known that fentanyl could be lethal. More states are passing fentanyl homicide laws.

Asked what unbiased word or phrase might best characterize drug deaths, experts in drug policy and treatment struggled.

Some preferred “overdose,” because it is entrenched in data reporting. Others use “accidental overdose” to underscore lack of intention. (Most overdoses are, in fact, accidental.) News outlets occasionally use both, reporting that a drug overdose took place due to fentanyl poisoning.

Addiction medicine experts note that because most of the street drug supply is now adulterated, “poisoning” is, indeed, the most straightforward, accurate term. Patients who buy cocaine and methamphetamine die because of fentanyl in the product, they note. Those addicted to fentanyl succumb from bags that have more toxic mixtures than they had anticipated.

Martin, whose son was killed by fentanyl, bitterly agrees. “He was poisoned,” she said. “He got the death penalty and his family got a life sentence.”