0:00:01 – Announcer

You are listening to the National University Podcast.

0:00:10 – Kimberly King

Hello, I’m Kimberly King. Welcome to the National University Podcast, where we offer a holistic approach to student support, well-being and success- the whole human education. We put passion into practice by offering accessible, achievable higher education to lifelong learners. Today we’re talking about the current state of the fentanyl crisis and, according to the DEA’s Drug Threat Assessment, fentanyl and other synthetic opioids are responsible for approximately 70% of lives lost, while methamphetamine and other synthetic stimulants are responsible for approximately 30% of deaths. Fentanyl is the nation’s greatest and most urgent drug threat. Two milligrams of fentanyl is considered a potentially fatal dose. Today, we are joined by two law enforcement experts.

On today’s episode, we’re talking about fentanyl, and joining us are two law enforcement experts. First, sergeant Bill Miles started his career with the San Diego Police Department in 1998 after graduating from San Diego State University, go Aztecs, with a BA in journalism, I spent nine years in patrol, working numerous assignments, including the beach team, enforcement, crime suppression team and the juvenile service team. Following patrol in the Western Division and Mid-City Division, he then transferred to the gang unit, working as an intervention officer to keep juveniles out of gangs. He was subsequently promoted to detective, working in the graffiti unit, then on to narcotics and homicide. In 2017, Bill was promoted to sergeant and eventually transferred to internal affairs before working in his current role as a group supervisor at the Narcotics Task Force, specifically the overdose response team.

Also with us today is Detective Scott James, and he has worked 24 years with the San Diego Police Department, including 12 years in patrol at Mid-City Division, City Heights and the Northern Division Clairemont, Pacific Beach area, and 12 years in investigations. His experience includes work with the Vice Unit, narcotics Street Teams, the San Diego County Integrated Task Force, and he has over 300 hours of narcotics-related training, and is a drug abuse recognition expert. He’s recognized as an expert by the San Diego County Superior Court in the area of narcotics and has testified in court proceedings for narcotic distribution cases and has defendants arrested for being under the influence of a controlled substance. Wow, impressive, and thank you for your service. Thank you for both what you do. We welcome you to the podcast. How are you?

0:02:54 – Bill Miles

Great. Thanks for having us.

0:02:58 – Kimberly King

Thank you. Why don’t you fill in our audience a little bit on your mission and your work before we get to today’s show topic? And I’ll start with you, Bill.

0:03:09 – Bill Miles

Sure, well, I’ve been over here with the Federal Task Force for about 15 months and I’ve got an opportunity to work with some great investigators. We have approximately six different agencies that all combine efforts to work together to combat fentanyl, and we work with overdose and overdose victims and try to identify the source of supply to that matter.

0:03:40 – Kimberly King

Incredible. And I know I always say it’s like job security, because it’s never ending, isn’t it? So it must be fascinating just sitting around the dinner table talking to both of you. And what about you, detective?

0:03:53 – Scott James

So I’ve been with the police department, like you said, 24 years. I came to the Narcotics Task Force about eight years ago. I started with the asset recovery group, which is deals with financial investigations and seizures of assets, and then I went to a regular enforcement group and back in December 2023, I came over here to Team 10 and started working on the overdose response team.

0:04:23 – Kimberly King

I know, like I was saying it’s never ending, and being this close to the border, so I wanted to ask today we were talking about the current state of the fentanyl epidemic, and it is an epidemic. What can you share, what fentanyl is for those that don’t really understand it and why it’s so dangerous? Either one of you?

0:04:43 – Bill Miles

Um, yeah, yeah, sure, I can start off with that. So the fentanyl is the most potent pain reliever on the market. Just imagine it’s 50 times stronger than heroin and about 100 times more stronger than morphine. This just shows you how powerful it is. It’s a schedule two narcotic, which basically means it has a high potential for abuse, but it’s still recognized within the medical community as having medical benefits, such as pain relief. One of the main concerns about fentanyl is it’s considered so dangerous because you could die from a dose as small as two milligrams, which is equivalent to about 15 grains of table salt. You can’t smell it, you can’t see it. So that’s one of the things which why it’s so dangerous and why it’s killing so many people in our community.

0:05:42 – Kimberly King

So how are people getting fentanyl?

0:05:46 – Scott James

Traditionally, it’s from their SOSs, what we call SOSs- social supply. They’re drug dealers. That’s typical friends, social gatherings, places of that nature. They also use other things that have up and coming as dark web and we’re seeing a lot more of social media, so Snapchat, Instagram, things of that nature they’re able to purchase online and it’s readily available, believe it or not. Just a few clicks of a mouse and you’re into a market that you can get pretty much anything, including fentanyl.

0:06:22 – Kimberly King

And I have a question I’m not sure. So I heard you say that you can’t smell it, but what about the drug dogs or the canines? Can they be trained to specifically point out?

0:06:39 – Bill Miles

It’s funny you ask that. I actually just had this discussion with a canine officer and that was my specific question to him. I said, hey, if we deploy your dog around a vehicle which we suspect has fentanyl in it, will he alert? And the direct answer to that is yes.

0:07:00 – Scott James

And when we say it doesn’t smell, it’s like usually you know cocaine has a certain smell to it. If you’ve been around cocaine enough, you open a bag, or even not even open a bag, you can smell it through the plastic, whereas fentanyl is not so much that way. But you kind of have to have that expertise, I guess you can say, or time around cocaine to kind of know the difference. But I mean, if you were to look at it you probably wouldn’t be able to tell the difference between cocaine and fentanyl just by sight.

0:07:31 – Kimberly King

That was my next question about telling the difference. And so if to kind of dumb it down, so to speak, when you talk about the grams, but like a packet of sugar, would that be something that’s comparable or even smaller than that, like on your fingernail? Is that how small.

0:07:48 – Scott James

A packet of sugar would kill about 100 people. If that was filled with fentanyl, the same amount of sugar in a packet would kill 100 people.

0:07:58 – Kimberly King

Oh my gosh.

0:08:00 – Bill Miles

Yeah, 15 grains of table salt. So if you imagine just pouring out some salt on a table and isolating 15 granules of salt, that’s going to be approximately two milligrams of fentanyl, which can potentially kill somebody.

0:08:25 – Kimberly King

So you talk about a little bit of what it looks like, and it looks like cocaine. For your trained eyes, you can probably detect a difference, as you’re talking about the smell. But what is the paraphernalia that’s associated specifically with fentanyl?

0:08:37 – Bill Miles

So a lot of times when we respond and arrive to the scene of an overdose, we see things such as tutors. To the scene of an overdose, we see things such as tutors and in our vernacular a tutor is kind of like- It could be identified as kind of like a straw or a pipe which is open at both ends. Another item of paraphernalia would be foil. Commonly this foil is crunched up or, if it’s open, there’s burn marks on the foil which indicates fentanyl use, not to mention the small baggies which often do contain the fentanyl powder as well as pills. So blue pills, m30s.

0:09:24 – Kimberly King

So I know, you know, if a mom is cleaning up her kids’ rooms and they find these, the blue pills, does it specifically say M30s on there so that they would know to look that that’s what a fentanyl pill looks like.

0:09:37 – Scott James

Yeah. So they would have M on one side stamped and then 30 on the other side stamped and a blue pill. And in fact the pharmaceutical company doesn’t even make those anymore in oxycodone. So pretty much every M30 we come across is actually a knockoff. It’s a fentanyl pill. There’s no oxycodone in it whatsoever.

0:10:05 – Kimberly King

So the use of fentanyl it certainly increased, as you were discussing, but how has it increased and where are you seeing it really across the nation? We’re here on the border in Southern California. Is there like a trajectory or what are you seeing as far as the amount of how it’s increased?

0:10:29 – Bill Miles

Well, I’ll try to answer that question. So, as far as the individuals who are overdosing from fentanyl, it’s across the board, as young as 15, as old, as I believe Scott had a case where the female was 77. It doesn’t stop at ethnicity, it’s pretty much across the board.

0:10:51 – Scott James

All facets of life, all different age groups, all different socioeconomic groups, I mean, you name it, they’re affected by it.

0:11:00 – Kimberly King

No one is immune. In other words, correct. My daughter went to school in Indiana, to college, and I know there they call it- I don’t know what that corridor is there, but what, what does it typically? How does it get here? And then, where is it? Do you see a pattern?

0:11:19 – Scott James

I guess that’s my question well, as far as patterns are concerned, right now what we’re seeing is, um, here, locally in San Diego county, most, most, we’re seeing an uptick in fentanyl powder. Um, not as many pills anymore, um, whereas, say, take Arizona, we’re hearing that they’re seeing more pills and they’re seeing powder. Um, I don’t know if that’s because it’s easier to smuggle pills, you know, and then powder. I don’t know what, what the reasoning is behind that, why we’re seeing more powder, they’re seeing more pills, but that seems to be the trend locally In the farther east, you get, it sounds like more pills than powder. I don’t know, it might be a stigma in certain areas to pills, right, it’s easier. We all take pills, right? We take a pill, doctor gives a pill, we take it. Doctor gives a pill, we take it. The stigma is not there.

But now I got a powder, I gotta put it out on the table and, and you know, ingest it somehow, whether it’s smoking, it’s snorting it, and so it’s kind of a stigma at that point. Nobody wants to do it. So I I think that’s why pills were more prevalent at first, um, but now you’re able, uh, you’re able to, um, ingest the amount you want to ingest. Now you’re, it’s a little safer for you, right? At least that’s the thinking behind it, and personally I believe. But that’s kind of the trend we’re seeing where we’re seeing more powder here, Arizona’s seeing more pills, and I think more pills are kind of trickling farther into the country than they are near the border.

0:12:49 – Kimberly King

So, from the untrained eye, what are the signs and symptoms of fentanyl use? So what does you know? I think I would think somebody that’s on coke or meth may be hyper and maybe you could see something on their pupils. But what does it look like when you’re on fentanyl?

0:13:10 – Scott James

So for people under the influence you’ll normally see droopy eyelids, constricted pupils, the heart rate’s going to be real low, falling asleep, and usually at the most unusual times or places, right, you can be having a conversation, that can be in the middle of the sentence and they can start falling asleep. I’ve always said you know heroin addicts, and now fentanyl addicts, trying to interview those people- I usually have to ask the question four or five times before I get a full answer because they’ll start falling asleep during their answer. So those are the signs and symptoms of somebody under the influence at the time. Um, but as far as in general, maybe just you know they’re generally withdrawn from friends and family. Production and school and work have dropped. Um, personal hygiene suffers and is ignored.

And you got to realize fentanyl is usually a lone- or opiate use in general- is usually a lone activity. They’re not doing it with groups of people. You know, it’s not something most people are proud of, really. I mean, when they get addicted to these things and so they kind of do it on on it secretly and uh. So those are kind of the signs and symptoms. Somebody that’s withdrawn from family and friends is probably the biggest one, just a normal change in demeanor, right, something that’s not usual. There’s something going on and uh, plus you put those other signs and symptoms of somebody under the influence and you know you can kind of gauge what’s going on at that point.

0:14:53 – Bill Miles

So, Kimberly, I also want to add in that I often work in a patrol aid capacity downtown and just from my training and experience with fentanyl, I tend to notice people under the influence more, or people who could be under the influence of fentanyl. I tend to notice people under the influence more, or people who could be under the influence of fentanyl, and I think one of my worst fears is when I’m driving down there and I’ll see somebody passed out. It’s like okay, hey, are they sleeping? Are they actually under the influence of fentanyl? Because unfortunately, so many individuals down there are using fentanyl, they’re under the influence of fentanyl and there’s been times when I’ve gotten out of my black and white just to check on the welfare of individuals, applying a sternum rub, trying to wake them up, trying to make sure they’re okay, because there’s numerous calls I mean just off the top of my head, probably anywhere between eight to 12 radio calls, just the central division alone of individuals who have overdosed.

0:15:51 – Kimberly King

You know, and I, we see it all the time when they’re on the nod, I guess, is what they call that. But also recently, and I don’t know if this is just fentanyl or what this is I’ve also heard about tranq if from the East Coast, but where they’re literally just leaned over and that’s it. They could be standing in the middle of the street or whatever, but they’re hunched over and what is- is that fentanyl?

0:16:18 – Bill Miles

So I’ll just touch on this super quick. Tranq is super popular on the East Coast. It’s an animal tranquilizer, it’s uh. Correct me if I’m wrong, Scott, but uh, it’s an animal tranquilizer, it’s not. It’s not scheduled. Um, our biggest concern with Tranq or um xylazine is that, uh, Narcan does not affect it. So if somebody does quote overdose on xylazine, the effects of Narcan will not be applicable. We typically go out on overdoses. We’ll test the dope and there’s only been one occasion where we had a suspected narcotic come back positive for xylazine. So thank goodness it’s. It’s still not too prevalent out here on the west coast, especially in San Diego,

0:17:16 – Scott James

And usually it’s used as a cutting agent for for fentanyl. So they’ll mix it with fentanyl, you know, and and again. It like, like Bill said, it kind of it doesn’t basically blocks Narcan for lack of a better term from acting on life-saving measures with the opioid overdoses. So it’s more of a cutting agent, kind of like you hear about baking powder with cocaine or whatnot. As a cutting agent. It’s kind of the same thing, but it’s got that name back East- Tranq. You hear it a lot.

0:17:55 – Kimberly King

And you know what- Two things that you both have brought up is Narcan, naloxone, which is the reverse agent, right, so it’s through the nose, right? And so what you’re saying is Naloxone doesn’t work with certain drugs. Is that what I’m understanding you’re saying?

0:18:13 – Scott James

So Naloxone, Narcan, Narcan, it’s obviously not a generic name, but it’s a-

0:18:21 – Kimberly King

Kleenex, tissue-

0:18:23 – Scott James

Yeah, so it only works on opiates, that’s it. It doesn’t work on anything else, including xylazine. So if you’re overdosing on cocaine, Narcan is not going to help you. The good thing about Narcan is that if you’re not sure, you can give it to them, and if they’re not on opiates it’s not going to hurt you. I can squirt it up my nose right now and it wouldn’t do anything to me at all. So that’s the good thing about it. If you’re not sure, give them Narcan anyways and it might help them out and bring them back. And, like I said, if they’re not on opiates it’s not going to hurt them. And there’s something else going on.

0:19:06 – Kimberly King

To that point. How do we know if there’s a drug that has fentanyl in it, and I think there’s a misnomer of being laced with fentanyl? But you just said cutting too. So how does that work? How, first of all, can we tell? Are there test strips? And then what is that process? How does fentanyl get into cocaine, for instance?

0:19:30 – Scott James

I’ll be honest with you, I think. First of all. I think well, we hear lace all the time, right? That pill’s laced with fentanyl? Well, it’s not laced with fentanyl. It’s actually a fake pill that’s made to look like something else, but it’s actually made with fentanyl.

We have heard incidences where people have ordered cocaine and they’ve gotten fentanyl and then they end up ODing on it. There have been some times where we’ve heard that cocaine has been adulterated with fentanyl. Whether that’s on purpose or accident, I couldn’t tell you and why somebody would do that, unless somebody did it to make like a speedball type of thing for themselves? I couldn’t tell you for sure why you would put the two in together. I can tell you we have talked to users who are using meth and fentanyl right now and they believe that the meth will help them. If they do overdose on the fentanyl, the meth will help them come out of it, which is not really the case. You’re going to die in fentanyl anyways. It’s just not going to help you. But they actually believe that that’s actually a possibility. So we’re seeing that more and more, where we’re seeing people using meth and fentanyl together.

0:20:48 – Bill Miles

We’ve actually seen users in possession of test strip kits, because I think everybody’s afraid of the stuff, and everybody knows what fentanyl can do, but unfortunately that doesn’t always stop somebody from using. So we’ve seen poly drug users often test what they’re using just to try to ensure themselves that it doesn’t contain fentanyl.

0:21:16 – Kimberly King

So I mean, parents have to be just so scared. In this day and age and you said as young as 15, what should parents do or loved ones do when they find out someone’s using fentanyl?

0:21:35 – Bill Miles

Well, I’ve got three kids. I’ve got a 19 year old, I’ve got a 16 year old and a 15 year old and the first thing I tell them is for one, if you’re at a party, you see pills floating around. Do not take it. It’s like- you don’t know what’s in that pill. It’s like a chocolate chip cookie. I mean, sometimes you bite into the cookie, you don’t get a chocolate chip. Sometimes you bite into the cookie and you get four or five. So if you’re the unlucky person who got four or five chocolate chips, it’s actually fentanyl. You’re most likely going to overdose and you could die.

0:22:07 – Scott James

If you think your loved one is on opiates or fentanyl heroin, I think it’s important to have Narcan on hand or naloxone, just because that’s the one thing that’s going to help you bring them back. And I would have multiple doses because- you hit them with the Narcan. Five minutes later that Narcan wears off, they’re overdosing again because the opiates aren’t out of their system, it’s just blocking the opiates from entering the bloodstream and whatnot. So have multiple doses on, and then, try and convince them to go to rehab, and especially an in-house rehab. Get them away from those friends, right, misery loves company, right.

0:22:52 – Bill Miles

Something that we’ve seen also is, according to witnesses hey, they overdosed, we gave them Narcan, they came back and next thing you know, they were sleeping. Great, they were snoring, it was terrific. So, yeah, they were fine. Unfortunately, what we found is oftentimes this snoring is agonal breathing, which indicates that the opioids, so to speak, have come back and they’re actually overdosing, again unbeknownst to the people around them, which often results in death.

0:23:27 – Kimberly King

Wow, that’s a really a key point as well. And when you were talking about even rehab, what is rehab like for somebody? Or maybe you can just kind of talk about rehab for different drug use. It is my understanding and I could be wrong about this, but it’s probably one of the hardest drugs to rehab and just become clean from is methamphetamine. Am I right about that? And what does that rehab look like for fentanyl?

0:23:58 – Scott James

Well I think if you were to talk to any drug user getting clean off any one of their drugs. It’s hard for them, right. I mean it is an addiction you ever tried to stop? No, no, I’m a coffee drinker. You ever try to stop drinking coffee? I mean it’s- You know you go through the withdrawals, right. So I mean, it’s hard to stop. So, but I think one of the hardest drugs that I’ve heard of talking to people is opiates. I mean heroin especially. You know that the withdrawal symptoms are just horrible and some people have actually died from withdrawals from opiates. So, it’s not something that should be taken lightly, it’s something that you know it’s, it’s definitely, it’s definitely a problem. An you know I, I’ve told people that I’ve, that I’ve come in contact with in patrol.

You know, hey, get away from those friends, get away from those bad influences. And I’ve told them numerous times hey, maybe even leave the county, leave the state, go somewhere else. And I actually had a female in Clairemont when I was in patrol there. She actually did that, she actually left, the only one I actually ever contacted again.

I saw her about three years later and she looked great. She had gained weight, she looked great and this, she was addicted to methamphetamine and she ended up saying hey, that was the best advice I ever got, because initially she was like well, I can go to Ohio and I could find meth there. I go, yeah, but you’re not going to find it right away. Maybe you can convince yourself not to go try and find it and get yourself some help. She said it worked. I’m not saying that’s going to work for everybody, but it definitely is worth a shot. Let’s be honest the person that’s really going to decide whether they’re going to get clean or not is the person that’s using the drugs. They’re going to have to be the ones that initiate it. If they’re not willing to get clean, they’re not going to get clean. There’s nobody that’s going to tell them otherwise.

0:26:08 – Bill Miles

It’s a struggle. That withdrawal process is miserable, and I would not want to wish that on anybody, Just to see the pain and suffering those people are going through just trying to get themselves clean.

0:26:25 – Scott James

I’ve been told think about the worst flu you’ve ever had and times that by a hundred. That’s a withdrawal from opiates.

0:26:30 – Kimberly King

So it’s. It’s so interesting to hear your perspective on this, because you’re you’re I love- Thank you for sharing the story of the young woman. I do hear this sometimes just when you found out somebody’s done time, and on a couple of occasions- my husband is in law enforcement- so him having some, I guess, some communication sometimes when he meets people and they share their stories and they say, yes, it’s either moving away, finding a new set of friends, having family support, but also you know, when you, when they’ve been, when they’ve done time, they’re obviously clean and they said a lot of times, we hear the stories that you know.

Thankfully I did, I got you know, I was put away, I couldn’t, I couldn’t use and it changed my life and that’s something that, you know. It’s not everybody’s success story but hopefully people can understand that and I guess you have to have compassion for people that are addicted and going through that, because we don’t know what that process is like. San Diego Police- what’s the SDPD doing to address the rise of fentanyl and the use of the San Diego community?

0:27:44 – Bill Miles

Well, like I told you earlier, I’m part of a federal task force which targets individuals furnishing fentanyl to others who, unfortunately, overdose. Our team consists of 10 investigators, one of which who’s on call once a week, and this is 24-7. So if there’s an overdose at 1 am, 2 am, that on-call investigator is getting a call. If there’s an overdose within the city of San Diego or La Mesa- those two jurisdictions- with potential evidence that could help identify a source of supply associated with the overdose, this is something that we would quote, “roll to” or attempt to investigate. Also, because we work together on a task force, we have the option to charge federally or through the DA, whichever would be more appropriate for this case.

0:28:43 – Kimberly King

Well, my last question is what advice do you have for the community members who come across a loved one and you’ve talked a little bit about it but that are experiencing an overdose? You talked about naloxone, Narcan, you know, and I guess really embracing those loved ones and finding resources for them. I know there are a lot of resources, but you also pointed out that you have to be willing to make that change and that’s a really tough position to be in. I’m sure you have frequent flyers that you deal with on a daily basis.

0:29:16 – Scott James

Yeah, unfortunately, that’s true. I mean you know, you get to know your, you get to know those people very well, especially when you’re you’re dealing with them in patrol on a daily basis. I mean a first name basis, pretty much, at that point. But as far as coming across and maybe a loved one who’s ODing, obviously you got to call 911 first. That’s, that’s number one. Get those medics rolling and if you’re alone with them, obviously you’re going to have to leave that loved one to go call 911. If you don’t have a phone with you, or have somebody else call, if there’s somebody else around. Administer Narcan as the next one. Get that Narcan rolling, um, get them started. And then life-saving measures, if necessary- CPR, mouth to mouth, if necessary.

At that point, and uh, we touched on it before, but it’s not snoring, it’s dying. Um, that agonal breathing is, it sounds. It kind of sounds like a weird snoring if you hear it. And uh, if it doesn’t sound normal, it probably isn’t. And uh, that means somebody needs some intervention fast. So we hear it all the time. You know all he, you know my, my. I came in my on the chair at the desk and fell asleep there and he was snoring, so I thought he was tired. I just left him there. Well, he wasn’t snoring, he was- that’s the body trying to suck in that air, trying to keep the air flowing through the body. And, like I said, they’re dying. They’re not, they’re not snoring, they’re not sleeping.

0:30:55 – Kimberly King

You know, thank you this is actually one of the first times I’ve heard this and I feel like this needs to be its own media campaign, just to- it’s not snoring and dying- because that’s such a key point. And and again, our parents, our kids and it’s heartbreaking to hear how young these kids are. It just seems like every generation has the next most potent drug use. So I really appreciate your time today. Thank you so much. This has been quite the education. So, thank you. We appreciate you joining us and if you want more information, you can visit National University’s website. It’s nu.edu. And gentlemen, thank you again for your service and for your time and what you’re doing for our community.

0:31:53 – Bill Miles

Thank you.

0:31:57 – Kimberly King

You’ve been listening to the National University Podcast. For updates on future or past guests, visit us at nu.edu. You can also follow us on social media. Thanks for listening.