FACT CHECK: ‘Just 118 Pounds Of Fentanyl Could Kill More Than 26 Million People’

David Sivak | Fact Check Editor

Democratic Sen. Ed Markey claimed Jan. 28 that “just 118 pounds of fentanyl could kill more than 26 million people.”


Verdict: True

The Drug Enforcement Administration (DEA) says that 2 milligrams of fentanyl is a lethal dose in most people. That works out to 227,000 deaths per pound of fentanyl, or 26.8 million for 118 pounds.

The 2 milligram estimate is widely cited, though a lethal dose of 3 milligrams is sometimes reported.

Fact Check:

Markey frequently speaks about the dangers of fentanyl, a powerful synthetic opioid that has fueled an overdose epidemic in the U.S. There were more than 70,000 drug overdose deaths in 2017, with roughly 28,000 (excluding methadone) attributable to synthetic opioids like fentanyl.

Markey’s home state of Massachusetts witnessed around 1,600 deaths from synthetic opioids that year, according to the Kaiser Family Foundation – the fifth highest of any state.

The DEA says fentanyl is 50 times more powerful than heroine and that as little as 2 milligrams would be deadly to most people.

“For perspective: A lethal dose of fentanyl as shown by @DEAHQ,” Ohio Rep. Dave Joyce tweeted Jan 10.

Tim Pifer, director of the New Hampshire State Police Forensic Laboratory, provided The Daily Caller with a slightly higher estimate of 3 milligrams for the average lethal dose.

On Jan. 28, Markey wrote letters to the Department of Defense and State Department asking if the agencies were prepared for a different public health threat posed by the drug – a terrorist attack. “Our agencies need to have a strategy for the terrifying prospect of this extremely potent drug falling into the wrong hands and being used as a weapon of mass destruction,” he tweeted.

Fentanyl can be ground up and left in public spaces, dispersed as a gas or used to assassinate public figures.

Russian forces released a gas to incapacitate dozens of armed rebels who had taken more than 800 people hostage in a Moscow theatre in 2002. The gas, reportedly a form of fentanyl, not only killed the rebels, but also more than 100 of the hostages.

The 118 pounds mentioned in Markey’s tweet refers to a drug bust made by Nebraska state troopers last April. Troopers pulled over a truck carrying 54 kilograms, or 118 pounds, of fentanyl that were hidden in a false compartment of the vehicle.

Media outlets at the time extrapolated that the drugs seized had the potential to kill 26 million people. “The U.S. Drug Enforcement Administration says as little as two milligrams of fentanyl is a lethal dosage in most people. Using that calculation, the 118 pounds of fentanyl could kill about 26,761,928 people,” reported The Kansas City Star.

The math checks out: with 453,592 milligrams per pound, 118 pounds could prove lethal to 26.8 million people.

This, of course, assumes a lethal dose of 2 milligrams. With the estimate of 3 milligrams provided by Pifer, 17.8 million people could be killed.

Nonetheless, Markey’s claim that 26 million “could” be killed is reasonable. The 2 milligram figure has been cited widely – by the DEA, the Environmental Protection Agency and other government agencies. It originates from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), an agency of the European Union, and is based on the findings of four papers that discuss the effects of fentanyl.

The New Hampshire State Police derived its estimate from a review of the literature, toxicological reports and information from other forensic labs. On a case-by-case basis, the lethal dose depends upon several factors, including the tolerance of the person and the way the drug is administered.

“Injection is the main route of this type of drug and what we predominately see here,” Pifer told TheDC. There were nearly 400 deaths in New Hampshire related to fentanyl in 2017.

“We have had many reports of the syringe’s orange safety cap still clenched in the victim’s teeth when they are found which also illustrates the speed at which a lethal dose can act upon the body,” he said.

A growing number of police departments are carrying an antidote, naloxone, to save opioid abusers who have overdosed, although the drug sometimes requires multiple doses to save someone’s life.

The Department of Health and Human Services (HHS) has sponsored the development of a more effective antidote to opioid overdoses.

“Repeat doses of the treatment may not always be feasible, especially in a large-scale terrorist attack,” Rick Bright of the HHS Office of the Assistant Secretary for Preparedness and Response said in a September statement. “Improved opioid exposure treatments are critical to adequately address this growing threat to public health and health security.”

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David Sivak

Fact Check Editor
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