Part II: Missouri's Fentanyl Poisonings Rise to Record Levels.

Missouri's dramatic rise in fentanyl-related overdoses was reported in Part I of this two-part series. In Part II, we report that previous efforts to combat the surge in illicit fentanyl supply from China failed, as Chinese factories shifted production to basic fentanyl precursor chemicals, known as dual-use pre-precursors. Mexican drug cartels now synthesize fentanyl from these basic chemicals and have overpowered the Mexican government. All efforts to reduce the fentanyl supply appear to be failing. Missouri has implemented harm reduction methods: training first responders and educating people who use drugs in safer practices. Harm reduction agencies are distributing naloxone at unprecedented levels. The "One Pill Can Kill" campaign begun by the Drug Enforcement Agency (DEA) in 2021 and foundations created by bereaved parents aim to educate young people on the extraordinary danger of counterfeit pills. In 2022, Missouri is at a crossroads, with record numbers of fatalities from illicit fentanyl and new levels of effort by harm reduction agencies to combat the soaring rate of deaths from this powerful narcotic.