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From an alleged poisoning to pills flooding into southern Utah, fentanyl has made headlines in the Beehive State.

But what is the drug behind a murder charge against Kamas realtor Kouri Richins for allegedly killing her husband Eric, and so-called “Operation Sour Cream,” and how is it impacting Utah?

Here’s what we know.

What is fentanyl?

Fentanyl is a synthetic opioid typically used to treat patients with chronic severe pain or severe pain following surgery. It is similar to morphine but is 50 to 100 times stronger.

That means a lethal dose of fentanyl is much smaller than other opiate drugs like oxycodone, hydrocodone and heroin. Even a few milligrams of it — equivalent to a grain of rice — can be deadly for anyone who comes into contact with it.

Most cases of fentanyl-related harm, overdose and death in the U.S. are linked to an illicitly manufactured form of the drug.

It is sold as powders and nasal sprays and pressed into pills made to look like prescription opioids. It also is mixed in with other drugs like heroin, methamphetamine and cocaine to increase their potency.

How is it getting into Utah?

Most of the fentanyl involved in overdose deaths enter the U.S. illegally through Mexico, according to the U.S. Drug Enforcement Administration.

Court records detailing a drug trafficking investigation first reported by The Washington Post detail a St. George-area drug ring that ordered methamphetamine and fentanyl from Mexico, picked up from California, distributed in and around St. George and sent payment back to Mexico.

The Post’s story describes Interstate 15, which passes through St. George and connects Los Angeles to much of the country, as “American’s main fentanyl artery.”

The organization likely trafficked thousands of potentially lethal doses of fentanyl into southern Utah, based on court records. For example, agents intercepted one call where the alleged leader of the drug ring received “15,000 buttons” and “15 waters,” code words for different illicit drugs. They interpreted that as 15,000 fentanyl pills and 15 pounds of methamphetamine.

The DEA recently announced the results of “Operation Last Mile,” which targeted people associated with the Sinaloa and Jalisco cartels and responsible for the last mile of fentanyl and methamphetamine distribution.

Between May 1, 2022, and May 1, 2023, the operation led to 3,337 arrests and the seizure of nearly 44 million fentanyl pills and more than 6,500 pounds of fentanyl powder, according to a press release.

That removed nearly 193 million deadly doses of fentanyl from communities across the country.

The DEA’s Rocky Mountain Field Division, which covers Utah, Colorado, Montana and Wyoming, tied 60 cases to the Sinaloa Cartel and 12 to the Jalisco Cartel.

The division seized more than 375,000 fentanyl pills and 25 pounds of powder, equal to more than 865,000 potentially lethal doses.

The DEA was unable to provide state-specific numbers.

Pills are more common in Utah, according to the state’s crime lab. About 60% of fentanyl samples submitted to the lab in 2020 were in the form of counterfeit pills, according to an annual report.

Utah’s Highway Patrol seized 6,125 pills in 2020, according to numbers provided by spokesperson Sgt. Cameron Roden. The state agency seized about 22 times that many pills in 2021, when the number jumped to 139,568.

There was another large jump in 2022, when state troopers seized 617,125 pills. That’s an increase of 431%.

Utah Highway Patrol also has seized several pounds of powder in the past few years — 3.2 pounds in 2020, 17 in 2021 and 14.11 in 2022.

How many people are overdosing?

Fentanyl is killing Utahns at an alarming and sharply increasing rate, according to the report from the state’s Drug Monitoring Initiative.

Twenty-five people overdosed and died on fentanyl in 2010, according to the state’s medical examiner.

That number saw minor increases and decreases until 2015 then jumped up to 45 in 2016. It stayed steady again until 2018, when it started rising rapidly.

Almost 120 people died because of a fentanyl overdose in 2020.

Between 2015 and 2020, fentanyl-related overdose deaths increased nearly 400%.

An annual report on overall illicit drug from 2021 use says fentanyl is the “main driver” of an increasing number of drug-related deaths.

The report adds that “opioids in general continue to pose the most significant drug-related threat to life in Utah, primarily driven by illicitly manufactured fentanyl imported into the United States from Mexican Transnational Criminal Organizations.”

Like the opioid and heron epidemic, fentanyl is ravaging every part of the country, regardless of socioeconomic status.

Los Angeles County’s department of public health found that in 2021, more affluent areas had higher numbers of fentanyl overdose deaths, though the county’s least affluent areas had a higher rate of deaths per 100,000 people.

In Utah, the powerful drug is now rooted in a complex story of Summit County wealth, a disagreement over a $2-million home purchase and a contested estate.

What is the state doing?

Utah’s Department of Health and Human Services provides fentanyl and naloxone education through its violence and injury prevention program, said Joel Johnson, a spokesperson with the department.

Naloxone, sometimes better known by the brand name Narcan, is a life-saving medication that can reverse an overdose from fentanyl and other opioids when given in time.

DHHS also works to gather information on seizure data, Johnson said, and employs epidemiologists to collect and evaluate overdose data.

Utah is launching a fentanyl test strip campaign to educate people who use substances and their friends and family members about the need to test doses of pills or drugs for fentanyl, Johnson added.

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