Overdose deaths in Barry County, southwest Missouri, statewide and nationally are all on the rise, and according to the Ozarks Drug Enforcement Team, for every recorded overdose, there may be three times as many more.

Chad Allison, commander of ODET, which covers five southwest Missouri counties, said though they know overdoses are occurring, tracking overdose deaths is a challenging task.

“So many go unreported because of HIPAA laws,” he said. “The only times we truly know is if we are there. If people make it into the hospital and die, we may not hear about it. Of the ones we know about, there’s probably three times as many that go unreported.”

Allison said for that reason, ODET does not track overdoses and deaths, as no figure could be factually accurate. In Barry County, at least two overdose deaths have been confirmed this year, 43-year-old Matt Cooper of Eagle Rock, and 44-year-old Billy Jagger, of Cassville.

“Why we think we are seeing this spike — and it’s not just here but all across the country — is that fentanyl is getting mixed with everything,” Allison said. “Someone may try to go buy meth, and not be able to tell it’s laced with pure fentanyl. We’ve been hearing that from our interviews in lockup on distribution cases that even they do not know what they are buying. They may ask for heroin and get fentanyl.”

The potency of fentanyl combined with the user being unaware of its presence can be a deadly combination. Allison said it only takes 2 milligrams to overdose, and fentanyl is 50 times stronger than heroin and 100 times stronger than morphine.

Allison said in ODET’s coverage area, methampetamine is still the most prevalent drug, with authorities seizing 50,000 grams last year to the 1,000 grams of fentanyl. That dynamic makes methampetamine laced with fentanyl even more dangerous.

“In the Joplin area, we are seeing two to four overdose calls per day, and some people just get dropped off at the emergency room,” Allison said. “A lot of times, people overdosing, especially in Barry County where there are fewer hospitals and resources, and they are not able to get aid or the other people with them are too high to know what’s happening or be able to help.

“If you look at the numbers, you can start to see the increase in 2012, and since 2021, there have ben over 100,000 fentanyl deaths nationwide per year.”

Fentanyl typically comes in pill or powder form, and with the latter, as many as three or four table salt-sized granules can be a lethal dose.

“Now, they are compressing it into pill form, but when someone take a pill, they don’t know where within that pill the fentanyl is,” Allison said. “If you cut the pill in half, one half may have all of it, and the other have none at all. People overdosing are not trying to do that obviously — they just truly do not know what they are getting or how much is in there.”

Allison said using ODET’s TruNarc analyzer in a recent a recent controlled buy of 1/4 gram of meth showed the substance contained not only methamphetamine, but heroin and fentanyl, as well.

“It was suppose to be meth, but it tested positive for fentanyl and heroin, too,” he said. “If we had not seized that and someone had taken it, there’s no doubt that person would have overdosed.”

Allison said strings of overdoses typically indicate a bad batch of pills or substances being distributed, and all authorities can do is chase the trail based on what people tell them.

“There may be a bad batch of pills out there because so much of it is bought in pill form,” he said. “On the criminal justice side, until we get someone to talk about where they got it from or catch a dealer with it, we have to wait for autopsies and toxicology before any charges can be filed, and that takes time. It’s not like a homicide where we are looking for a gun or a murder weapon.”

Allison said there’s no specific way to tell what’s in pills either, as ODET has seen fentanyl-pressed pills in all different colors and sizes, and even the powder form of fentanyl can be off-white or brownish-yellow.

“There’s just no way to tell,” he said. “If we didn’t have our TruNarc system, which can scan substances through the bag, we would try not to handle it as much. It used to be they thought it could get airborne, but now they say it needs to be absorbed through a membrane, which could be in the nose or ears if close enough to it. Chances are just being in the same room with it will not hurt you, but we deal with it every day. We wear gloves and have our equipment to test it in the package. Once it is in your system, Narcan is about the only way to counteract it.”

Allison said the path fentanyl takes to reach southwest Missouri is not an original one. Chemicals required to make the substance are shipped from China to Mexico, where the cartels process them into the powder and prepare it to ship in the United States.

“It goes across the border like everything else,”Allison said. “The main hubs around us are cities like St. Louis, Kansas City, Springfield, Tulsa, Oklahoma City and Chicago.”

Allison said the best way to counteract the drug issue is with vigilance and communication.

“It’s obviously being distributed in Barry County, so report any drug or suspicious activity, and if you have a family member who has a problem with it, maybe help convince them to talk to la enforcement about help us get closer to the source. Like meth, fentanyl has an addiction rate of 98 percent, so once you start, it’s nearly impossible to stop. There are many rehab centers in the area that can help.”

Allison said having Narcan available when around someone dealing with addiction can also be beneficial.

“If you have Narcan handy, in most cases, it’s pretty effective,” he said. “What we see when we use it is if the person is still breathing and has a pulse, it usually helps. Many places give it away for free, so it wouldn’t hurt to get some if you know someone who may be at risk. We carry the nasal spray, which is easy and keeps anyone from getting exposed.”

For law enforcement to find greater success in reducing illegal substance availability, Allison said it will take the community at large helping when it can.

“The more eyes and ears we have, and the more educated people are, the better it will be for us,” he said. “it is an epidemic, and it doesn’t appear to be going anywhere any time soon.”

Allison said ODET has been filing more fentanyl cases in the last year at the federal level, which he said they prefer because individuals convicted must serve at least 80 percent of their sentences.

“I don’t know how many indictments we filed last year, but a lot of the drug cases have been fentanyl or heroin,” he said. “It’s tough to work because we can only work off the info people tell us. We’re not seeing overdose numbers as bad as in Jackson or Greene counties, but there’s still work to be done.”