Kentucky lawmakers are considering a bill that would increase criminal penalties for fentanyl distribution.

But critics say the legislation will only result in people being locked up for longer amounts of time and doesn't include any measures to address the state's overdose crisis.

House Bill 215 passed the House yesterday and now heads to the Senate. It would require individuals convicted of aggravated trafficking or importing of fentanyl to serve at least 85% of their sentence before being eligible for release, and prohibits pre-trial diversion.

Carmen Mitchell - criminal justice policy researcher with the Kentucky Center for Economic Policy - explained that it can be challenging in practice to differentiate between importing and possession, and could result in harsher sentences for people who use drugs but have never sold them.

"So there's a lot of discretion with system actors to decide what to charge people with
based on the context," said Mitchell.

She said research shows that as long as demand is high, incarcerating more people for selling drugs does not reduce the supply of drugs or make communities safer.

Under current Kentucky law - people who are convicted of aggravated trafficking of carfentanil, fentanyl, or fentanyl derivatives can be sentenced to between ten to 20 years in prison and must serve at least half of their sentence before being eligible for release.

She added that extending sentences for fentanyl also can potentially exacerbate racial disparities in the criminal justice system, pointing to a 2020 report that found 75% of people serving federal sentences for trafficking fentanyl were people of color.

"And so we know that unfortunately, from the start," said Mitchell, "Black people tend to be charged with the higher, harsher sentences like trafficking and aggravated trafficking."

Mitchell said she believes lawmakers should focus instead on expanding access to mental and behavioral health treatment.

"Kentucky is in the midst of a very serious overdose crisis," said Mitchell. "We stay around the top 10 nationally of all states for overdose fatalities, and it's a very serious problem that continues year after year."

Nationwide, drug overdoses have hit record levels. According to the National Center for Health Statistics, more than 100,000 Americans died of overdoses in 2021 - up almost 30% from the 78,000 deaths in the prior year.

The State of Indiana wants to learn more about Hoosiers' experiences with substance-use disorder and addiction-recovery services.

Administered by the state's Division of Mental Health and Addiction (DMHA), the "Recovery Capital Index" will take a holistic look at the addiction-recovery resources available to people across the state, to help determine whether further resources are needed to ensure patients stay on the path to recovery.

Becky Buhner, deputy director of addiction and forensic treatment for the DMHA, said the data will help policymakers craft targeted responses to addiction-recovery needs.

"We can then look at a ZIP code to determine if there is an area of high need within that ZIP code," Buhner explained. "That's going to allow us to make funding decision in the future as to how we can better allocate our resources to meet the needs of that area."

People can complete the survey online or by texting "RECOVERY" to 833-638-3784. Buhner said the state wants to hear from a wide variety of people, including those currently using drugs, those in recovery, and their family and friends.

The state said it has allocated more than $45 million in grant funding over the past four years to combat the opioid epidemic. Buhner pointed out Indiana has spent years expanding its addiction-recovery infrastructure. But she noted there are people who need help who are not connected to the recovery system, and the survey will help state health officials learn about those needs.

"We released it on Friday, and as of Saturday morning, we had 234 people that signed up for the text-message series," reported. "We had 99 individuals that actually completed the Recovery Capital Index, which is a 43% response rate."

She added the data compiled from the survey will be made public after six months. According to provisional data from the Indiana Department of Health, the state saw more than 2,500 drug overdose deaths last year, a five-year high. About 80% of those deaths were due to opioids.

Ohio's overdose crisis has been heavily linked to the use of prescription painkillers or heroin, but it is not the case anymore. Health officials now warn historic levels of overdose deaths are being exacerbated by the availability of counterfeit pills laced with fentanyl, a potent and deadly synthetic drug.

Shabbir Imber Safdar, executive director of the Partnership for Safe Medicines, said fake pills are being sold as prescription painkillers such as OxyContin, the anxiety drug Xanax, and stimulant medications.

"There's a lot of young people who take Adderall, and they're not particularly careful about where they get their pills," Safdar pointed out. "I think we're going to see a rise in deaths in the 16-24 age range from fake Adderall made with fentanyl."

In May, two Ohio State University students died from suspected use of fake Adderall pills laced with fentanyl. Ohio is expected to report more than 5,200 overdose deaths for 2021, compared with just 327 in 1999.

Counterfeit medications are commonly sold through social media, on hidden sites on the "dark web" or in person by someone claiming they are real. Safdar noted an estimated four in 10 pills with fentanyl contains a potentially deadly dose.

"Even the first fake pill you ever take might kill you because if it has too much fentanyl, there's no time to get addicted, that first pill will kill you," Safdar stressed. "So it's really a game of Russian roulette when you take one of these pills that did not come from a pharmacy, which is the only safe source."

The Drug Enforcement Administration recently issued a Public Safety Alert about the rise in the lethality and availability of fake prescription pills containing fentanyl, and is encouraging people to only use prescription medications as directed by a medical professional and dispensed by a licensed pharmacist.

Online sales of counterfeit prescription pills containing fentanyl are on the rise, and experts say social media apps like Snapchat and TikTok are driving the surge, including in Tennessee.

Shabbir Safdar, executive director of the Partnership for Safe Medicines, said an alarming number of counterfeit prescription drug pills containing fentanyl are being bought online by teens and young adults.

"And in fact, just in the last four years, we've tracked fatalities in 19 different states from people who've met a drug trafficker on Snapchat and then bought a fake pill," Safdar reported.

According to the Tennessee Department of Mental Health and Substance Abuse Services, more than 2,000 Tennesseans died of fentanyl-related drug overdoses in 2020, more than double the number in 2019.

Tennessee is one of many states recently passing laws decriminalizing fentanyl test strips in an effort to reduce deaths. The tests work by dipping the strip in water containing dissolved drugs.

Safdar noted he believes strips should be legal, but pointed out they do not always detect fentanyl in large batches.

"In fact, there's a young man in Tennessee that we profiled in the last couple of years, who he and his friends all order Xanax off the dark Web, and they each took a pill," Safdar recounted. "It was only this young man's that had the fatal amount of fentanyl in it."

Safdar pointed out more Americans are turning to online pharmacies for acetaminophen, aspirin, blood thinners and other routine medications, but said there's risk in buying products from any source other than a licensed pharmacy.

"During the pandemic, as many as one in seven Americans went online to purchase medication, and many of them went to these fake Canadian pharmacy websites," Safdar emphasized.

According to a study in the Journal of the American Pharmacies Association, there are more than 11,000 websites based in the U.S. and Canada calling themselves "pharmacies" and selling drugs online.