In 2013, 14 people in Manchester, New Hampshire, died of drug overdose. Last year, this number increased to 69 fatal overdoses -- but what's even more alarming is the rise in overdose deaths caused by the synthetic opioid fentanyl.
In 2013 only one fatal overdose involved a victim with fentanyl in their system but in 2015 68 percent of victims of overdose deaths had taken fentanyl, according to Manchester's chief of police, Nick Willard.
"Fentanyl is what is killing our citizens," Willard said in testimony before Congress last week.
Fentanyl, which is abused for its euphoric effects, can be used as a direct substitute for heroin for individuals who are opioid dependent. However, fentanyl is a very deadly substitute. According to the Drug Enforcement Administration, the drug is 100 times more powerful than morphine, and 30-50 times more powerful than heroin. Fentanyl abuse often results in overdoses that can lead to death.
These are the states with the highest overdose death rates:
Manchester isn't the only city seeing an increase in fentanyl related overdoses. The office of the chief medical examiner in New Hampshire told The Guardian that more than two-thirds of fatal overdose victims in the state died with fentanyl in their system last year.
The potent drug is also having a damaging impact in Canada. Last year the Canadian Centre on Substance Abuse warned that fentanyl-related deaths had increased in Canada's four largest provinces.
"Between 2009 and 2014, there were at least 655 deaths in Canada where fentanyl was determined to be a cause or a contributing cause. This represents an average of one fentanyl-implicated death every three days over this time period. This figure is likely an underestimate," the study says.
Like the heroin crisis in America, this fatal trend can be marked by the increase in painkillers like OxyContin being prescribed. Now, addicts who are looking for a more powerful high are turning to the more dangerous drug, fentanyl.
This isn't the first time the United States has faced fentanyl problems. The Guardian reports that more than 1,000 people died from overdoses cause by the drug between 2005 and 2008. During these years, all deaths could be traced to a single lab in Mexico and once the lab was shut down fentanyl problems ended.
The DEA hasn't targeted a lab responsible for the new epidemic, DEA agent Tim Desmond says. Currently, federal agents are working with police to target local dealers. "Sometimes we have to start at the bottom of the food chain in order to go up the ladder," he said.