Here's a link to the latest version of the US Drug Enforcement Administration's annual Threat Assessment. It's for 2018.
Overall, they say most Fentanyl being sold and used in the US today is coming from China and Mexico, presumably in powder form. Traffickers are selling it without diluting it.
They're also selling it in the form of
counterfeit prescription pills.
Fentanyl is also being mixed with cocaine, with most of the Ohio cocaine overdose deaths in 2017 being the result of fentanyl in the mix. (p 47). In Ohio, the top causes of overdose deaths were fentanyl, heroin and the cocaine/opiate (heroin or fentanyl) mix.
https://www.dea.gov/sites/default/files/2018-11/DIR-032-18 2018 NDTA final low resolution.pdf
The DEA annual report is always an interesting read as the world of illegal drugs (and the crime associated with them) seems to change from year to year. Scary.
Again, it's stunning to see Ohio in the top 3 or 4 states for drug overdose deaths year after year. Something is really wrong here. Some news reports claim its because Ohio has an ineffective program for distributing Narcan to high risk populations. They only offer Narcan through specific government contractors via the Ohio Dept of Health. It's not working very well. In Carroll County, the only sites to get Narcan are through a few local drug stores.
Some cities and counties are doing better, because they've worked hard to make the Narcan program accessible. Others not so much.
Map
In the city of Green, OH (not too far from Carroll County) they recently began putting Narcan in local hotel rooms
City of Green To Install NARCAN Kits In Hotels
The person accessing Narcan has to pay for it and must be covered under one of several state health insurance plans. So, I'm assuming if you're uninsured, you don't get Narcan.
https://odh.ohio.gov/wps/wcm/connec...-8319927d-0a2b-4673-9de9-01185736b297-mmG7fCa
The third-party payer of the person receiving* the naloxone can be billed. The person receiving the naloxone will need to provide his/her Medicaid or insurance card to the Project DAWN site.*The person receiving the naloxone from the Project DAWN site may or may not be a person at risk of overdose.
So if you're someone on parole or probation for a drug offense, you're not going to be able to buy Narcan at the local drugstore without filling out a lot of paperwork and identifying yourself. Even then, you have to be insured.
You can get naloxone for free if you get it from a Project Dawn site (run by the Ohio Dept of Health), but there is no Project Dawn program in Carroll County.
https://odh.ohio.gov/wps/wcm/connec...-1911ad13-0bc9-4218-88a2-3d6f9afdbe28-mlJuzGb
Map
Just some general background information
ETA: Link to another recent article about Ohio coroners raising alarms over another spike in overdose deaths and the need to do better education and outreach to make more Narcan available to the public, especially families with members who are at risk of overdose.
Ohio Coroners Warn Of July Spike In Overdose Deaths