Sources

Every number in the story, and where it comes from.

Ch. 1 · What is it?

• About fifty times stronger than heroin. Drug Enforcement Administration, Fentanyl Drug Fact Sheet.
• Two milligrams can be a lethal dose, about as much as 10 to 15 grains of table salt. Drug Enforcement Administration, One Pill Can Kill.
• 7 out of every 10 fake pills with fentanyl held a potentially lethal dose. Drug Enforcement Administration, One Pill Can Kill fact sheet, September 2023 (lab testing, 2023).

Ch. 2 · How does it get here?

• China as the main source of precursor chemicals and pill presses; India as a growing source. Office of the Director of National Intelligence, Annual Threat Assessment of the U.S. Intelligence Community, 2025.
• Production in Mexico and smuggling through official crossings. Drug Enforcement Administration, National Drug Threat Assessment, 2025.
• 11,486 pounds found at the U.S.–Mexico border; 86% at official crossings; 96% through California and Arizona. U.S. Customs and Border Protection drug seizure statistics, fiscal year 2025, as compiled by the Washington Office on Latin America (WOLA).

Ch. 3 · How does it spread?

• Distribution along interstate corridors. Drug Enforcement Administration, National Drug Threat Assessment, 2025.

Ch. 4 · What does it do?

• Normal adult breathing is 12 to 20 breaths a minute. MedlinePlus (U.S. National Library of Medicine), Vital signs.
• Signs of an opioid overdose: slow or stopped breathing, snoring or gurgling sounds, blue or gray lips and fingertips, no response. CDC, Lifesaving Naloxone; SAMHSA Overdose Prevention and Response Toolkit.
• Brain damage can begin within about four minutes without oxygen. MedlinePlus, Cerebral hypoxia. (Check this source before final.)
• Naloxone is sold without a prescription; give a second dose after 2 to 3 minutes if there's no response. U.S. Food and Drug Administration, OTC approval of Narcan nasal spray (March 2023); Narcan Drug Facts label.

Ch. 5 · Who does it take?

• About one overdose death every 7.5 minutes; about 70,000 deaths in 2025. CDC National Center for Health Statistics, provisional drug overdose death counts.
• Deaths per year, 2015–2025. CDC NCHS, final mortality data (2015–2023) and provisional counts (2024–2025). Peak: 107,941 in 2022.
• About 1 in 11 American adults in recovery (about 23.5 million). (Source to confirm before final: SAMHSA National Survey on Drug Use and Health.)
• Overdose death rates by state, 2022 and 2023 (the “Here’s yours” map). CDC National Center for Health Statistics, Health E-Stat 101: Changes in Drug Overdose Mortality and Selected Drug Type by State, United States, 2022 to 2023. Age-adjusted rates per 100,000; “increase” and “decrease” are only used where NCHS marks the change as statistically significant.
• State overdose deaths over time (2010–2013, 2014–2017, 2018–2021), the share involving opioids, and treatment facilities per 100,000 people (the chart under each state). NORC at the University of Chicago, Overdose Mapping Tool (opioidmisusetool.norc.org), using CDC National Center for Health Statistics death records, SAMHSA treatment facility listings (March 2023) and Census ACS population (2017–2021). Deaths are totals for each four-year period.
• Quiet Wall example stories. The cards marked “Example story” are written by the design team as placeholders. They are not real submissions and disappear as real stories are added.
• Help lines. 988 Suicide & Crisis Lifeline; SAMHSA National Helpline, 1-800-662-4357; Never Use Alone, 877-696-1996.

About the map

• Routes are simplified. They show the main paths described by U.S. law enforcement, not every road or every shipment.
• Line thickness shows main vs. secondary routes, not exact amounts.
• The two circles at the border are sized by the share of fentanyl found in each group of states in 2025.
• Interstate lines are drawn from major cities along each route. Map data: Natural Earth and the U.S. Census Bureau.