The death certificate for Ryan Bagwell, 19, of Mission, Tex., says he died from a fentanyl overdose. His mother, Sandra, disagrees. On an April night in 2022, he swallowed one pill from a bottle of Percocet, a prescription painkiller that he and a friend bought that day at a Mexican pharmacy just over the border. The next morning, his mother found him dead in his bedroom. A federal law enforcement lab found that none of the pills from the bottle tested positive for Percocet. They all tested positive for lethal quantities of fentanyl. “Ryan was poisoned,” said Mrs. Bagwell, an elementary-school reading specialist. As millions of fentanyl-tainted pills inundate the U.S. masquerading as common medications, grief-scarred families have been pressing for a change in the language used to describe drug deaths, reports the New York Times. They want public health leaders, prosecutors, and politicians to use “poisoning” instead of “overdose.” In their view, “overdose” suggests that their loved ones were addicted and responsible for their own deaths, whereas “poisoning” shows they were victims.
For decades, “overdose” has been used by federal, state, and local health and law enforcement agencies to record drug fatalities. Over the last two years, family groups have challenged its reflexive use. They are having some success. In September, Texas began requiring death certificates to say “poisoning” or “toxicity” rather than “overdose” if fentanyl was the leading cause. Legislation has been introduced in Ohio and Illinois for a similar change. A proposed Tennessee bill says that if fentanyl is implicated in a death, the cause “must be listed as accidental fentanyl poisoning,” not overdose. Meetings with family groups helped persuade Anne Milgram, the administrator of the Drug Enforcement Administration, which seized more than 78 million fake pills in 2023, to routinely use “fentanyl poisoning” in interviews and at congressional hearings. In a hearing last spring, Representative Mike Garcia (R-CA) commended Milgram’s word choice, saying, “You’ve done an excellent job of calling these ‘poisonings.’ These are not overdoses. The victims don’t know they’re taking fentanyl in many cases. They think they’re taking Xanax, Vicodin, OxyContin.”