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Counterfeit pills are killing Americans by the thousands. This Edmond family knows the heartache

Daily Oklahoman - 6/6/2021

Jun. 6—In a police report, she left a north Oklahoma City bar with an acquaintance around 9 p.m. on Aug. 6 and drove to a drug dealer's apartment to buy oxycodone.

In a state Medical Examiner's report, she died from a fatal mix of drugs that included fentanyl, a synthetic opioid about 100 times stronger than morphine, that international criminal cartels press into counterfeit prescription pills and smuggle into the United States by the millions each year.

In the words of her parents, Lea Marie Montgomery, who died just two days shy of her 31st birthday, was a bright and beautiful young woman who loved people, had recently undergone dramatic weight loss, fended off addiction for about four years, and looked forward to completing her studies and becoming a nurse.

Her mother recalled something Montgomery said in moments of unbridled excitement during the weeks leading up to her death:

"Mom, I've never been this happy in all my life."

Montgomery died amid a record number of drug overdoses in the U.S. propelled by the use of illicitly manufactured fentanyl.

The rise of overdose deaths started in 2019 and continued through the COVID-19 pandemic, according to the Centers for Disease Control and Prevention.

Provisional overdose death estimates for the 12-month period ending in May 2020 showed 81,230 deaths in the U.S., which the CDC says is the largest number of drug overdoses for a 12-month period ever recorded.

During the same time period, synthetic opioid deaths increased 38.4%.

As with the rest of the country, the Sooner State has been hit hard by the recent overdose epidemic.

The 12-month provisional count ending in October showed a 28.3% increase in overdose deaths across the U.S. and a 20.8% increase in Oklahoma. According to the CDC, 731 Oklahomans died of a drug overdose during the time frame, but there were likely more as investigations and toxicology tests take time to report.

In December, the CDC issued a health advisory warning Americans about the increase of fatal drug overdoses driven by the increase in synthetic opioids.

From Jan. 1, 2020, to May 1, the Oklahoma Bureau of Narcotics seized 95,994 counterfeit pills, many of which are round, blue in color and stamped to look like 30 milligram oxycodone.

An investigation in Chickasha uncovered 4,700 of the pills sourced from California.

The state narcotics bureau investigated 20 overdose deaths related to the counterfeit pills. Five defendants have been charged with murder in nine homicides investigated by the agency.

Experts say the epidemic is driven by large profit margins in the making and selling of fentanyl, an expanding market of chronic pain patients who turn to the streets because strict laws are in place to prevent the over-prescribing of opioids, and the allure of a potent drug that is often added to heroin.

Prosecutors say they will continue to file felony murder charges against those who deal pills that cause overdose deaths.

Parents say losing a son or daughter to fentanyl is unbearable.

Keith Montgomery is a dentist whose Edmond home in a gated community is filled with trophies from exotic hunting trips, and skirted by a lush lawn that invites turkeys and deer.

On a recent evening he sat at his dining room table and recalled the weeks following his daughter's overdose death. His wife had to remind him to pay the bills. In a haze of sorrow, Montgomery had let the mail pile up.

"People that are not aware of it don't understand what's going on," he said. "They don't understand how many people are dying and how prevalent it is until they know someone who has died from it. Or they've lost a child personally. It's heartbreaking."

The pills that killed Lea Marie Montgomery likely originated from across the globe.

Transnational criminal organizations obtain chemicals from China that are smuggled into Mexico by mislabeling the product and shipping it through commercial means, according to the U.S. Drug Enforcement Agency.

Mexican cartels, which have connections across the U.S., including Oklahoma, use illegal pill presses in clandestine laboratories to manufacture the pills by the thousands, at well-below a dollar per pill to make.

The pills are trafficked across the southwest border in freezer bags, shoe boxes or a variety of small containers that can be hidden in vehicles. Known on the streets by many names, including "Mexican Oxy" and "M30," the pills can fetch anywhere from $20 to $80 each.

"It's more valuable than gold because gold's only going to sell for the price of gold on the New York market this morning," Oklahoma Bureau of Narcotics spokesman Mark Woodward said. "I can sell pills to an addict by looking in their eyes and seeing how desperate they are and then I name my price on the spot."

In some cases, investigators have discovered pill presses in Oklahoma. On Jan. 6, the Oklahoma Bureau of Narcotics and the Alcoholic Beverage Law Enforcement Commission found a large illegal pill manufacturing operation run out of a Tulsa liquor store.

OBN confirmed a pill press in the back room of the liquor store capable of producing over 3,000 pills an hour, and powder residue that tested positive for methamphetamine.

Woodward said suspects were pressing the meth powder into pills with stamps featuring cartoon characters and symbols typically associated with Ecstasy tablets. Agents also found several pill press stamps with markings similar to counterfeit prescription drugs, including Xanax and Percocet.

In the DEA's 2020 National Drug Threat Assessment released in March, Acting Administrator D. Christopher Evans wrote that the availability and use of cheap and highly potent fentanyl has increased, with "millions of counterfeit pills containing fentanyl seized" last year.

In 2019, data from the National Forensic Laboratory Information System showed 100,378 fentanyl reports identified by forensic laboratories, marking a 12% increase over 2018.

John Scott, assistant special agent in charge the DEA for Oklahoma, said one out of every four pills sent to a Dallas lab for analysis comes back with fentanyl in it.

"We're not seeing it just in the metro areas in Oklahoma City and Tulsa, but we're seeing these fentanyl pills in small towns," Scott said. "We've seen overdose deaths in Lawton, Anadarko and Ardmore. It's not just a big city problem. These pills are out there in rural Oklahoma and they're taking lives."

A lethal dose of fentanyl is about two milligrams, Scott said. His agents have seized pills with more than twice that amount.

"One pill can kill," Scott said.

Woodward said in some cases, patients have had their supply of opioids cut off by doctors. In turn, they look to friends, or dealers on the streets, for pain-numbing drugs like oxycodone, but are given or sold counterfeit pills instead.

The pills hit the streets here around 2013, Woodward said.

"Fast-forward eight years later, it's really one of the biggest opioid issues we have in the United States and certainly here in Oklahoma," he said. "I think that was what the tea leaves were saying — in the U.S. right now, we've got a lot of people heading to the streets because their doctors cut them off so let's supply them on the streets."

OBN and healthcare groups across the state are urging doctors and patients to discuss entering into pain management contracts.

Outside the doctor's office, many fentanyl-related deaths occur when a person obtains pills from someone they know and trust. An addict, in pain and sick from withdrawals, won't question the source or content of the pills, Woodward said.

"You're really rolling the dice," Woodward said.

Lea Marie Montgomery was born in Tulsa and grew up to play volleyball for four years at Bishop Kelly High School. She loved swimming, skiing, riding western saddle horses and traveling with family and friends.

She enjoyed cooking, and in the final year of her life she made gourmet meals for her friends and co-workers.

She struggled with addiction. In 2015, her family moved to Edmond, and Montgomery joined Hope is Alive, a faith-based program that helps those suffering from drug addiction.

She was in the program for nearly four years, and became a house manager, then an administrative assistant to one of the program's founders. Montgomery eventually left the program and began working with her father at his dental office while continuing to study nursing.

On the night of Aug. 6, Montgomery left a north Oklahoma City bar with a female acquaintance. They contacted a 32-year-old convicted drug dealer named Jerry LeFlore, who has been in and out of state prison.

According to an arrest warrant, when they asked LeFlore if he had Xanax, Leflore responded "that he had Roxanne," another street name for counterfeit oxycodone pills.

At LeFlore's apartment, Montgomery's acquaintance gave him $20 and he gave her one blue pill with the marking "M30" on it. Montgomery's acquaintance told police Montgomery gave LeFlore money and he handed her the same color pills with the same markings on them.

Montgomery's acquaintance said she went into the bathroom, crushed half of her pill and snorted it. She told police she watched Montgomery go in the bathroom, crush her pill and snort it, too.

But just before Montgomery snorted the drug, her acquaintance told police, she heard LeFlore tell Montgomery the pills he gave her were "not what you think they are."

A short time later, Montgomery and her acquaintance left the apartment and entered Montgomery's car, which was parked less than 50 yards from LeFlore's apartment door, police said. They both passed out.

Around 11:07 p.m., police were dispatched to the apartment complex on an overdose call. Montgomery's acquaintance made the emergency call after waking up.

Police found Montgomery passed out in her car. Multiple life-saving measures were taken, including the use of naloxone, also known by its brand name, Narcan, which is either injected intravenously or sprayed up the nostril of a patient suspected of overdosing.

The medication works quickly, and counteracts the narcotics until a patient can be taken to a hospital for further treatment.

Narcan use administered by the Emergency Medical Services Authority in the Oklahoma City metro area fell nearly 30% from 1,089 instances in 2016 to 763 instances in 2020. Through May 18, EMSA has used the medication 323 times.

John Graham, chief of operations for EMSA, said on overdose calls, first-responders see everything from patients appearing normal, to patients who are already dead.

"A true overdose, the way we kind of see it, is they're not responsive, they're difficult to wake up, they're acting totally out of their norm, perhaps in a dangerous way," Graham said. "Those are the patients that we want to treat, kind of get them back to normal as best we can, transport them to the hospital."

While Narcan use is falling, Graham said overdose cases involving fentanyl are common in Oklahoma City.

"We're starting to see things that are laced with fentanyl," Graham said. "People are trying to buy pain medication of all kinds. It's common for people to want to buy oxytocin or something like that. It's not. It's fentanyl. And the dose is too high. And people aren't prepared for that and unfortunately it's taken their lives."

EMSA transported Montgomery to Integris Baptist Medical Center. At 11:46 p.m., doctors pronounced her dead.

In its autopsy report, the state Medical Examiner's Office says Montgomery died from an acute, mixed-drug toxicity of ethanol, fentanyl and trazodone, an antidepressant.

Montgomery's acquaintance agreed to assist investigators in a sting operation to buy drugs from LeFlore.

On Jan. 11, former state Attorney General Mike Hunter filed one count of murder in the first-degree felony murder against LeFlore, who also faces one count of felony distribution of controlled dangerous substances.

"We're very serious and focused with regards to how we're dealing with drug trafficking, and we're going to continue to take the approach that we've taken, which is if you're going to conduct yourself in a way that is going to in a very likely fashion cause the death of another, we're going to treat you as if you are responsible for a homicide," Hunter, who resigned his post effective June 1, told The Oklahoman.

Under Oklahoma law, a person commits the crime of murder in the first degree regardless of malice when that person takes the life of a human being, or if the death of a human being results from the unlawful distribution of a controlled dangerous substance or synthetic controlled substance.

Hunter, who in 2019 won a $465 million opioid case on behalf of the state against Johnson & Johnson, authored the drug-related murder legislation in 1989 while serving as a Republican in the Oklahoma House of Representatives.

The Attorney General's office this year requested an aggravated drug trafficking bill, which was sponsored by state Rep. Jeff Boatman, R-Tulsa, and state Sen. Darrell Weaver, R-Moore.

Signed by Gov. Kevin Stitt, under House Bill 1567 those caught with five grams or more of fentanyl can be charged with aggravated trafficking, face a sentence up to life in prison and a fine up to $500,000, a spokesman for Hunter's office said.

If someone is caught with one gram, they can be charged with trafficking and face up to 20 years and a fine of up to $250,000.

Opponents of such policies say they are ineffective strategies born out of America's failed war on drugs.

In a 2017 report title "An Overdose Death Is Not Murder: Why Drug-Induced Homicide Laws Are Counterproductive and Inhumane," the New York-based nonprofit Drug Policy Alliance said the laws do not deter drug use or sales, but undermine "911 Good Samaritan" laws, foster misuse of prosecutorial discretion and perpetuate racial disparities.

"We've seen these types of prosecutions brought increasingly over the past 10 years, and yet we haven't seen the intended effect of reducing the rates of fatal overdoses or supplies themselves," said Grey Gardner, senior staff attorney for the Drug Policy Alliance.

Gardner said the incarceration approach to fighting the drug epidemic has cost taxpayers billions of dollars, and if policymakers were truly serious about addressing the problem, they would enact decriminalization measures, increase treatment options and make harm-reduction tools such as fentanyl test strips readily available to the public.

"The rhetoric doesn't change the fact that there are better ways to approach this problem," Gardner said. "The problem is that people don't necessarily know what's in substances. That we are not providing safe and effective ways of people finding out exactly what's in substances, whether they're the person who is using the substance, who is in receipt of the substance, or the person who provided the substance ...

"These are incredibly complex problems and complex issues that policymakers and law enforcement officials tend to oversimplify."

Hunter said in his view there is no deadlier substance on the street than fentanyl, and stiff penalties against dealing the substance are part of curbing the problem.

"It's rough justice, tough justice, but I'm not going to apologize for it," he said.

Among supporters of such legislation are some who have lost loved ones to fentanyl, like the parents of Lea Marie Montgomery.

"A drug dealer can kill a whole bunch of people," Debra Montgomery said.

Keith Montgomery wants LeFlore off the streets for the rest of his life.

"Is it going to bring my daughter back?" he said. "Is it going to give me great satisfaction? Not necessarily. But the one thing I know it will do, if he is convicted, he will not be able to create misery in another family's lives."

Montgomery joined the Oklahoma chapter of the online support group Team Sharing, for parents who have lost a child to substance abuse.

"They welcomed 15 new members one day," Montgomery said. "That's 15 families that lost a child."

The day before her overdose death, Lea Marie Montgomery joined a friend at her father's dental office. The friend was nervous about getting a tooth pulled. Montgomery held her hand.

Keith Montgomery recalled how typical it was of his daughter. She cared about people and aimed to make those she knew feel loved and included.

"Everybody gravitated to her simply because she was just so fun to be around," he said.

Montgomery's voice trembled. Tears filled his eyes.

"Lea Marie was just a wonderful girl," he said. "Beautiful eyes. Beautiful smile. She lit up the room. She never met a stranger. She made everybody feel comfortable, happy. She just had that unique personality. It's just hard not having her around."

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