It feels like everyone’s battle here, even if the natural inclination of most of us is to use the other subway exit when a human being is splayed in unnatural angles across several grimy steps.

Users operate in an ecosystem of acceptance that fentanyl is lurking everywhere, from the desperate addict in Midtown to the darlings in SoHo who know to do their lines together, never stray from that one trusted dealer and always test the supply. A deadlier dose might be one bump away.

This is a city still expunging the last remnants of the Sackler family’s funding of its artistic and culinary institutions. The billionaires that created an empire of pain through their overly aggressive dumping of opioids into the medical industry have been quickly and ruthlessly replaced by the stunningly efficient merchants of the fentanyl trade.

It needs to feel like everyone’s battle if a baby in the Bronx can lose his life at daycare. The facility contained kilo presses which crush the batches of synthetically produced pills into the powder that gets cut into all manner of drugs, bulking up the weight and reducing the cost for any range of user. Fentanyl doesn’t discriminate.

The fact that emergency responders suspected a one-year-old had overdosed as soon as they had ruled out carbon monoxide poisoning is a chilling sort of wisdom gleaned from having seen it all before. But it helped them save the lives of a two-year-old and an eight-month-old, dispensing Narcan and pulling them back from the brink.

Bartenders are being recruited to the first line of response, too, and paramedics keep what seems like a permanent watchful eye over busy quarters such as the Garment District, where the cluster of major transport hubs, Port Authority and Penn Station, create a bottleneck of depravity.

Walk north on Eighth Avenue from Madison Square Garden and the atmosphere darkens. All colours, all genders, all ages, the frenzied community of addicts and their dealers dart back and forth across three lanes of traffic and a chaotic bike path.

This is tough and inappropriate to admit, but you can’t help having a pang of sympathy for the tourists who booked the convenient seeming Holiday Inn, the outside of which attracts the city’s converging dilemmas of homelessness, mental health, and illegal drugs.

It’s important to disregard the out-of-towners. They won’t make the same mistake next time. This section of the city housed the homeless at hotels during the darkest days of 2020. It took so long for office workers, tourists, and garment trade hustlers to return that the addicts and the dealers kept these blocks for themselves.

Open drug use in the doorways of 35th, 36th, and 37th St and too many overdoses caused urgent action from the city. But it’s never enough, as clearly evidenced by exasperated Mayor Eric Adams appealing for the public at large to figure out a way of helping him and his embattled administration which has endured a very rough summer.

Meanwhile, private landlords watched with dread from their sanctuaries in the Hamptons as the value of their high rises nosedived and employed their own private security to harass the already beleaguered.

It was all very dystopian for a while, but New York’s story isn’t unique, not in the US or abroad. It’s simply that the scale stretches so far beyond what a city of diminishing returns can afford to handle. 

Billionaires and millionaires keep leaving for lower state taxes elsewhere and the city budget gets slashed, while the weight of expectation to save lives falls on emergency responders and exhausted social workers.

It’s easy for me, a privileged white male passer-by, to cross the street and let the groups do their thing. The addict buys his fix and holds the door of the overpriced coffee shop for me to follow him in. The barista is happy to give him the cup of water, so he can shoot up across the way, and then move on to my order.

We’re lucky if we don’t know someone impacted by the crisis. A former professional footballer who used to orbit around our soccer club while he spends a wasted retirement in New York City has been brought back from the dead by paramedics not once but twice. The bartender son of a retired NYPD detective wasn’t so lucky when his fentanyl-laced batch of coke ended his life during a lads’ trip to Nashville.

The latest celebrity to have their death attached to the drug is the widely admired Irish-American actor Angus Cloud, who died from an accidental overdose, an “acute intoxication due to combined effects of methamphetamine, cocaine, fentanyl, and benzodiazepines”, according to a statement by the Alameda County Coroner’s Office in California.

Fentanyl test strips are encouraged without fear of judgement here, but Texas refuses to overturn a ban. It’s a senseless and cruel attempt to deny the all-encompassing threat.

Fentanyl accounts for the majority of the estimated 100,000 Americans dying of illegal drug overdoses each year, more deaths than ever.

This week, US authorities announced a stepping up of their efforts to combat the problem with seizures of cheap fentanyl increasing five-fold since 2020, according to the Washington Post.

As much as it’s a pointless exercise to ignore and outlaw the best available prevention mechanisms, as they do in Texas, it’s important to acknowledge the myths that have hampered the response. Urban myths perpetuated by police officers have been debunked by toxicologists. Overdosing from skin contact is not happening and medical experts point out that it’s difficult to get fentanyl into the body without smoking or injecting.

But it’s proving all too easy to get the drug across borders and into our cities and sadly into safe places built for children.

New York City is doing its best to react to the reality of the surge in supply. One way is not to recoil.