"Stimulants are still in the lead," Deneen Kilcrease said during a Rome Rotary Club lunch presentation that included charts, photos and examples of what they're finding on the street.
"Meth is still the state favorite, followed by cocaine ... but almost everything else is synthetic opioids," the Georgia Bureau of Investigation chemist noted.
Kilcrease said they're seeing significant increases each year in the illicit use of prescription pain medications — such as oxycodone, alprazolam, hydrocodone and fentanyl. And there are more related drugs that aren't approved for human use.
The effects are like heroin, which is also seeing a resurgence, but exponentially greater.
Fentanyl, which is up to 100 times stronger than morphine, is used in anesthesia and prescribed as a patch to treat chronic pain. It's now found in powdered and pill form along with the banned U-47700 and Carfentanil, which is 100 times more potent than fentanyl.
"It's transdermal (absorbed through the skin), and even a little flake can cause a reaction in a human being," Kilcrease said.
Bartow County's record seizure of 40 kilograms of powdered fentanyl in March 2016 led the GBI to revise its safety protocols for handling drugs. State laws and protocols got another update last year after a string of overdoses on counterfeit pills that started in Macon.
"You never know what you're going to get," she said.
Most of the counterfeit pills are bought over the Internet, from labs in China and Mexico. They're hard for states to regulate because underground chemists can modify the formulas to make analogues that aren't specifically outlawed.
Kilcrease said the GBI helped Georgia adopt a chemical definition last year that covers all but one analogue — "They're all Schedule I drugs now." The one that slipped through the cracks is slated to be added during this session of the Georgia General Assembly.
Alazopram is the most common ingredient the GBI finds in counterfeit pills, she said, but the No. 2 slot is held by a surprise contender.
"It's 'none.' No drug." she said. "But it's not really a surprise when you remember it's all about the money."
The latest threat is a substance called Gray Death, a blend that looks like concrete mixing powder and contains Carfentanil. Kilcrease said the name doesn't deter addicts that have worked their way up from pills to shooting heroin.
"At some point it doesn't matter what's in it; we've had them say it doesn't matter if they die," she told the Rotarians. "When you get to the point where you're putting a needle in your arm, you're at the point where you'll use Gray Death."