Apparently, the addition of Fentanyl that is not diluted properly is responsible for the spike.
Fentanyl is what the Russian police resorted to when Chechen Mooselimb terrorists took over a theater in Moscow in 2002.
It worked fine. Put the terrorists and the theater-goers to sleep. Russian police then shot the sleeping terrorists.
But, unfortunately, not all the theater-goers woke up.