 Dr. Jody Rich is an addiction specialist at Brown University. Rhode Island has one of the highest rates of fatal overdoses involving cocaine. If you're using cocaine every day and then one day it's cocaine plus fentanyl, that could be enough to kill you because you don't have any tolerance. People who use coke and meth aren't taking precautions that a lot of regular opioid users have learned to do, like carrying the opioid reversal medication Narcan, not using drugs alone, and testing their drugs for fentanyl.