U.S. Senator Edward Markey (D-MA) was at Holyoke Medical Center on Friday for a meeting with state lawmakers and health care providers to discuss Massachusetts’ opioid crisis and the increasing illegal use of the painkiller fentanyl. Markey told reporters after the closed-door meeting that the opioid crisis is the terrorist threat for an ordinary American family.

“It’s not in Aleppo or Fallujah,” It’s here, Markey said, and another storm is coming with the increased use of fentanyls. The highly potent opioid has become a factor in a number of heroin overdose deaths, and Markey said the drugs are coming over the border.

“As a member of the Senate Foreign Relations Committee,” Markey said, “with regard to our relationship with Mexico and China, my belief is the State Department now has to elevate this issue to the same level we place on terrorism overseas.”

Massachusetts Department of Public Health data show that in the first half of 2016, among 439 individuals who overdosed on opioids, two-thirds of them screened positive for fentanyl – a drug that can be 50 times more potent than heroin. In July, a report from the U.S. Drug Enforcement Administration labeled fentanyls an unprecedented threat. “The sudden arrival of wholesale amounts of counterfeit prescription drugs containing fentanyls will result in an increase in overdoses, deaths, and opiate-dependent individuals,” the new DEA report says.  Fentanyls can be mixed into heroin. The DEA says since 2014, U.S. law enforcement agencies have been seizing a new form of the drug counterfeit prescription opioid pills containing fentanyls that often resemble authentic medications they were designed to mimic.