According to the CDC, “More people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid.” With most of these deaths, prescription painkillers and heroin have been the main focal points of concern while another, more powerful and dangerous synthetic opioid, fentanyl, has been sweeping across the country.
What is Fentanyl?
Fentanyl is a Schedule II narcotic used as an analgesic and anesthetic approved for the management of acute and chronic pain in cancer patients. Pharmaceutical fentanyl, according to the DEA has been available since the 1960’s and “can serve as a direct substitute for heroin in opioid dependent individuals.” Fentanyl, much like heroin, crosses the blood-brain barrier quickly to induce euphoria and opioid-like effects, including respiratory depression. The commonality among most heroin addicts is the risk of intravenous injection.
Dosage forms are available in oral transmucosal lozenges, (Actiq®), commonly referred to as the fentanyl “lollipops”, effervescent buccal tablets (Fentora™), transdermal patches (Duragesic®), and injectable formulations. Until recently, manipulations of the patches were concerning with the gel intended to be absorbed over a 3 day period, but, often removed through various means for injection or ingestion. In the illicit drug trades, opium grows are becoming more costly to maintain and since fentanyl is purely a synthetic drug made with precursor chemicals obtained through illegitimate sources, it has been flooding the heroin markets as a heroin combination or replacement and is often sold as “China White”.
Fentanyl Potency Dangers
It’s no secret that heroin is often mixed with unknown variants, but, it’s becoming more common for heroin and cocaine to be mixed with fentanyl, a drug with opioid potency equivalencies up to 100X stronger than morphine and 5X stronger than heroin. While pharmaceutical fentanyl can be abused and diverted to the street for sale, fentanyl analogs are the frequently found sources identified in recent overdose trends. According to an emergency CDC HEALTH ADVISORY,” most cases of fentanyl-related morbidity and mortality have been linked to illicitly manufactured fentanyl and fentanyl analogs, collectively referred to as non-pharmaceutical fentanyl (NPF).”
No one can be sure of the exact potency variations in these sources because they are manufactured in clandestine labs much the same way that heroin is, adding to the dangerous effects for both the naïve user as well as the experienced. Unfortunately, addicts tend to develop a desperate physiological need to satisfy urges for opioids or prevent impending withdrawals regardless of the risks. For a lot of them, the added knowledge that someone has overdosed on an opioid product increases their desires to use it.
Getting Help for Opioid Abuse and Dependency
For most individuals engaging in the illicit abuse of opioids, there is absolutely no sure way to protect against an overdose and treatment is the most effective means of achieving abstinence, preventing relapse, and staying alive. Resources to provide or sponsor the comprehensive list of services these individuals need to detox and remain in treatment longer is now more accessible, affordable, and supportive than ever before.
For many opioid addicts, the treatments would include medications to help individuals detox and improve health and social functioning while engaging in counseling, behavioral therapies, and supportive services that address their complexity of needs. According to the SAMHSA, “Integrated treatment or treatment that addresses mental and substance use conditions at the same time is associated with lower costs and better outcomes such as:
- Reduced substance use
- Improved psychiatric symptoms and functioning
- Decreased hospitalization
- Increased housing stability
- Fewer arrests
- Improved quality of life”
Increased Funding for Medication-Assisted Treatments (MAT)
Recognizing the severity of the situations involving those who abuse opioid prescription painkillers and often convert to heroin as a cheaper and more potent high, the increases in fentanyl overdoses are raising the awareness and need for more effective and affordable treatments. This year, increased funding for Opioid Treatment Programs (OTPs) dispensing methadone and buprenorphine are combined with additional funds to supply naloxone, an opioid antagonist able to reverse opioid overdose symptoms.
In a March, 2016 Whitehouse.gov press release, the President’s FY 2017 Budget calls for “$1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use.” The funding is part of a strategic plan to reduce the number of opioid addiction consequences including overdoses and includes “$920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders.”
If you or someone you know is at risk of fentanyl overdose, give us a call at 800-442-6158 Who Answers? to learn about treatment options.