In the midst of the deadliest opioid epidemic in history, the concern has shifted from prescription opioid killers to more illicit substances. Since physicians have begun to crack down on the number of opioids they prescribe and the frequency of refills, those who have an opioid addiction are left to seek out other options. Heroin use has spiked among those whose addiction first began when taking prescribed painkillers. For some, it became too difficult or expensive to acquire pills, so they shifted to an illicit substance like heroin which costs less and is easier to find on the streets.
Dangers of Fentanyl
The increase of heroin use has now caused a new “shift” in the opioid epidemic, leading to an unprecedented rise in opioid overdose deaths. The main culprit behind this alarming statistic is the drug called fentanyl, a synthetic opioid that is almost 50-100 times more potent than morphine, and 30-50 times more potent than heroin. Fentanyl is prescribed to patients who suffer from chronic-pain or pain related to end-of-life circumstances where their condition is terminal. When misused, this drug is incredibly deadly, even in very tiny doses. Its purest form is a grainy white powder, with crystals similar to that of table salt. Because many street drugs are “laced” with other components, illicit drug makers are starting to use fentanyl in their heroin manufacturing. This is causing people to accidentally overdose, not knowing that their street heroin contains fatal amounts of fentanyl.
The effects of fentanyl are very similar to heroin, and its “high” can be described as extremely euphoric. Many people who use the drug become quickly addicted to it. While it is approved by the FDA for medical use, most fentanyl distribution and consumption is illegal. Most of the drug is trafficked through China and Mexico, showing up on the streets of America. The problem with this kind of illegal distribution is that people do not know the potency of the drugs they are buying. The rise in overdose deaths due to fentanyl is becoming an international wakeup call, showing just how addictive opioids are and how deadly they can be when misused.
The drug is mostly extracted from pharmaceuticals, largely the fentanyl patch, which extracts the drug out in its liquid form.[ Patch makers have taken precautions by making the patch more difficult to tamper with by using a mesh material. However, foreign fentanyl makers are still going through the trouble to extract it, as it’s much easier to do than making heroin. Despite the prevalence of heroin, it’s still slightly difficult to produce. Since heroin needs to be grown and extracted from a poppy plant and then curated and created, a synthetic choice like fentanyl just seems more appealing. Due to its potency in much smaller quantities, it’s also much easier to transport than heroin. Fentanyl mules are transporting this drug in cars and planes, instead of boats, causing the influx of availability in the US.
The way fentanyl affects the brain is just like other opioids. The drug enters the system and quickly begins to cross the blood-to-brain barrier, binding with opioid receptors, and quickly causing the individual to feel a very numbed, “euphoric” feeling. The quicker the binding process between the opioid and opioid receptor, the more euphoric the feeling which makes fentanyl the most powerful drug in comparison to morphine and heroin. To put in comparison just how small of a dose of fentanyl is needed to create an effect; it is often used in micrograms, rather than milligrams, of other opioids.
The physical effects fentanyl users can experience is a very intense and quick high, with some rather unpleasant side-effects including nausea, vomiting, sedation, and respiratory impairment. Just like other opioids, many overdose deaths are due to respiratory arrest, or when someone stops breathing. Due to the analgesic or numbing nature of opioids, the nervous system can become so impaired that the lungs fail to perform their function. Even a small dose of fentanyl can be fatal and cause breathing to stop.
Rising Deaths and Exposure
Pockets of the US are experiencing more overdose deaths from fentanyl. Nearly half of all opioid-related deaths are caused by this drug, and the risk is so high that first responders have to change the way they do their jobs[ . EMTs, police, and forensic pathologists are at risk of potentially coming into contact with fentanyl when responding to overdoses. Fentanyl is so powerful that accidentally ingesting or breathing in only a tiny amount of residue can send a fully grown adult to the emergency room. The DEA created a warning video to help warn first responders of this growing risk, potentially saving lives from accidental exposure to the drug when tending to those who have overdosed or are in possession of the drug. Lab workers and emergency room nurses and doctors have also been instructed to wear protective gear when handling patients that may have fentanyl residue on them to prevent them from coming into accidental contact. With a drug that is this powerful, it’s no wonder many people are dying due to overdose.
In spring of 2016, America and British Columbia declared the overdose rates due to fentanyl a public health emergency, pushing for people who may use illicit drugs to become more aware of potential contamination or “lace” of their street-bought heroin. Websites like www.fentanylsafety.com gives worldwide access to information on fentanyl and the enormous risks the drug poses to those who are dealing with substance use disorders.
The opioid epidemic continues to be a large problem in the US, and a drug like fentanyl is now causing a majority of overdose deaths for those who are addicted to opioids. Due to the nature of illicit drugs and lack of control of dosages, many people are accidentally overdosing due to profitability and ease of production and distribution of fentanyl. Illicit drug dealers may be inadvertently harming their customers with the use of fentanyl, but with the ongoing prevalence of this drug on the streets, it doesn’t show signs of stopping.