Author: Justin Mckibben
In Philadelphia, there have been nearly 800 fentanyl overdoses this year.
According to figures released by the US Centers for Disease Control and Prevention (CDC) a sharp rise in drug overdose deaths, which many attribute in part to fentanyl, is causing a drop in American life expectancy.
As 2018 begins, many are afraid of what the future may bring concerning more deadly drugs reaching the streets, overdoses, and deaths. One area, in particular, is the streets of Philadelphia. Now, many in the area are pointing out that heroin is no longer the poison most popular on the illicit market. Fentanyl in Philadelphia is now the main ingredient in the drug problem.
How Fentanyl in Philadelphia is Changing the Scene
Patrick Trainor is a special agent with the Philadelphia division of the Drug Enforcement Administration (DEA). Trainor has kept an eye on the Kensington neighborhood for two decades. When talking about the drastic impact the lethal synthetic opioid has brought to the heroin market, he states,
“Fentanyl has drastically changed the landscape… Sixty-four percent of fatals in Philadelphia County are fentanyl-related. There’s no dope out here now, it’s all fentanyl. Even the old timers are scared of it.”
In areas like Emerald Street, AKA Emerald City, even drug users carry Narcan regularly.
Dangers and Death
Even addicts who are now content with using fentanyl are aware of the risks. But many say that compared to heroin, fentanyl’s rush is intense and immediate.
It is painful to use because it burns the vein. Some choose to chance the elevated risk of abscesses by injecting under the skin. This practice is said to reduce the risk of overdose and prolong the high. Yet, overdoses come almost instantaneously. Beyond that, the comedown of fentanyl is said to be abrupt, and the withdrawal period is a long and difficult one.
Tolerance for the drug builds quickly; dependence on the drug is rapid and pretty much unavoidable. Even those revived by Narcan can fall back into overdose due to the immense strength of the drug.
A lot of the issues related to fentanyl in Philadelphia can be connected to how it hit the street in the first place. According to interviews with drug users in the Kensington area, when fentanyl first started flooding the market the dealers didn’t know how to handle it, and the users didn’t even know about it. They had no idea about the risks of the drug, and overdoses were everywhere.
But then the dealers caught on when customers started dying all over, and so they changed the way they cut the drug in order to keep their consumers. Trainor himself notes,
“You’re paying the same for something that’s roughly 100 times more powerful, so why would you buy heroin? The demand is for the most powerful thing they can get. Heroin will never be able to compete with fentanyl. It just can’t.”
There is no wonder why fentanyl in Philadelphia has become the dealers choice, the economics of fentanyl trafficking are easy to understand.
Unlike with heroin, there is no need to wait for the poppy harvest to start production. To yield a kilo of fentanyl, the chemicals one would need cost less than $5,000. At $55,000-$60,000 per kilo delivered, fentanyl is the about the same price as heroin but earns traffickers far more once it is cut and packaged for the street.
Each kilo of fentanyl can be cut out to approximately 330,000 doses, according to Trainor. A single kilo is enough to kill half of the counties residents.
Two factors make fentanyl in Philadelphia such a difficult drug to get ahead of:
No dominant trafficker
With drug problems in the past, a substance coming into any area would probably be controlled by a single, relatively predictable trafficker or trafficking family, but not with fentanyl.
This incredibly powerful and potentially life-threatening drug is coming from China, ordered over the dark web, or coming up from Mexico. It isn’t being shipped in through the typical channels, and thus law enforcement has found it increasingly difficult to track.
It is easy to modify
Fentanyl is a synthetic drug, therefore it is pretty simple to change the formula. Every time traffickers make subtle changes to the chemical ingredients of their batch, the DEA analysts struggle to adapt and catch on before the recipe has been changed again.
“It used to be just fentanyl but now we’ve noticed eight different analogs in this area and around 40 nationally. Our chemists estimate there could be 200 additional variants.”
One of those variants is Carfentanil. This horrifically hazardous material is a painkiller… for elephants and other large mammals! It is estimated to be up to 10,000 times stronger than morphine. Carfentanil has shown up in other areas in the past, such as Cleveland, Ohio. It is still rare for street consumption, but it has shown up along with fentanyl in Philadelphia medical examiner’s office.
Over the past three years, fentanyl-related deaths across America have increased by 540%. According to the Journal of the American Medical Association, for the first time, the majority of fatal overdoses are fentanyl-related, accounting for nearly all the increases in drug overdose deaths from 2015 to 2016. Part of facing the ongoing opioid epidemic is providing effective and comprehensive addiction treatment opportunities. As more and more people die every day from these insidious substances we have to do all that we can to help fight back. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help!
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Deaths due to drugs like fentanyl and other synthetic opioids continue to rise at a devastating pace in America. Despite the implementation of a special opioid commission to tackle the opioid crisis head-on, and even after the President of the United States issued a public health emergency concerning this ongoing issue, drugs like fentanyl are still finding their way into the country.
So how is it that these dangerous drugs are still getting across our borders?
Mailing Law Loophole
Much of the current flow of fentanyl into America is said to be connected to a major loophole in mail security. As it stands, every day up to one million packages overall get into the US without being screened.
Under the current laws, most international packages must include some general information, such as:
- Information on the sender
- The packages destination
- Contents of the package
These seemingly simple details can, in fact, help authorities track and detect packages containing illicit substances. However, these are not bulletproof methods of detections.
A big part of the problem is a loophole that exists within our current system. According to Alex Wolff, of the bipartisan coalition Americans for Securing All Packages,
“Due to a loophole in the global postal system, packages sent via private couriers (like UPS or FedEx) are required to have the advance electronic data used by law enforcement to screen and stop dangerous material, while packages shipped via foreign postal services are not.”
Wolff explains that when materials are sent through certain channels from outside the country, they are sent without the necessary security data that law enforcement agencies require in order to screen and stop dangerous packages.
Considering that fentanyl and other synthetic opioids are expected to be produced primarily in China, much of the drug is being shipped through this international loophole right into the United States. Thus, law enforcement is essentially flying blind in their efforts to catch a lot of the drug as it slips into the country.
The STOP Act
In an effort to put an end to this exploitation of the mailing system, the Synthetics Trafficking & Overdose Prevention (STOP) Act was introduced to the Senate and House of Representatives in February of 2017. It is currently listed as H.R. 1057, as introduced by Republican Representative Patrick J. Tiberi of Ohio. This bipartisan and bicameral legislation could be a huge step forward. Sponsors for the bill include:
- Ohio Republican Senator Rob Portman
- Wisconsin Republican Senator Ron Johnson
- New Hampshire Republican Senator Kelly Ayotte
Each of these officials represents a state that has been hit hard by the opioid crisis. Surprisingly, almost a year later there has been no further action by Congress to pursue this bill.
Still, Alex Wolff remains optimistic that Congress will act soon to push the bill forward. Now the STOP Act also has the support of:
- The National Council of State Legislators
- Fraternal Order of Police
- The American Medical Association
To clarify, there are a few other prominent “STOP” Acts in the past, including:
TheSober Truth on Preventing Underage Drinking Act (STOP Act) of 2006
This was America’s first comprehensive legislation on underage drinking.
The Strengthen Opioid Misuse Prevention (STOP) Act of 2017
This was a law for North Carolina aimed at curbing the misuse and abuse of opioids.
Putting a STOP to Fentanyl Shipping
Whether having tracking information on international packages seems like a big deal or not, most experts take it very seriously. According to former assistant secretary in the Department of Homeland Security Juliette Kayyem, who is a lecturer on international security at the Harvard Kennedy School,
“You have the demand problem, the public health problem of making sure people cannot be addicted, but on the supply-chain issue, one of the loopholes is clearly the postal system,”
True, not very many drug distributors write “fragile fentanyl shipment: Handle with care” on their postage. However, Kayyem says that collecting data from senders, even those who are less likely to be truthful is important for law enforcement to be able to stop drugs like fentanyl from coming into the country. Kayyem states that even if someone from another country is shipping things in and lies about what is in the package, that lie itself becomes a means to get them in the long run.
Should this bill be pushed into action? Is this enough, or should there be a way to impose even more strict regulations on international mailing to put a stop to the exploitation of the mailing system? Is this the best way to curb fentanyl use and overdose?
In the past few years, overdose deaths due to synthetic opioids like fentanyl have skyrocketed. Over 20,145 people died from synthetic opioids other than methadone in 2016. But the opioid crisis isn’t just about preventing the drug from coming into the US. We also need to support effective addiction treatment options. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
The Global Commission on Drug Policy (GCDP) is an international institution of global leaders and intellectuals working to help study and inform initiatives on addressing drug use all around the world. This think tank offers recommendations concerning drug use and its consequences for societies across the globe.
The GCDP consists of members from various nations, including but not limited to:
- The United States of America
- The United Kingdom
Former U.S. President Jimmy Carter wrote an op-ed in The New York Times explicitly endorsing the recommendations of the Global Commission on Drug Policy, and the group has released various reports over the years focusing on the efforts to curb the spread of drug abuse.
Recently the GCDP released a position report on the North American opioid epidemic. In this report, the commission issues recommendations that appear to endorse the expansion of harm reduction techniques to battle the ongoing crisis.
The Turning Point for America
According to the GCDP’s new report, North America is at a turning point in the way that drug addiction is viewed. This is not too much of a surprise, considering now more than ever there has been a push for a more compassionate perspective on drug use and addiction. America now finds itself in a unique position where the stigma that has so long been attached to addiction is starting to be abandoned, and more progressive action is being taken.
Now the Global Commission on Drug Policy believes national policymakers should take advantage of this unique opportunity to reduce opioid-related deaths through harm reduction. In the report the authors state:
“While in recent years media and politicians have been more open to viewing addiction as a public health problem, leadership is needed to turn this into an urgent and commensurate response to the crisis,”
One way that the Global Commission on Drug Policy ideals clashes with that of the Trump administration, currently steering drug policy in America is that the GCDP does not endorse the old policies of the War on Drugs.
GCDP vs War on Drugs
Back in June of 2011, the GCDP stated:
“The global war on drugs has failed, with devastating consequences for individuals and societies around the world.”
Again, this recent report echoes that sentiment, saying that attempting to cut off the opioid supply is not the answer. The new report notes how this approach has been tried before, as the first reactions to the opioid epidemic were to limit prescriptions and to introduce pills that were harder to manipulate.
The report goes on to note that this response drove people to use cheaper and often much more potent street drugs instead of prescription pills. Fentanyl is one of the worst synthetic opioids to contribute to the outbreak of overdoses and deaths across the country.
The Global Commission on Drug Policy says cutting off the supply of opioids into the country cannot be effectively executed until after supportive measures are put in place. This means supporting not only both people battling addiction but also people with chronic pain. The report insists:
“The aim is to achieve the right balance in regulation to provide effective and adequate pain care, while minimizing opportunities for misuse of these medications.”
To reduce the harmful impacts of opioids, the commission calling for the acceptance and implementation of harm reduction strategies.
The Global Commission on Drug Policy Suggests Harm Reduction
So if they are saying that the War on Drugs did not work, and neither will bulking up borders, then what will?
Well, according to the GCDP, harm reduction is the right move. The new report calls on American lawmakers to promote programs like:
Naloxone Distribution and Training
As the opioid overdose antidote, Naloxone is an invaluable tool to have in the fight against the opioid epidemic in America, but the price for the drug continued to skyrocket as the epidemic got worse. Making it more available could give access to and train people with life-saving medication to thousands or even millions more.
Safe locations where IV drug users can trade old, contaminated needles for new, sterile needles to help prevent the spread of blood-borne illness like HIV.
Facilities where drug users can go to use their drugs with sterile equipment safely, reducing the number of overdose deaths by providing a place free of punishment for them to use with medical emergency resources on site.
These kinds of programs would allow for users to check their drugs for the presence of any unknown substances it may have been diluted with. For example, most fentanyl users do not know they are using fentanyl.
Decriminalizing Drugs in America
In another aspect of the report, GCDP also makes a much more revolutionary and more radical suggestion that many may consider qualifying as harm reduction: decriminalization.
The report states:
“The Global Commission on Drug Policy also calls for the elimination of illicit drug markets by carefully regulating different drugs according to their potential harms. The most effective way to reduce the extensive harms of the global drug prohibition regime and advance the goals of public health and safety is to get drugs under control through responsible legal regulation.”
With this philosophy in mind, the GCDP made two more drastic recommendations:
- End the criminalization and incarceration of people who use drugs nation-wide in Canada and the United States.
- Allow and promote pilot projects for the responsible legal regulation of currently illicit drugs including opioids.
The idea is that by decriminalizing drugs, they can bypass criminal organizations and ultimately replace the current black market.
“Do not pursue such offenses so that people in need of health and social services can access them freely, easily, and without fear of legal coercion,”
We have begun to see a watered-down variation of this kind of strategy with many Police Assisted Addiction and Recovery Initiative (PAARI) programs, where law enforcement is helping addicts get into treatment instead of arresting them when they ask for help.
Better Treatment Research
The report insists that more research is necessary in a few critical areas in order the effectively address the opioid crisis and the overall drug problem in America.
One of the key points of research the GCDP proposes is for finding the most effective treatments for addiction, specifically to prescription opioids. In addition, the report shows support for medication-assisted treatment (MAT) and opioid substitution therapy (OST) as a means to preserve life to assist in the recovery process. While these programs are met with some of the same contentions as safe injection sites or decriminalization, the commission seems adamant about using harm reduction to keep people alive long enough to get better.
Michel Kazatchkine, a doctor and commission member, said in a recent interview:
“Repression is harmful. Wherever repressive policies are in place, people will not be in the best condition to access services.”
While he and other commission members are in no way naïve to the fact there is no way decriminalization will happen at the federal level soon in the U.S., they remain hopeful that states or cities will make decisions which don’t require federal approval, or for which they are willing to enter to fight with the federal process.
Overall, the hope of the GCDP is that these suggestions, coming from a group of world leaders fully invested in understanding the issue, will convince American and Canadian lawmakers to take a progressive approach to the crisis.
What could some of these changes mean for those trying to recover from opioid abuse? How could some of these ideas change the way addiction treatment operates within America?
One thing is for certain, in fighting opioid addiction, whether as a society, as a family or as an individual, there needs to be compassion and action. It takes courage and it takes a degree of uncertainty. But with the right resources, there is hope for a greater future. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
That’s right, you read the headline correctly. Law enforcement could soon be giving heroin to addicts, for free, in an attempt to fight addiction. While harm reduction is an admirable concept to preserve the lives of those suffering from addiction, this is a hard bit to chew.
Various countries are working to drastically reform drug policies. Some states in America have even started to pursue expanding access to naloxone, needle exchange programs and even safe injection sites. Other countries around the world have gone to new lengths in decriminalization, while others go to new extremes in the War on Drugs. Yet, despite all this variations of progress, giving away heroin seems like the most abstract idea yet.
Police in Durham, a city in northeast England, are planning to offer free heroin to drug users. Why? They say the objective is actually to reduce both crime and addiction.
The Free Heroin Plan?
Durham Police and Crime Victims Commissioner Ron Hogg spoke recently on his logic for providing heroin to addicts. In his statement he said,
“The aim would be to enable people who have become addicted to heroin to follow a program that would stabilize their addiction in a controlled environment, and reduce their dependency on heroin until they stop taking it,”
The idea isn’t just to give addicts free heroin and let them loose, but to create a very distinctive atmosphere of support in hopes of inspiring recovery. The proposed free heroin program would work in combination with a traditional substance abuse support program, and the users would be monitored on use and tapered off. According to the Independent newspaper, the free heroin clinics could be established in the Durham area before the end of this year.
What do Police Think of Free Heroin?
It seems the police department is hoping that if drug users have access to free heroin then they won’t have to resort to crime to support their addiction. While they are aware of how this idea might seem strange, the idea is that they may be able to further decrease all other devastating results of addiction on the community. Crime, spread of disease, overdose death and more.
According to the Independent newspaper, Durham Chief Constable Mike Barton also says the initiative would take away from drug dealers’ profits. With drug users having access to free heroin they hope it will cripple the trade on the illicit drug market. Barton states:
“We need to get over our moral panic about giving people heroin as part of a treatment plan,”
“Our primary concern is to prevent crime. If we’ve got people who are addicted to Class A drugs committing crime, it makes good sense to get that person off drugs.”
Commissioner Hogg also goes on to say,
“The aim of the initiative is to save the lives of addicts, shut down drug dealers and reduce acquisitive crime,”
“It would also reduce demand on police time, and the courts, and I believe it should also help lower the prison population.”
The impact of heroin on the U.K. should of course be noted as a cause for desperate measures.
- 2015-2016 statistics show there were 149,807 people receiving treatment for opioid use disorder in England
- Between 2012 and 2015, heroin-related deaths doubled from 579 to 1,201 deaths in England and Wales
So of course, as the opiate epidemic rattles countries all over the world, a few have decided to react in very different ways. Apparently, some parts of the U.K. are moving toward a very, very liberal stance.
Fix Rooms and Safe Injection Sites
England is not alone on this. Let us also note that Switzerland has actually offered a free heroin maintenance program since 1994. Other governments in the U.K. have approval for similar safe injection initiatives, including:
- The Netherlands
Last October, Glasgow, Scotland became the first city in the U.K. to approve plans for “fix rooms”. These are sites where people will be provided medical-grade heroin and clean syringes with the intent to contain the heroin epidemic.
The free heroin program in Switzerland began in Zurich. It is now credited with decreasing crime in the area. Information indicates this program has expanded to 23 clinics. But it isn’t just free heroin in these locations. These “fix rooms” also provide counseling and support.
Harm Reduction… or Reorganizing?
Now, we have to ask, is this as crazy as it sounds? While the police in these areas seem to be openly admitting that giving away free heroin is indeed enabling, they seem very convinced that things have gotten so bad this is the best they can hope for at the moment. Again, they are hoping to contain the fallout of heroin abuse in their communities and provide information and treatment resources. The idea sounds pretty intense, but some would say desperate times call for desperate measures.
So is this harm reduction, or just reorganizing? Is this tactic set to prevent even more suffering and destruction, or is it a feeble attempt to make some semblance of order out of the chaos of the opiate crisis?
From a personal opinion, as an addict in recovery, I can say I honestly don’t know. It sounds incredibly dangerous and almost irresponsible to say that law enforcement will provide free heroin. Yet, I have to try and understand their logic; that it might be able to prevent some crime. It might take a nice piece of money out of drug dealer pockets, and it might preserve lives long enough to convince them to get treatment. Then again, an addict like me might just take advantage of the free heroin program and get more off the street while also getting free, government funded drugs too.
Past data might show some support to this innovation. I guess we will just have to wait and see what becomes of this. Until then, there should always be an emphasis on the possibility of effective and comprehensive treatment. Even with the free heroin program, the idea is to get people the treatment they need.
We want to know what YOU think.
Addiction and drug abuse have become relevant in every aspect of American life. Police, politicians, educators and community leaders are trying to create radical changes in perspective. Not every perspective is easy to understand, but the common goal is inspiring lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Naloxone expansion is something we consistently see as a topic of discussion. Naloxone, or the name-brand Narcan, is an opioid overdose antidote that is in high demand as one of the primary tools in the fight against the ongoing overdose outbreak. Law makers and law enforcement agencies have joined with community organizations and pharmacy companies in trying to provide this medication to more and more people.
New legislation across the U.S. has made access to Naloxone more common than ever. Now, the drive for Naloxone expansion is leading us to another avenue. This is beyond supplying the families of addicts, the addicts themselves and first responders.
Some may remember, back in September, the Food and Drug Administration launched a competition to app developers in the name of improving resources for naloxone expansion. The contest was seeking a mobile app for connecting people experiencing a drug overdose with someone nearby who can administer naloxone. With technology being used to expedite just about everything in our world, it only made sense to use it to help save lives if possible.
The winner of the Naloxone App Competition has been announced this month, and the $40,000 cash prize has been claimed. Their mission: to make it possible for more people to be first responders for opiate overdoses.
The OD Help App
The winning app is the OD Help App, creared by Team PwrdBy, a small start-up in Venice, California. The start-up’s CEO Jared Sheehan says this innovation stems from the idea of making naloxone assistance as available as ride-sharing services like Uber and Lyft. With Uber and Lyft drivers being so spread out, the idea is the app could cover a lot more ground and reach more people in the event of opioid overdose.
Sheehan says there’s still a lot of work to be done before the app is made available to the public. To implement this kind of program with Uber or Lyft, it would require reaching out and coordinating with ride-sharing companies. Sheehan stated:
“Is there a way if every Uber driver had a naloxone kit in the back of their car, that you could call someone and they’d be able to come over and administer naloxone?”
So in essence, the idea of the OD Help app would be to be able to alert naloxone carriers of an overdose (OD) and give them the option of being dispatched to help revive someone experiencing the overdose.
Expanding Team PwrdBy Naloxone Plan
According to Sheehan, ride-sharing apps are just one avenue that Team PwrdBy is setting its sights on. The company is also exploring more traditional distribution systems.
One such method Team PwrdBy wants to look to for inspiration for the OD Help app is the AED network, the automated external defibrillators network across schools. The goal is to better comprehend how these programs are funded and distributed. Modeling after an already successful style of expanded access for other emergency medical supplies may be vital to changing the way we expand naloxone access.
All of this is to save as many lives as possible.
How OD Help Works
The OD Help app connects opioid users with a crowd-sourced network of naloxone carriers. Using GPS, it specifically connects someone who may experience an overdose with someone nearby who has access to naloxone. The app is also able to be personalize to the user’s specifications. One feature lets you set it up so in the event of an overdose the app would only alert people in your selected support network. And naloxone carriers can disable alerts if they are not able to respond.
Another feature available with the OD Help app is a breathing monitor. This can be helpful for people who use opioids alone. It gives the app a way to communicate with others when the user can’t. The wearable monitor is able to detect if the individual’s breathing rate is dangerously low, a sign of overdose. In this case the OD Help app automatically alerts a naloxone carrier nearby.
The app also features information on:
- How to correctly identify an overdose
- How to administer naloxone
Another hope is that the app will also inform younger generations about the dangers of opioid abuse, and about overdose prevention. The hope is the app could reach a younger population and make them aware of how to get access to naloxone and how to administer it. Many young people don’t think of pharmacies as a place to get the drug that could save their lives.
Put to Good Use
The truth is, not all people will be able to have access to a consistent supply of naloxone. The drug also doesn’t last forever. For those who would need to have an overdose antidote resource, the OD Help app could be a safe-guard against being completely unprepared for an overdose.
Some people may be embarrassed or have some reservations about personally obtaining naloxone. With the OD Help app they could reach out to someone if they truly needed the help.
If you or someone you loved were overdosing, would it be useful to be able to look on an app and find someone close by with the tools to help? Some people would say you should just call an ambulance, but what if it could get there sooner? Or what if someone is afraid of reporting it? Too many people die for these very reasons, but they shouldn’t have to. Sure, some people may ask if they would let a random citizen administering the antidote. However, some might say any help is worth having.
Then on the other side, would people be willing to come to the rescue if they had the resources? If your phone rang and the OD Help app said someone needed help around the corner, would you? Would you be happy you could?
Something tells me plenty of people would be willing to put this tool to good use.
This writer has said this before; the preservation of all lives should be a responsibility of all who have the ability to help; not just for public health officials, but everyone. As part of that, Palm Partners is dedicated to contributing to the rehabilitation and revolutionary growth possible with holistic treatment for drug and alcohol abuse. If you or anyone you know is struggling with substance abuse or addiction, please call now.
CALL NOW 1-800-951-6135