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
For some time now government officials in different states across America have been pushing for the implementation of safe injection sites in their neighborhoods to combat the perpetual rise of opioid addiction and overdose death. This time last year there were proposals in New York, California and Washington D.C. to open such facilities. With the rising rates of overdose and death more officials have asked for the opportunity to at least examine the potential impact of safe injection sites. Now, officials are pushing for safe injection sites in Boston.
This request didn’t come lightly, either. The Massachusetts Medical Society is actually imploring state officials to open a safe injection site within the City of Boston, with desperate hope of curbing the numbers of casualties.
Safe Injection Presented to City Council
The Boston city council members heard arguments both for and against safe injection sites in Boston, and the debate is on as to what to do with the information.
Advocates for safe injection sites in Boston believe such facilities save lives by making emergency medical treatment immediately available. Dr. Henry Dorkin with the Massachusetts Medical Society supports the idea, stating:
“In fact, if you don’t have them in a facility with Narcan readily available, they’ll die very quickly,”
Just to clarify, safe injection sites are secure locations with medical staff available where addicts can use heroin under medical supervision. It provides what could be considered neutral ground where the drug user will not have to worry about being charged with criminal possession, while also having a first line of defense against overdose. Safe injection sites do not provide drugs, they simply provide the space and with some clean needles are also available.
Probably one of the most popular examples used by advocates of safe injection sites has been the famous facility in Vancouver, Canada that helped save dozens of lives. City Councilors Anissa Essaibi-George and Frank Baker, who requested the hearing, point out that the safe injection sites in Vancouver reduced fatal opioid overdoses by 35%.
This kind of decrease in overdose fatalities would make a huge difference in Massachusetts. The state Department of Public Health says the state’s top cause of accidental death so far this year is opioid overdose. The department says an average of 6 people a day in Massachusetts die from opioid overdoses in 2017, making. A 35% decrease would make a tremendous improvement on the community.
Anti-Injection Sites Argument
Opponents of safe injection sites in Boston say that these facilities do nothing to address the true problem, which is addiction. Sue Sullivan of the Newmarket Business Association states:
“It’s an existence. We need to figure out how we’re going to save these people and it’s not safe injection sites,”
Looking at the Vancouver statistics was apparently not enough to convince the entire city council. One feature of safe injection sites is that they often have a team of treatment professionals who encourage addicts who visit the facility to get treatment. They provide information about safe medical detox and other levels of care to those who are interested in getting help. However, one city council member, Frank Baker, states:
“263,000 visits a year by 6,500 individuals. And it has only 404 referrals to onsite detox,”
Some officials believe that this measure of harm reduction isn’t enough to really solve the issue without getting more people into drug addiction treatment and off the streets.
Possible Benefits of Safe Injection Sites in Boston
The primary function of safe injection sites is to preserve life. The idea is that while it may not be a lasting solution, it is a way to save lives. Safe injection sites allow people struggling to have the opportunity to survive their addiction long enough to get treatment. Beyond slowing down drug related deaths, safe injection sites in Boston could offer a number of other positive outcomes.
In May of last year we also covered a report titled Alternatives to Public Injection in which experts with experience operating supervised injection facilities (SIFs) shared data that shows:
- People who use SIFs take better care of themselves
- SIFs reduce or eliminate addicts needle sharing
- Ultimately, participants reduce their drug use all together
- SIF participants gain access to other medical and social services
- Participants have resources to seek addiction treatment
- SIFs do not increase drug use in the surrounding area
- Crime and public disturbances decrease in the areas around these programs
- There has not been a SINGLE overdose death in any of these programs over many years of operation
Rates of people visiting safe injection sites attending treatment may not be as good as they could be. However, the fact that they have no experienced a single overdose death at these facilities is an incredible improvement.
Are we going to see safe injection sites in Boston? Are more American cities going to consider this option? Is having a safe injection site a good idea?
While getting the right kind of safe and effective addiction treatment can create lasting change, preventing the ongoing deaths from drugs is also a worthy cause. Holistic healing programs are designed to address every aspect of addiction. If you or someone you love is struggling, 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
Author: Justin Mckibben
Sometimes new policy can be good. Sometimes, not so much.
The opiate epidemic in America has hit some states with staggering rates of overdose and death. The paralyzing truth gripping the nation today is that more people are dying from drug overdose than homicides and car crashes. Heroin, fentanyl and prescription painkillers collectively decimate entire communities. People from all over are starting to push officials and lawmakers for more progressive and effective solutions.
Addiction has led to an overdose outbreak that shakes the country to the core, everywhere. Now, Florida lawmakers are pushing for new legislation to try and protect and serve those who suffer from an overdose. One of the first bills on the 2017 agenda is one that hopes to change how law enforcement treats overdose victims.
Although, another bill is trying to turn things in a very different direction.
Florida HB 61 Bill
Florida Representative Larry Lee, a Democrat from Port St. Lucie, has filed a proposal titled HB 61. If approved, this piece of reform would require several new policies for healthcare providers, starting with hospitals.
- It would require hospitals to screen overdose victims to determine the need for additional health care services
- Prohibits hospitals from discharging overdose patients to a detox or treatment facility until stabilized
- Requires attending physician to attempt contact with patients primary care physician, or other treatment providers, who prescribe controlled substances to notify them of overdose
- Requires hospital to inform medical director of treatment center (if patient is currently in treatment) of the overdose
- Hospital must inform overdose victim’s family or emergency contact of overdose
- Must inform contacts what drugs they suspect to have caused overdose
- Attending physician must provide list of drug treatment providers and information about Florida’s Marchman act and Backer act in case the family or contact wishes to seek legal action to protect the addict
The Big Change in HB 61
Lastly, what is probably the most progressive part of this legislation, is the HB 61 bill would prohibit criminal charges from police officers and prosecutors against the overdose victim for possession of any drugs found on them during the incident.
This final aspect of HB 61 this writer thinks is a big deal, because from personal experience I have seen and heard many stories of individuals not calling for help in the event of an overdose out of fear of prosecution. In some cases people actually die because of the fear of criminal punishment. Adding this kind of measure to the bill is an attempt at eliminating the loss of life due to fear of discrimination. Even if it is not a perfect system, this kind of reform takes first responders and law enforcement a step closer to dealing with addicts who are fighting a fatal illness like sick people instead of criminals.
Florida SB 150 Bill Attacks Fentanyl
From across the aisle we see another push from Republican Senator Greg Steube from Sarasota. The question is, will this push go in the right direction? On December 12, he introduced bill SB 150. This is set to be a direct attack on fentanyl.
For those who are not yet familiar, fentanyl is an incredibly powerful, and lethal, opioid painkiller. It’s medical use is to sedate surgical patients and relieve chronic pain. However, being several times more powerful than heroin, it has crept into the illicit drug trade in various parts of the country. And with its arrival also came a horrifying increase in overdose and death.
This proposal means to make 4 grams or more of fentanyl a first-degree felony through:
November 20, the Palm Beach Post released an analysis of people who died in 2015 from heroin-related overdoses. Out of the 216 individuals profiled in this report, 42% of the cases were found to involve fentanyl. So of course, with Steube coming from a district hit particularly hard by the opiate epidemic, it is logical to want to do everything you can to cut the flow of fentanyl off.
Yet, some say that this kind of strategy is too close to the concept of mandatory minimums.
Is SB 150 Too Close to Mandatory Minimums?
For those who need more clarification, mandatory minimum sentencing laws were a “one-size-fits-all” strategy implemented originally back in 1951 against marijuana, then repealed in the 1970s, and refined in 1986. In 1973, New York State enacted mandatory minimums of 15 years to life for possession of more than 4 ounces of any hard drug.
The idea is that regardless of the individual or the circumstances that a certain crime will have an inflexible punishment across the board. Ever since their introduction, criminal justice advocates have fought these laws, and they have always been surrounded by debate and controversy.
Essentially, some are already saying that SB 150 will ruthlessly make addicts into victims of the already overpopulated prison system. To be clear and fair- the bill does not seem to directly require a specific prison sentence like mandatory minimums, but it’s similar in that it treats every issue related to fentanyl the same.
The issue has already been argued time and time again that non-violent low-level drug offenders have spent excessive amounts of time in prison for possession of a substance. In some cases, an individual will do more time behind bars for possessing a large quantity of drugs than someone who has actually killed someone. Some have come to the conclusion that this tactic just doesn’t work.
The fear with SB 150 is not about the manufacturers or the dealers as much as it is for the consumers. Sometimes individuals purchase drugs on the street believing it to be heroin or another substance without even knowing there is fentanyl in it. So this bill would make first-degree felons out of desperate addicts?
What is Right?
The big question we all face at the end of the day is- what is the right thing to do? How is the best way to handle something that feels so utterly out of hand?
Well, it would seem like its time to finally let go of the archaic stigma. More states and law enforcement officials are turning to compassionate and supportive progress. Many places in America are starting to do everything they can to help people struggling with addiction to find help before it is too late. So why move backwards?
In my opinion, strictly based on what has been presented so far, SB 150 seems dangerous. There are countless advocates out there who say that intensifying the punishment is not how you deter the crime. Especially when it comes to addiction, because this kind of method still suggests it is a moral failing and not a psychological and physical illness.
HB 61 seems to be trying to call health care providers to action and add more accountability on the front lines in the fight against the overdose outbreak. At the same time it seems to move in the opposite direction of SB 150 by trying to limit the persecution of addicts. HB 61 makes more room to help preserve life and offer treatment and solutions. By now we should already know, the solution isn’t a War on Drugs, it is community and compassion.
These are some of the initial responses to recommendations recently made by the grand jury. Every day there are countless people suffering. And every day there are countless more recovering and fighting to help others recover. If you or someone you love is struggling, please call toll-free now. We want to help. You are not alone.
CALL NOW 1-800-951-6135