Years ago if you asked the average American what fentanyl was, odds are they wouldn’t be able to tell you. Most would probably assume it was some important medical compound found only in hospitals. It almost sounds like the name of some edgy chemical you’d associate with either Breaking Bad or the Unabomber. Sadly, gone are the days of such blissful ambivalence.
Today, America has a more realistic idea of what fentanyl is.
Most adults and young people have at the very least heard the horror stories about this now intensely infamous drug. If you have a television or a smartphone, odds are you have at least glimpsed the headlines. Because in the last few years the devastation caused by this powerful synthetic drug has spread all over the country, and cost countless lives.
Using data from the National Vital Statistics System, researchers have shown an involvement of fentanyl in opioid overdose deaths has quickly skyrocketed:
- 2010- 14.3% of opioid overdoses involved fentanyl
- 2016- 46% of opioid overdoses involved fentanyl
With nearly half of opioid-related overdoses, fentanyl is now involved in more deaths than:
- Prescription opioids- 40 % in 2016
- Heroin- 36.6 % in 2016
More than one drug is commonly involved in many of these deaths. Therefore, in some cases heroin and fentanyl are both accounted for. However, we can see how fentanyl has a growing presence that can definitely be felt, as dozens of thousands of Americans are dying every year due to exposure to this deadly drug.
So if you’re still unclear as to what exactly fentanyl is, let us look at how to better understand where it comes from and why it is so lethal.
Pain Medication Origins
Some people were indeed ahead of the curve when it comes to understanding fentanyl because it has actually been around for a very long time. The synthetic opioid is used as a pain medication, and in some cases combined with other medications for anesthesia. It has been used for years by hospitals, doctors, and even veterinarians to treat patients and puppies.
- 1960- Fentanyl was first created by Paul Janssen
- 1968- Fentanyl was approved for medical use in the United States
- 2015- 1,600 kilograms/3,500 pounds of fentanyl were used globally
- 2017- Fentanyl was the most widely used synthetic opioid in medicine
On its own, the substance typically looks like a white powder. As a medicine, fentanyl is available in a number of forms, including:
- Skin patch
And it may be hard for some to believe, but it’s true that one of the deadliest chemicals on the street today can actually be found in lollipop form for medical use.
The drug is such an effective painkiller because it is typically considered to be approximately 75% stronger than morphine for a given amount. However, there are fentanyl analogs such as carfentanil (carfentanyl) which can actually be as much as 10,000 times stronger than morphine. When translated to the illicit drug world, that means fentanyl and its derivatives blow heroin out of the water when it comes to potency and risk.
As a medication, fentanyl can be useful in treating chronic pain patients when utilized correctly. Pre-surgical and post-surgical use of powerful pain management medications is sometimes a necessary step to helping patients recover. In fact, fentanyl patches are on the World Health Organization’s List of Essential Medicines, meaning it is considered one of the most effective and safe medicines needed in a health system.
Black Market Poison
Despite the seemingly altruistic intentions behind the invention of fentanyl, it has been used illicitly since the mid-1970s. Now, there are more than 12 different analogs of fentanyl that have been identified as being illegally made and used recreationally. The synthetic opioid is used through:
- Taken orally
Some people who abuse opioids do seek out fentanyl. Fentanyl is sometimes sold on the black market after being diverted from legitimate medical supplies. Recently drug manufacturers have also been accused of racketeering in order to boost sales of fentanyl. Even the gel from inside the transdermal patches may be ingested or injected. Those fentanyl lollipops have also made their way into the illegal drug trade.
But a large number of people who end up using fentanyl do it unintentionally. It has been used to adulterate or ‘cut’ heroin, and it has been pressed into counterfeit pain pills and sedatives sold on the illicit drug market. More recently there has been a rise in overdose deaths among cocaine users involving the drug, which suggests that fentanyl is being heavily cut into cocaine as well.
So why are dealers using it? To name a few reasons:
- As mentioned before, it is extremely potent
- It is easier to smuggle into the U.S.
- The drug is very cheap to produce
In China, carfentanil was not a controlled substance until March of 2017, meaning it had been legally manufactured and sold over the internet up until barely a year ago.
While it is a profitable move for drug traffickers, it is a life-threatening variable for drug users. Variations of the compound can be so strong they are incredibly poisonous. Simply breathing air with atomized fentanyl in it, or touching a contaminated surface can kill you.
Because of the massive reach of the outbreak, it is important than ever to be aware of the symptoms of fentanyl overdose. These warning signs can include:
- Difficulty thinking, speaking, or walking
- Excessive drowsiness
- Frequent fainting spells (nodding off)
- Throwing up
- Pale face
- Blue- or purple-colored lips, fingernails, or extremities
- Choking sounds
- Pupil size reduced to small black circles in middle of eyes
- Low blood pressure
- Slowed heart rate
- Difficulty breathing
- Hypoventilation (slow, shallow breathing)
- Respiratory arrest
Adding to the terrible risk of coming into contact with illicit fentanyl or one of its derivatives is that opioid overdose antidotes like naloxone are not as effective when trying to reverse the effects. Sometimes an individual will require multiple doses of naloxone to be revived, ance revived a new overdose can actually occur when the initial dose of naloxone wears off. It is critical that someone who experiences an overdose received medical treatment immediately.
The nation has been caught up in a growing opioid crisis for years now, serving a shock to the healthcare system and public health officials everywhere. As the death toll climbs and more people are suffering and dying every day it is crucial that we raise awareness and take action to address drug abuse and addiction. One of the essential tools to fighting back is effective and innovative treatment options. If you or someone you love is struggling, please call toll-free now.
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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!
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Author: Justin Mckibben
Ohio has been a major epicenter of the overdose outbreak. In 2014, Ohio was #2 of states with the most overdose deaths. Since then, Ohio has topped the list for heroin overdose deaths in the country, and remains in the top 3 states with the highest overdose death rates, both overall AND per capita. In fact, the overdose capitol of America is actually Montgomery County, Ohio, with over 365 opioid-related deaths in the first 5 months of 2017.
So with Ohio being one of the states hit the hardest by the ravishes of the opioid epidemic and the overdose crisis, you would think that Ohio officials would be more apt to adopting progressive and preventative measures for saving lives. In some areas, yes. However, in others… not so much.
Butler County Sheriff Richard K. Jones says his deputies won’t carry Narcan, despite its effectiveness reversing the effects opioid and heroin overdoses.
Butler County Overdose Deaths
Making this a much more controversial issue, drug overdose is killing more people than any other cause in Butler County. According to a statement by Dr. Lisa Mannix’s office, in the first 4 months of 2017 the coroner investigated 175 deaths, and 96 of them were lethal drug overdoses.
The month of April was especially deadly for drug users in the area. According to Mannix, her office-
“- has never seen that many deaths of any kind in a single month.”
In just those 30 days, 30 people died from drug overdose. According to the coroner’s office, 83% of the overdose deaths involved illegal opiate substances. This includes the now infamous synthetic opioids such as:
If this deadly trend continues, the coroners office expects those rates will see a 50% increase from the total overdose deaths in 2016.
The Sheriff Says “I Don’t Do Narcan”
He’s Jones just happens to be the only sheriff in Southwest Ohio whose department does not use the opioid overdose antidote Narcan, or the generic Naloxone. And apparently, he has no intention of starting anytime soon.
Jones was asked about the lack of Narcan use by his police department shortly after the now controversial comments made by a Middletown city councilman suggesting a policy to refuse giving a response to overdose calls. According to the sheriff, local residents and even social workers often ask him why law enforcement continue to revive people who overdose multiple times. His response was simple; his deputies don’t. When interviewed and asked about it, Jones stated:
“I don’t do Narcan.”
Yes… let that just sink in for a second.
This is a man who has the job description of ‘protect and serve’ but when it comes to addicts, he would prefer to do neither.
So what was his justification?
Jones went on to rationalize his opinion by, according to the original report, ‘talking about babies he has seen born addicted to heroin in his jail and mothers who teach their teenage children how to use heroin so they can shoot the mom up.’ When the reporter pressed on about the lack of Narcan in his department, Jones stated:
“They never carried it. Nor will they. That’s my stance.”
The sheriff went on trying to validate his rationale by claiming safety was the primary priority. He argued that people revived from an overdose are often violent and are almost never happy to see the police.
So in short, it sounds like this sheriff would let sick and suffering men and women, even teens, die from overdose rather than save their lives… because they might be upset or aggressive?
What Do You Do?
As expanded access programs to provide Narcan to first responders have become more popular it seems some have gone on to debate how long should tax payer money do to saving lives, and how many times should someone be revived.
This is a tough conversation to have. For some there is no easy answer. Those who are more focus on being monetarily minded and conservative will typically argue that resources should not go to repeatedly paying to save addicts from death. But is it fair for anyone to decide whether someone should die or not simply because they are addicted to drugs? Are we really willing to let people die to boost the government’s budget?
However, for some of us the answer is easy- you cannot put a price on a life. Struggling with substance use disorder does not diminish the value of a person. It should go without saying that if the resources exist to prevent death from overdose, than we should use it. Narcan may not be the cure to addiction, but it might keep just enough people alive long enough to find help and make a difference in the world.
Thankfully, this isn’t how all of Ohio is handling the opioid overdose outbreak in their state. Sheriff’s deputies in surrounding counties carry the opioid overdose antidote, including:
- Warren County
- Clermont County
- Hamilton County
Other expanded access programs in Ohio are going strong and saving a lot of people, but of course the next step to solving the issue is helping to establish sources of effective treatment.
Drug addiction treatment can be the decisive variable that allows for these overdose victims and others suffering with substance use disorder to get a new chance at life. Holistic healing with innovative and personalized recovery programs has the potential not to just save a life, but transform lives. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
It should be obvious by now that expanded Naloxone access is a necessity. With the opioid epidemic spreading more and more and the overdose outbreak claiming so many lives everywhere, we must take advantage of every available asset to save lives. Because of price hikes that coincide with the increasing rates of overdose and death Big Pharma companies that produce the overdose antidote have come under fire many times in the past year. Now, one such company has reached an agreement with the state of Ohio to help ease the financial burden of protecting the people.
Authorities and city officials in Ohio battling the overdose outbreak will soon receive some financial relief. The state has struck a deal with the makers of Naloxone, Adapt Pharma, to provide the life-saving nasal spray at a discount.
The Ohio Overdose Outbreak
Being from the Buckeye State myself, it is disturbing to know Ohio has been hit so hard by the heroin epidemic. This is in large due to the recent introduction of Carfentanil. This incredibly poisonous substance is currently mixing into the drug supply through Chinese vendors, according to an Associated Press investigation. The investigation found several businesses based in China that export dangerous drugs with relative ease to the United States, including:
Carfentanil is so potently perilous that it even poses a risk to law enforcement that may come in contact with it during drug seizures.
The terrible truth is that Ohio has been an epicenter of the overdose outbreak. In 2014, Ohio was #2 of states with the most overdose deaths. Since then several stories of horrific overdose upsurges and deaths due to opiates have highlighted the devastation in the state.
Just this year Cincinnati, Ohio statistics show the city sees at least four overdoses per day on average. The dangerous drug Carfentanil has been seized at least 343 times in Ohio. In July, Akron paramedics responded to 236 overdoses, including 14 fatalities linked to carfentanil, in a period of just 21 days! July also saw Ohio Governor John Kasich push for Naloxone expansion, and the battle has been uphill to equip all those in need.
Ohio Public Interest Price Deal
The Public Interest Price deal was announced by Attorney General Mike DeWine this past Friday. The discount agreement with Adapt Pharma states that Ohio officials will be able to purchase naloxone nasal spray for $75 per dose. Now this still seems a bit high, but this price is a 40% discount from the wholesale cost of $125. DeWine explained the need for such action in order to make any progress on saving those in Ohio who are suffering.
“The cost to purchase naloxone has prevented some agencies from carrying this life saving drug. I hope that Adapt Pharma’s new price freeze for Ohio will allow more agencies to consider keeping naloxone on hand. I continue to urge law enforcement agencies to carry this drug, because it can mean the difference between life and death for those suffering from addiction.”
The Attorney General’s comments echo an issue that is present in many places across the country. Law enforcement agencies and First Responders are aware of the need for Naloxone. However, because the makers have spiked the price so high in the last few years the demand has been met with financial hurdles.
Continued Overdose Antidote Expansion
This isn’t the only deal Ohio is involved in to make the communities safer. The agreement Ohio has with Amphastar Pharmaceuticals, Inc. stands to to provide $6 rebates for every Naloxone syringe. This deal applies to all Naloxone purchased through March 2017. This deal has been active for a year now. In that time 82 local agencies have been reimbursed over $209,000 to offset the cost of Naloxone purchases.
The new Public Interest Price deal is set to last a year. In that time it could mean the difference between life and death for many people. Having the resources is now especially vital. One can only hope that more allowances are made where needed.
Naloxone and Narcan, both opioid overdose antidotes, should be made as available as possible. The fact that price has become such a problem is not just unfortunate; it is unsettling with all things considered. It is some consolation that companies are willing to acknowledge the need and offer some semblance of compromise to help.
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
(This content is for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
The number of overdose deaths in our country are already at a staggering rate, increasingly troubling by the minute. Some areas are hit much harder, but overall the tragic toll of the opioid addiction epidemic in America is obvious. Time after time we witness overwhelming reports of devastating deaths and high frequencies of serious complications from drug use.
Ohio is among the top states in the country to experience elevated rates of overdose per population, and Cincinnati has seen a viscous proportion of these. In a single weekend 30 heroin overdoses across Cincinnati were reported.
During just a 48-hour time frame from Tuesday to Wednesday there were 78 more overdoses and at least three deaths.
Finally, after a six-day period of emergency-room visits, the number of overdoses had reached to a number health officials are calling “unprecedented”: 174!
Cincinnati VS Carfentanil
According to one local news source, Cincinnati has four overdose reports per day on average, and usually no more than 20 or 25 in a given week.
The bigger problem; pure heroin is what’s responsible for that average, but that’s not what’s on the streets now.
The sinister element suspected to be responsible in this latest upsurge of overdoses is heroin cut with the latest opioid hitting the streets- Carfentanil. For those of you who don’t know yet, this is an elephant tranquilizer. Carfentanil supposedly has 10,000 times the potency as morphine!
At this point law enforcement officials are unable to identify the source of the toxic cocktail. Newtown Police Chief Tom Synan states that State, local and federal authorities have mobilized across Hamilton County to investigate where this incredibly powerful poison is coming from. So far they believe this record number of overdoses could be caused by a single heroin batch laced with Carfentanil.
Carfentanil, relatively similar to the opioid Fentanyl that has caused enough damage it its own right, is the strongest commercially used opioid. So just like with Fentanyl, drug dealers cut their heroin with Carfentanil to make it last longer and to deliver stronger, more addictive highs.
Tri-State Area Turmoil
New reports state that additional heroin overdoses in the tri-state area, plus New Jersey, tally up to more than 225 for this timeframe.
- In the same time period of the Cincinnati overdoses:
- Jennings County, Indiana reported 13 overdoses last Tuesday
- Montgomery County, Kentucky reported 12 overdoses on Wednesday
- Camden, New Jersey reported 29 overdoses between Tuesday and Thursday
All this news comes in after 27 people overdosed during a five-hour period in one West Virginia town in mid-August.
Still, these shocking and frightening rates springing up in Cincinnati have captured the most national attention.
Officials on a Mission
Newtown Police Chief Tom Synan also heads the law enforcement task force for the Hamilton County Heroin Coalition. This effort is a collaboration of public health and law enforcement officials from Ohio, Indiana and Kentucky working as a collective to combat the heroin epidemic afflicting the tri-state area. Many of these officials are very clear about their concerns, and about their mission. Hamilton County Commissioner Dennis Deters says this is a public health emergency like they have never seen before. Tim Ingram, the county’s health commissioner, said:
“This is unprecedented to see as many alerts as we’ve seen in the last six days,”
Officials are now pleading with the public. They have come out in the news to ask people to avoid the drug. The fact that the source of this potent batch is unknown and still out there makes them disparate to end this uptick in overdoses. Synan states,
“We’re urging you, please don’t do heroin right now. If for no other reason, because we don’t know what’s in the stuff on the street.”
He went on to point out the blatant disregard of dealers, saying:
“These people are intentionally putting in drugs they know can kill someone. The benefit for them is if the user survives, it is such a powerful high for them, they tend to come back. … If one or two people die, they could care less. They know the supply is so big right now that if you lose some customers, in their eyes, there’s always more in line.”
Harder to Fight
Further complicating matters is that Narcan– the drug that reverses the side effects of an overdose- is not working anymore, or at least not as reliably in cases such as these. When it comes to heroin overdoses, one or two doses of Narcan will stabilize a patient. So Narcan, and the generic Naloxone, expansion programs have taken great bounds forward in providing a line of defense.
However, these recent overdoses required two or three times that dosage. These more potent mixes have proven not only to be more deadly, but far more resilient to any medication-based efforts to save lives. Cincinnati is definitely not the only state in the nation dealing with this issue. The problem is growing, and with it so it the death-toll.
Now even more efforts must absolutely be put into raising awareness and providing education to the public. With such powerful new elements being introduced into the fight, the world should know what it’s up against. Real solutions should be made available, and real recovery begins with effective treatment.
CALL NOW 1-800-951-6135