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
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
You may remember back in early 2016 the pharmacy organization Walgreens announced two programs to address key issues in the opioid crisis.
- Safe medical disposal kiosks for unused prescription drugs
- Narcan expansion programs
By the end of 2016, Walgreens had expanded access to the opioid overdose antidote without the requirement of a prescription to 33 states and the District of Columbia. The Narcan opioid overdose antidote, also known by the generic name Naloxone, is a nasal spray that is utilized all over the country as a means to revive someone experiencing an opioid overdose.
Now, this life-saving compound is becoming even more accessible, as Walgreens is announcing the Narcan opioid overdose antidote will now be available at all of its over 8,000 pharmacy locations!
Pharmacies Stepping Up to the State of Emergency
This new move to combat the opioid epidemic comes at a crucial time. The epidemic continues to claim lives every day, with recovery advocates and government officials rallying for more resources to fight the problem.
Today, Thursday, October 26, 2017, the nation is expecting President Donald Trump to officially declare the opioid crisis a public health emergency at a scheduled White House event.
According to Rick Gates, Vice President of Walgreens,
“By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed.”
The company offers Narcan opioid overdose antidote without a prescription in 45 states and is willing to work with the remaining states to make to include them.
Of course, the fight for more availability of Narcan and Naloxone has been going on for some time. However, it seems as the country is calling for more sweeping action from government officials; pharmacies are taking it as a call to action themselves. Rick Gates went on to say,
“As a pharmacy, we are committed to making Narcan more accessible in the communities we serve.”
Walgreens also says it will inform customers about the Narcan opioid overdose antidote if they receive drugs with more than 50 morphine milligram equivalents (MME). This is actually a recommendation from the CDC.
It isn’t just Walgreens either. CVS pharmacy has expanded access to Narcan and other products that contain naloxone. CVS reportedly has been offering prescription-free naloxone in up to 43 states as of last month. CVS pharmacies have said that its locations “in most communities have naloxone on hand and can dispense it the same day or ordered for the next business day.”
Big Pharma’s Role
Big Pharma wholesaler AmerisourceBergen is also helping in these efforts. AmerisourceBergen is now distributing Narcan demo devices at no cost to Walgreens pharmacists. These demo devices will help with instructing patients on how to administer the medication safely and effectively.
Robert Mauch, Executive Vice President & Group President, Pharmaceutical Distribution & Strategic Global Sourcing for AmerisourceBergen, states,
“At AmerisourceBergen, we strive to provide our customers the highest quality care and support so they can ultimately enhance the lives of patients in their communities,”
“We recognize the important role we play in addressing the opioid epidemic, and our collaboration with Walgreens is another key milestone to supply our customers with access to lifesaving initiatives and emergency medications that can help keep individuals safe across the country.”
Ironically, AmerisourceBergen just so happens to be one of the three largest drug distributors that were mentioned in the recent 60 Minutes interview with ex-DEA agent Joe Rannazzisi. In the segment that has since caused a major uproar, Rabbazzisi said companies including AmerisourceBergen controlled probably 85%- 90% of drugs that went “downstream” and ended up on the streets.
This might not be what Mauch meant by “recognize the important role we play”, but at least it seems like AmerisourceBergen is taking steps to become part of a solution.
Meanwhile, Adapt Pharma, the manufacturer of Narcan Nasal Spray, celebrates this action by Walgreens to expand naloxone and Narcan access. Seamus Mulligan, CEO at Adapt Pharma states,
“This action is an important milestone and we applaud Walgreens initiatives to improve access to Narcan Nasal Spray in communities across the U.S.,”
“This effort, combined with the opportunity for patients and caregivers to obtain Narcan Nasal Spray without an individual prescription in 45 states, is critical in combating this crisis.”
America is working hard to find the right path on the road to recovery from the devastating opioid crisis. It is crucial that we make every possible resource available to help save lives. With opioid overdose killing an estimated 91 people every day, the need for this life-saving medication could not be more evident.
Beyond reversing the effects of an overdose, there is more we need to do. While having access to Narcan and naloxone can help tremendously, we also need to promote recovery and addiction treatment resources. Preservation of life is important, but giving people the help they need to live a happier and healthier life should also be a priority in the fight to overcome the opioid crisis. Palm Partners Recovery Center believes in actively providing the best in innovative and holistic treatment opportunities, to help transform lives. If you or someone you love is struggling with substance abuse or addiction, we want to help. 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: Shernide Delva
In the past, we’ve talked about the potential of opioid vaccines. These vaccines could have a major impact on lowering a number of opioid overdose deaths. They could completely shift the direction of how we treat opioid addiction. However, is the future of opioids imminent or far, far away?
Sadly, it will be a long time before we see opioid vaccines available for widespread use. Experts all agree that although the future of opioid vaccines looks bright, the process of getting a drug into the market is a lengthy one and we should not hold our breath just yet.
Recently, Health and Human Services Secretary Tom Price mentioned opioid vaccines as an exciting new development in the war against opioid abuse.
“One of the exciting things that they’re actually working on is a vaccine for addiction, which is incredibly exciting,” Price said during a briefing about the drug epidemic.
However, experts say it won’t be made public for years… if ever.
The process of a drug going from the research phase to the production phase is a long, tedious process. Opioid addiction vaccines have not even begun human trials yet. Researchers would have to put drugs through phase one, two and three trials before submitting them for approval by the Food and Drug Administration (FDA), given that the trials are successful.
“He may be a physician, but he’s not terribly well-informed about addictions,” said Dr. Thomas R. Kosten, a psychiatry professor at the Baylor College of Medicine with a concentration in addiction vaccines. “I can’t imagine the vaccine would be on the market before the Trump administration is over.”
Dr. Kosten knows all about vaccines. He worked on cocaine vaccines for 16 years before deciding that it “just didn’t work well enough” to continue. Today, he is working on a vaccine for fentanyl, an opioid painkiller up to 100 times stronger than morphine. Fentanyl has been a major culprit for overdose deaths in the current opioid epidemic.
Those who previously used painkillers turn to heroin due to the lower price and easier access. Unfortunately, often heroin is not just heroin and instead is laced with powerful painkillers like fentanyl which make a user much more susceptible to an overdose.
Dr. Kosten hopes his work on the vaccine will pan out, but he wants to ensure people are not holding their breath. These things take time.
“There are no opiate vaccines that have been in people at this point,” said Dr. Kosten.
Even if the vaccine passes trials and goes into full-scale production, it would only be used therapeutically, not as a preventative measure.
“The purpose is not to “mass-immunize a whole bunch of kids,” Dr. Kosten said. “That’s not at all what they’re designed for.”
For now, the vaccine is proving to be effective in animal testing. However, this is not necessarily good news.
“Sometimes, the translation from animals is not necessarily the same in humans. So we have to do the human studies,” said Dr. Ivan Montoya of NIDA’s Division of Therapeutics and Medical Consequences.
The goal of the vaccine is to allow the body’s own immune system to combat opioids before they can reach the brain and take effect.
“We don’t have to modify the brain to produce the effect,” said Dr. Montoya. “You take advantage of your own immune system and prevent access of the drug to the brain.”
In the future, Dr. Montoya hopes to come up with a vaccine that can block the effects of a wide range of opioids including fentanyl, heroin, and OxyContin.
While the prospect of opioid vaccines sounds promising, we are still far away from this becoming a reality. Therefore, stating vaccines as an exciting solution to the opioid epidemic is a bit of a stretch for now. Instead, the focus should be placed on increasing access to treatment. With the right program, recovery is possible. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135