There are an estimated 2.1 million Americans currently suffering from an opioid use disorder, and the government has deemed this a public health emergency. Prescription opioid overdose deaths have more than tripled in the past 20 years and unintentional overdose deaths from opioids have more than quadrupled since 1999. Roughly 91 Americans die each day from an opioid overdose. In the United States, overdoses kill more people than guns, or car accidents. Drug overdose is the leading cause of accidental death in the U.S., with over 75% of all overdoses attributed to opioids. Unfortunately, this epidemic is going to get worse before it gets better. This crisis has also sparked a dark underbelly of opportunistic criminals with access to a substance called Fentanyl. Fentanyl is relatively cheap, easy to order via the dark web, shipped primarily from China to any doorstep in the United States, and up to 50 times more potent than heroin. This year, one synthetic version called U-47700, commonly called “pink,” was linked to the deaths of two 13-year-olds in Park City, Utah. “Pink” is 12 times more potent than morphine, acetylfentanyl is 15 times more potent than morphine, and butyrfentanyl is over 30 times more potent than morphine. The most dangerous form is of fentanyl is carfentanil, used as a large-animal anesthetic in zoos. Carfentanil is 10,000 times more potent than morphine. Fentanyl-related overdose deaths increased by 78% in Utah during 2016. According to the Utah Health Status Update, there were 41 fentanyl-related deaths in 2016. That’s over three times as many as the 23 deaths reported in 2015. The report stated: “The majority of fentanyl-related deaths in Utah involve pharmaceutically sourced fentanyl; however, beginning in 2016, there has been an increase in deaths from illicit fentanyl.” Unfortunately synthetic opioids that have been produced in a lab are easily available for purchase online. China is a major supplier of fentanyl that come from illegal labs. This fentanyl is imported to the United States where it is used as a cutting agent for opioids and other drugs. Fentanyl is much more powerful than heroin and other opiates. Because fentanyl has been appearing in other opiates, many drug users do not even know they are ingesting it while abusing substances.
Here is what Andrew Sidoli, Executive Clinical Director at Recovery Ways had to say about the problem: “Recovery Ways’ patients report a widening variability in the potency of both heroin and black-market pills that is unpredictable. One dose may have very little effect, while the same dose of a seemingly identical product results in overdose. DEA seizures of counterfeit hydrocodone and oxycodone tablets this year have revealed the presence of fentanyl. These fentanyl tablets are marked to mimic other prescription pills such as Xanax. Just 2 milligrams of fentanyl can be fatal, and first-responders have overdosed through skin absorption and inhalation of airborne powder. This year, first-responders in Utah handling evidence or assisting overdose victims, reported dizziness, breathing problems, and even loss of consciousness. Even police dogs, whose job it is to sniff out narcotics, suffered overdoses after ingesting fentanyl (some handlers carrying antidotes to save them). First-responders are urged to use extreme caution, even during routine calls, and to use protective gear, including full bodysuits, when collecting unknown powdery substances. Earlier this year, a multimillion-dollar drug trafficking ring based in Cottonwood Heights, Utah, uncovered an operation that allegedly sold fentanyl-laced pills pressed to look like tamer prescriptions drugs. Customers throughout the nation ordered the pills online, which included fake Oxycodone and counterfeit Xanax. The distributors allegedly laundered money through bitcoin, and accepted the digital currency as payment. Agents seized 240 grams of fentanyl, and had previously raided another residence in South Jordan, Utah, where they found 100,000 counterfeit pills. Many fentanyl overdoses occur to people believing they are taking another drug. When those suffering from addiction purchase pills that originate from an unknown source, they are often unaware that they could be taking fentanyl-laced pills, and many of them unwittingly overdose as a result. Making counterfeit pills is like making chocolate chip cookies. When I bake chocolate chip cookies, I can’t control how many chocolate chips end up in each individual cookie. Some cookies may turn out to have very few chocolate chips, and some cookies may be abundant with chocolate chips. When pill counterfeiters using pill presses mix fentanyl with binding agents, it’s like making chocolate chip cookies with cookie dough. Some pills may come out with very little fentanyl, and some pills may turn out to have very high doses of fentanyl. Heroin is also increasingly cut with fentanyl to increase potency, and the result similar: one cannot control exact outcome of each bagged dose. A person suffering from addiction may buy $10 of heroin off the street, which is their typical dose (.05 gram). If that particular dose was cut with fentanyl, their seemingly “usual” dose could be lethal. The accessibility of Naloxone, which reverses opioid overdoses, has become more widely available and easily accessible, but there is much more that needs to be done before we can fully reverse this opioid epidemic.”
