Opioid crisis: Illegal Fentanyl spikes in the US

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FENTANYL

Aligned with a dramatic increase in abuse and deadly overdose, U.S. law enforcement reports a continued spike in cases involving synthetic opioid Fentanyl over the last three years. Encounters with the drug more than doubled in 2014 alone.

Fentanyl is a synthetic opioid that is similar to morphine but 50 to 100 times more potent – and dangerous. Though it is meant to be used for cases of extreme pain, such as cancer patients and end of life palliative care, illegally manufactured sources of the drug have been popping up both in the U.S. and internationally.

The following was compiled with data from the U.S. Drug Enforcement Agency (DEA) and the Center for Disease Control (CDC).

According to CDC’s Morbidity and Mortality Weekly Report published in September, 2016, there was a strong correlation between increases in synthetic opioid deaths and in seized Fentanyl products. That suggests, the authors say, “that illegally manufactured fentanyl is driving the spike in overdoses.”

In a growing number of cases, Fentanyl is being mixed with or completely replacing quantities of heroin being bought on the street. Often without the knowledge of the user. This has played large part in the uptick of both arrests and fatal overdoses involving illegal Fentanyl.

Key findings from the CDC and DEA also include:

  • The number of fentanyl encounters more than doubled in the U.S. from 5,343 in 2014 to 13,882 in 2015.
  • 13 states reported that fentanyl encounters grew by 100 or more from 2014 to 2015, with rapid increases reported in the Northeast (New Hampshire and Massachusetts) and Midwest (Ohio) and with additional patterns developing in the South.
  • The steady increase in fentanyl encounters from 2013 to 2015 indicates that the supply of fentanyl, primarily illicitly-made fentanyl, continues to increase primarily east of the Mississippi with small increases west of the Mississippi.

Opioid abuse and fatal overdose continues to skyrocket in the U.S.

According to the UN Office on Drugs and Crime, between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.3 million people in the United States who suffer from addiction in 2015. Between 2001 and 2014 the number of reported overdose deaths from prescription opioids more than tripled from 5,528 to 18,893 a year.

Historically in the U.S., opioids were typically reserved for people just after surgery, with severe injuries, or those with chronic cancer pain whose suffering was only going to get worse and required drastic measures to address it humanely. Most doctors were taught the similarities between prescription opioids and heroin in regards to their chemically addictive properties. In turn, opioids were only prescribed for these extreme pain cases.

In the 1990s, as a new generation of opioid medications were being rolled out by companies such as Purdue Pharma, Pfizer, Johnson & Johnson, and Endo Pharmaceuticals, there became changes to the culture of palliative medicine that encouraged opioid prescription for a larger variety of pain treatment – not just the original FDA labeling specifically directed at treating cancer pain.

Legal prescriptions to opioid pain medication have more than quadrupled since 1999 – increasing in tandem with overdoses involving the most commonly used opioid pain relievers, such as OxyContin, Vicodin, and morphine.

Four in five new heroin users started out misusing prescription opioid painkillers. As a consequence, the rate of heroin overdose deaths nearly quadrupled from 2000 to 2013.

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In fact, in a National Institute of Drug Abuse 2014 survey of people in treatment for opioid addiction, 94 percent of respondents said they chose to use heroin because prescription opioids were “far more expensive and harder to obtain.”

In these cases, prescription opioids were the gateway drug.

In response to the opioid abuse crisis, the CDC has recommended expanding the use of naloxone, an antidote to opioid drugs, as well as expanding the use of addiction treatment that includes medications.

In 2016, pop star Prince died of a fatal overdose to Fentanyl, which he had originally been taking to treat severe chronic pain. Just hours before his death, Prince had been consulting with doctors to address his addiction to the drug. The case of Prince may have been telling, as he had reportedly lived most of his life drug and alcohol free – with had no previous tendencies for substance abuse.

The Center for Disease Control (CDC) states the death rate of synthetic opioids, which includes Fentanyl, increased by 72.2% from 2014 to 2015. Synthetic opioid death rates (other than methadone) increased across all demographics, regions, and numerous states.