Since 1999, recorded drug overdose deaths in America have quadrupled. Opioids, whether prescription or illicit, account for over 70% of overdose events and are responsible for the steep annual rise in fatalities.
Addiction and the opioid market behave like a devastating arms race, leaving death and destruction in its wake. Users often start out using weaker prescription opioids with no intention of moving onto more potent ones. However, as tolerance rises, users are forced to seek stronger drugs to keep withdrawals at bay and soon find themselves using heroin or fentanyl.
As our tolerance to various drugs has increased, new substances have appeared on the market and have become more accessible and potent than their predecessors.
Since 2013, the rise in opioid-related overdose deaths started to increase at a rate never seen before. With hindsight, we can attribute this change to a rise in the distribution of a new synthetic opioid in the West: fentanyl.
Fentanyl is a synthetic opioid developed in 1968. As a Schedule II prescription drug, it can only be legally used to manage severe pain. It is most commonly prescribed for those recovering from major invasive surgery or suffering from conditions like late-stage terminal cancer. However, most of the fentanyl contributing to our opioid crisis is not coming from legal pharmaceutical companies.
Fentanyl is easy and inexpensive for illicit producers to make - far cheaper than its weaker cousin heroin. Because of its powerful potency, it is smaller and lighter, making it easy to smuggle. In reduced doses, it has the same opioid effects as heroin, so distributors use it as a cheap, easy-to-move cutting substance for other narcotics. It has also been found in growing amounts in cocaine and black-market versions of prescription medications.
The substance is so potent that law enforcement officers have overdosed simply by brushing up against it while working. It doesn’t take many small sand-sized grains to have fatal effects - fentanyl is said to be 80 times more powerful than morphine.
Testing for fentanyl can be expensive when done every time and requires a user to be prepared with strips. Realistically there is no way for someone to know if what they have bought is laced with this drug before using it.
Even if a manufacturer has mixed in an amount of fentanyl that they believe is less likely to produce overdose, each time it’s taken is still a game of Russian roulette. Once it has been portioned out and sold, we have no better idea of how many grains of fentanyl is in one dose than we do how many orange M&Ms there are in a bag before opening it.
Fentanyl overdose often comes on fast, sometimes when the needle is still in the user’s arm. Heroin overdose can take hours to overwhelm the system, so if you witness a person losing consciousness or showing withdrawal symptoms immediately after use, you have a good reason to suspect a fentanyl overdose. Symptoms of overdose include:
If you see these signs, don’t wait to see if it’s an overdose. The person experiencing these symptoms needs to be treated immediately. Administer naloxone if it is available, and get them to the hospital as fast as possible.
One hundred and thirty-six people die from an opioid overdose every day in the US, and each year these numbers continue to rise. You can help keep yourself or an addicted person you care about safe by carrying and learning how to use naloxone and fentanyl testing strips. However, the most effective way to avoid the roulette wheel spin of fentanyl overdose is to seek treatment and find abstinence.
Many options are available, from publically-funded outpatient programs to private inpatient facilities that will ensure your comfort and safety and give you the best possible chance of successful recovery. Heroin and prescription narcotics are difficult to escape from alone, but with fentanyl sweeping the country, it continues to get riskier all the time.
