Fentanyl — Worse than Heroin

The drug may be nothing new. But the headlines from just the past few days are clear and clearly devastating. We have a new and very big problem — and its name is fentanyl.

Out of Fox40 in Sacramento, “Seventh Person Dies from Fentanyl Overdose in Sacramento County”; from the Arizona Daily Star, “Fentanyl — the strongest opioid — making its way into Arizona”; and this from The Washington Times over the weekend: “Fatal overdoses caused by fentanyl increase in West Virginia”; and on Monday, Pharmacy Today ran this headline: “Heroin epidemic is yielding to a deadlier cousin: fentanyl.”

The list goes on and on.

Fentanyl, for those unfamiliar with the background, was first created in 1959 as an opioid used for pain management. The powerful analgesic, said to be 30 to 50 times stronger than heroin, is only now making an appearance among recreational users. The consequences are often deadly.

Federal agents are investigating how fentanyl found its way to Jerome Butler, 28, the first publicly known victim in the Sacramento area along with others who suffered overdoses starting last week.

“Fentanyl is nasty, nasty stuff,” Rusty Payne, spokesman for the federal Drug Enforcement Administration in Washington, D.C. told The Sacramento Bee. “And we’re seeing it more and more all over the country.”

In Cuyahoga County, Ohio, the drug is blamed for the deaths of at least 22 people so far in the month of March 2016, including 12 in a five-day span between March 10 and 14, county officials told cleveland.com.

“We’re seeing much more significant overdoses, not just in the number of them but in their severity,” Dr. Carla O’Day, director of the emergency department at St. Vincent’s Charity Medical Center in Cleveland, told the website.

The Centers for Disease Control last fall did a study in Ohio on those who are impacted and who are most at risk. WHIO TV reported recently that for the first time, health officials are now able to put a face on the heroin and fentanyl epidemic and it doesn’t fit the stereotype — it is white, suburban, educated men.

“Whenever a new drug comes out, you always have overdoses and deaths,” said Steve Galeria, a retired undercover narcotics detective in Los Angeles. Early street users of crack cocaine are a perfect example of this. Heroin addicts who began using crack tried to inject the new drug. “Crack isn’t water soluble,” Galeria told LifeZette. “It’s like putting sand in your veins, and it causes heart attack.”

Now, users are mixing fentanyl into their heroin to make it more potent. “Cutting heroin with fentanyl is the worst possible idea that you can imagine,” Dr. Childers said. “Opiate receptors in the brain not only produce a euphoria, but they also block the brain’s control of respiration. You can die from respiratory depression.”

[lz_bulleted_list title=”Drug Overdose Deaths” source=”http://www.cdc.gov”]Overdose deaths increased significantly from 2013 to 2014.|Deaths involving heroin, specifically, are up sharply.|Trend is closely tied to opioid pain reliever misuse and dependence.|Availability, cheap price, high purity are the biggest concerns. [/lz_bulleted_list]

But creating more potent drugs is just part of the drug culture, according to Galeria. Heroin on the streets now is about six times more powerful than it was as a new drug in the 1970s. Even marijuana — child’s play compared to a compound like fentanyl — is about 10 times stronger.

“More recently, there have been clandestine laboratories that synthesize cheap versions of fentanyl,” Dr. Steven Childers, professor of physiology and pharmacology at Wake Forest Baptist Medical Center, told LifeZette. Nobody is holding these labs accountable for the purity of the medicine, he said, and they contain “all kinds of toxic compounds, solvents — even human fecal matter.”

Falling prey to the addiction can happen innocently and easily.

While in college at Brigham Young University-Idaho in Rexburg, Andrew Thompson (not his real name) began borrowing Adderall from his fiancée to help him focus better in his classes.

Thompson had been to several doctors in search of help for his attention problems, and they all prescribed him antidepressants. But Adderall gave him what he wanted: focus and energy. So when he went to his primary care physician and explained what he needed, the doctor readily handed out a prescription for the medicine. “If you need some extra help for a test, go ahead and take an extra pill,” the doctor said, according to Thompson.

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But the doctor didn’t explain that Adderall is an amphetamine, a nervous system stimulant that can be a gateway drug for more serious drugs. It only took three days before Thompson was addicted. Soon he was taking triple the recommended dosage. Then he began crushing the pills and snorting them on the morning of a big test so that they would take effect faster.

Thompson began using Adderall illegally in 2004, and from there it was a quick trip to harder drugs like meth. He didn’t realize he was a drug addict until six years later. He just thought he was making use of a medicine to help his mind function better.

Recent statistics from the National Institute on Drug Abuse show Thompson is a member of a large crowd. Approximately 52 million people in the U.S. over age 12 have used prescription drugs non-medically in their lifetime — and 6.1 million people have used them non-medically in the last month.

When Thompson realized he was addicted, he went to his parents for help. They checked him into a highly rated recovery program, but it was basically a hoax.

“They had him drink something that was high in vitamins, put him in a sauna to sweat out the drugs, and then made him jog. But (in) the rest of the program they tried to indoctrinate him into Scientology,” said Amy Thompson, Andrew Thompson’s mother. He ended up climbing out the window and calling his drug dealer to come pick him up.

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Experts suggest a variety of approaches to address the emergence of fentanyl. Dr. Ruth Potee, medical director of the Franklin County House of Corrections, said that a “just say no” mentality is not enough today.

“Our kids need to be taught how to manage uncomfortable feelings and situations in healthier ways,” she told LifeZette. “Learning to exercise, meditate, pet a dog, sit with a friend when you are feeling overwhelmed, angry, or sad is a much healthier approach to life’s hardships than to numb yourself up with sugar, video games, or drugs.”

Thompson is still working on recovery. A good program in Savannah, Georgia, helped him get clean for close to two years.

Now he is an assistant manager at the Walmart in his town in Arkansas, but he has started taking half a pill of Adderall each day — just to clear his head.

“I’ve told him that it’s a bad idea, but that’s all I can do,” said Amy Thompson, his mother. “If I worry I’ll make myself crazy. Am I concerned? Heck, yeah.”

This piece has been updated.