RU Texas The Beat

Fentanyl Rapidly Becoming Nation’s Most Urgent Drug Threat

[fa icon="calendar'] Jan 5, 2017 3:37:14 PM / by RU Texas posted in Recovery, Treatment, opioids, Fentanyl, Fentanyl Addiction

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It’s a drug that many believe will be the dominant substance abuse threat of 2017. It has already contributed to a prodigious rise in the already staggering rates of heroin and opioid overdose in the United States. It’s one of the most powerful opioid narcotics known to clinicians, law enforcement and prevention advocates. It was present in Prince’s highly publicized autopsy. It’s called fentanyl, and it’s claiming the lives of more and more Americans each month. Over the past few years, fentanyl has emerged as an increasingly urgent drug threat and its effects have been reported more and more by local and national media outlets as its bodycount increases.

Fentanyl is a potent synthetic opioid narcotic used in the treatment of severe chronic and post-operative pain. It is reported to be 50 to 100 times more powerful than morphine and extremely addictive. Common brand names of fentanyl include Duragesic, Abstral, Subsys, Lonsys and Sublimaze. Fentanyl is often used to treat patients with chronic pain who are tolerant of other opioids. In cases of recreational use, users often don’t even realize they’re taking the drug and wind up overdosing as a result. Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash. The drug is coming into the United States largely from Mexico and China, and is considerably cheaper and easier to produce than pure heroin.

Fentanyl deaths have spiked all across the country, including New York City and Long Island, where the drug has officially replaced heroin as the dominant opioid amidst record overdose rates; Illinois, where deaths are up 42 percent in certain counties; and Oregon, where deaths have nearly doubled since 2014. New Hampshire has become a sort of incubator for fentanyl, in addition to being plagued by other opioids. Perhaps the most tragic and alarming aspect of the American fentanyl outbreak is that experts see no real end in sight, or even a tipping point at which the epidemic will start to wane.

According to a government report released last August, the number of fatal fentanyl overdoses jumped 79 percent in 27 states from 2013 to 2014, while law enforcement seizures of the drug increased 426 percent in eight of those 27 states. States that were most affected of the 27 included Massachusetts, Maine, New Hampshire, Ohio, Florida, Kentucky, Maryland and North Carolina. Fentanyl is resistant to the anti-overdose drug Narcan and should not be handled with bare hands or even breathed in. Law enforcement officers are forced to wear oxygen tanks and protective suits when in a fentanyl manufacturing facility and they can only wear them for 15-20 minutes at a time.

Treatment for fentanyl is the same as that of other drugs; however, detox may even be more difficult. As clinicians, lawmakers, police and prevention advocates brace for an even tougher battle against drug abuse and addiction, they would do well to put fentanyl at the top of their list of priorities. This drug has taken the already pervasive and deadly opioid epidemic to the next level, and shows no signs of slowing down.

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What Does 2017 Hold for Addiction Treatment?

[fa icon="calendar'] Jan 2, 2017 5:09:23 PM / by RU Texas posted in Recovery, Opioid Addiction, Treatment, Heroin Addiction, Fentanyl, New Year

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Fotolia_123519808_Subscription_Monthly_M.jpgAs we begin to settle into another year, it can be overwhelming to contemplate how quickly time passes, and to think about what we failed to accomplish the year prior. The passage of time can be even more overwhelming when we’re working against the ticking clock of addiction. Whether it is ourselves or a loved one that has come to need help for drugs or alcohol, we are quickly reminded of the urgent and decidedly terminal nature of addiction, and the damage it can cause when left unaddressed. To that end, it is worth turning the arrival of a new year to our advantage by examining what is (or should be) on the horizon for clinical treatment in 2017.

This past year, the United States made great strides and sweeping demonstrations of commitment toward the monetization of addiction treatment, from the passage of the Comprehensive Addiction and Recovery Act to various states like New York and Ohio pledging additional resources to fighting addiction within their state. We also, however, saw multiple and highly publicized examples of overdose via social media which put a more-human-than-ever face on the American addiction epidemic. Some of these issues resulted in the direct and undeniable endangerment of children. It is also worth noting that Massachusetts is facing a battle to continue opioid treatment funding.

The reality is that, despite all of the new attention and money going toward addiction in the United States, there continues to be new and emerging threats that make us feel as though we’re taking one step forward and two steps back. It is, therefore, worth examining what types of substance abuse pose a particularly dangerous threat in the coming year in order to develop comprehensive strategies to dealing with them. For example, 2016 saw the seemingly rapid proliferation of a drug called fentanyl, a powerful opioid that is approximately 100 times more powerful than morphine. Its increase in accessibility is leading to an increase in overdose deaths all over the country, including New York, New Jersey, Illinois and more. The fentanyl problem is particularly urgent because the drug has proven to be resistant to Narcan, unlike other opioids.

Also big in 2016 was the continued infiltration of synthetic drugs like U-47700 or Pink. This drug, in particular, has sustained a temporary ban from the US Drug Enforcement Agency because of its involvement with at least 46 confirmed deaths—31 in New York and 10 in North Carolina. Law enforcement agencies have seized the drug in powder form and as counterfeit tablets that mimic pharmaceutical opioids. Earlier this year, law enforcement in Ohio seized 500 pills resembling a manufacturer's oxycodone immediate-release tablets. However, laboratory analysis confirmed that they contained Pink. Pink is usually shipped in from China and is typically combined with other drugs like heroin and aforementioned fentanyl.

Synthetic drugs represent a larger problem of overseas labs changing the chemistry of similar drugs that have already been banned here in the United States in an effort escape legal accountability. Lawmakers have been only marginally effective in keeping up with the regulation and prohibition of these drugs; and by the time they are made illegal, a new and unregulated version is waiting just around the corner. In the meantime dozens of people often suffer fatal overdoses because these drugs were allowed to fly under the radar for so long. This is a problem that has been going on for years, but emerges in different forms on a regular basis. All it takes is a slight change in a seemingly inconsequential chemical compound.

In addition to these latent addiction threats, the United States continues to struggle with a rampant and devastating heroin and prescription painkiller epidemic, as well as the enduring threat of cocaine and methamphetamine. Drugs like oxycodone and hydrocodone, though more difficult and expensive to obtain, continue to be a forceful driver of American overdoses. While 2017 may represent new and old challenges for the addiction care community, it also represents new opportunities to treat those who truly need help, and to, patient by patient, start reversing this tragic and alarming trend. With the right resources, attitude and level of commitment, we can do this.

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