Did you know that 130 people will die after overdosing on opioids every single day in the United States? It’s a number that continues to rise in our nation, and the misuse and addiction to opiates including prescription pain relievers, heroin, and synthetic opioids such as fentanyl, is contributing to a severe national crisis that is affecting the public’s health.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that the total economic burden caused by prescription opioid misuse alone in the United States is around $78.5 billion a year. The figure includes the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.
Despite the figures listed above, opioid deaths are still underreported. In 2017, heroin accounted for 15,428 deaths, which is a similar figure to the year before. It’s common knowledge in the medical community that fentanyl and heroin are not the first drugs that someone will use; instead, they began with using prescription opioids. Total drug deaths related to opiates in 2017 tallied up to 70,237, which was up from an already astonishing 63,632 in 2016, initially the worst year on record.
In a stunning turn of events, more people died in the Vietnam War in two years than opiate drugs. Heroin contributed vastly to the numbers above, but fentanyl was solely responsible for 28,466 total deaths.
The amounts are unfathomable considering there have been significant efforts to stop this epidemic.
Today, for the first time in history, Americans are more likely to die from opioid overdoses than car crashes. Based on information made available to the public, individuals have a 1 in 103 chance of dying in a motor vehicle crash over their lifetime, but a 1 in 96 chance of dying from an opioid overdose. Opioid overdose deaths are now primarily driven by illicit fentanyl, which has spread in black markets for drugs. Mexican drug cartels can shoulder the blame for the rise of fentanyl in the country. It is imported from China and synthesized in clandestine labs south of the border. The drug is being cut with everything from heroin to cocaine.
While the drug crisis has overwhelmed many communities, there are many advocating for its removal from society. In 2017, U.S. President Donald Trump declared the opioid crisis a public health emergency, and the government has been fighting diligently to ensure safety for its citizens. There has been funding toward getting people the treatment they need, which has been a vital piece toward ending this drug crisis.
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Fentanyl is a synthetic opioid that initially was used to treat people with severe chronic pain. The drug is used under the supervision of medical professionals but has become a topic of conversation in the current state of affairs. When the medication is taken as prescribed, it is a fast-acting painkiller that can be used for many different types of pain. Fentanyl was created for those who became tolerant to medications like Percocet, OxyContin, or Dilaudid to manage their pain. When fentanyl is compared to other opiate drugs, it is unique in that it has a high transdermal bioavailability, meaning it is absorbed into the bloodstream through the skin.
Fentanyl works similarly to other drugs in its class. It is a central nervous system (CNS) depressant, but there is one significant difference — it is 50 times stronger than heroin and 100 times stronger than morphine. The natural opioids in our bodies known as endorphins are designed to block pain from being transmitted. Our endorphins do this by binding to receptors at the site of pain, and opioids are much stronger and are intended to mimic the effects put off naturally by the receptors in the brain.
Some drugs offer minimal signs that addiction is developing, but fentanyl is a drug that can only be taken by someone with high opiate tolerance. Those with low tolerance who attempt to consume fentanyl can immediately suffer an overdose. Many of those who do become addicted to the drug say they had no other choice but to try fentanyl because their access to heroin dried up.
As of late, fentanyl has been the drug of choice for dealers, leaving heroin users with no other choice but to buy it. Fentanyl’s strength makes it even more dangerous, and the high fatality rates back up these claims.
Overdose is the primary concern because it is often consumed unknowingly. A tiny amount can cause a person to overdose, as it is 50 times stronger than heroin. Someone who is tolerant of heroin may suddenly end up fighting for their lives if they consume a bag laced with fentanyl. Fentanyl users claim the drug produces euphoria, which makes it a desirable choice.
There are warning signs that are directly related to fentanyl use. The first step is a tolerance when the body gets used to an opioid and counteracts it to balance out brain chemistry. As tolerance continues to grow, you will begin to develop a dependence on fentanyl. At this stage, if you abruptly abstain from the drug, you can experience cravings or intense withdrawal symptoms.
The final stage in a substance use disorder is an addiction, and it is defined as the compulsive use of a drug despite the consequences that follow. If you have been arrested as a result of your fentanyl use and continue to use, this could indicate an addiction.
If you believe that you or a loved one is struggling with a fentanyl addiction, behavioral signs to look out for include:
Addiction treatment is a gradual process that begins in the most intensive phases and decreases as the client responds to treatment. The withdrawal symptoms from fentanyl are not deadly like benzodiazepine or alcohol withdrawal, but it can make someone very sick. Opioid withdrawal is uncomfortable and has been described as symptoms akin to the flu. Medical detoxification is the first and necessary step in the continuum of care. It will ensure the client is comfortable for the duration of their stay.
When the client has reached the point where fentanyl is removed from their system, they will be moved into the next level of care. Since fentanyl addiction is extreme, they will likely be placed into residential care. Today, there are new methods called Medication-Assisted Treatment (MAT). It allows someone in the depths of opioid addiction to take drugs like methadone or Suboxone in conjunction with their therapy. It will help manage their cravings and let them abstain sobriety if traditional treatment has not been effective.
Addiction treatment will be coupled with therapies that are designed to change behaviors and how someone responds to cravings. These include:
The purpose is to discuss triggers that are going to occur post-treatment. The client will also create a relapse prevention plan that helps deal with the stress of life once they leave the security of treatment.
National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
White House. Ending America’s Opioid Crisis. Retrieved from https://www.whitehouse.gov/opioids/
Drug Enforcement Administration. Fentanyl. Retrieved from https://www.dea.gov/factsheets/fentanyl
NIDA. Trends and Statistics. Overdose Death Rates. Retrieved from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
Centers for Disease Control and Prevention. (2019 September 11) Statcast. Week of September 9, 2019. Retrieved from https://www.cdc.gov/nchs/pressroom/podcasts/20190911/20190911.htm