The Centers for Disease Control and Prevention says that fentanyl is responsible for 29% of all fatal overdoses. This makes it the #1 cause of ODs in the U.S.
Throughout every era, the American population seems to gravitate toward a different drug.
The 1980s had cocaine. The 90s had heroin. In the early 2000s, addicts took to prescription drugs like Oxycontin and Vicodin.
And while all of those drugs remain prevalent today, it appears that fentanyl, an addictive painkiller is the defining drug of our time.
Although it was invented in 1960, the opioid has become a household name within the past few years. The drug’s infamy stems largely from the fact that it contributes enormously to America’s growing overdose rate.
In fact, the Centers for Disease Control and Prevention recently declared that it is the #1 cause of drug overdoses in the United States.
In their most recent National Vital Statistics Report publication, the organization outlines some statistics around overdose rates in the U.S. Specifically, they look at which drugs cause the most overdose deaths.
Their findings: fentanyl has quickly become the biggest killer. Although heroin killed the most Americans between 2012 and 2015, this synthetic opioid has taken the title. Each year, the number of people who die from it doubles, meaning that the country has a crisis on its hands.
But what is this deadly drug, anyway? Where did it come from and what is it prescribed for? And, most importantly, what can be done? Where can fentanyl addicts find the treatment they need?
In this article, we’ll answer all of those questions and more.
What is Fentanyl? A Brief Profile of the Deadly Substance
If you’ve never heard of this highly addictive drug before, here’s what you need to know:
Fentanyl is a synthetic opioid. Much like oxycodone and hydrocodone, it’s a drug created in labs to mimic the effects of natural opioids like heroin.
The difference, however, is that this drug is far more powerful. According to the National Institute on Drug Abuse, it’s between 50 and 100 times more potent than heroin.
It is currently classified as a Schedule II prescription drug.
According to the U.S Drug Enforcement of Administration, drugs with this classification have accepted medical use. However, they also have a high potential for abuse and are known to cause addiction.
Other drugs with this classification include morphine, opium, oxycodone, and hydrocodone.
Fentanyl products are produced and sold by a number of different manufacturers. Janssen makes a project called Sublimaze, for example. Teva Pharmaceutics makes a similar product called ACTIQ.
Other brand name products include Instanyl, Abstral, Lazanda, Haldid, Fentora, and Duragesic. Each is manufactured by a different company.
The drug is also manufactured illegally in “pill mills”. Many experts believe that these fentanyl analogs are responsible for the large majority of overdose deaths.
The drug is mainly prescribed to individuals who suffer from chronic pain. They may experience pain as a side effect of another illness like cancer or as a symptom of a painful disease like fibromyalgia.
Typically, doctors prescribe it to those who’ve developed a tolerance to less powerful opioids.
In recent years, the drug has been employed in capital punishment. A death row inmate in Nebraska, for example, received a lethal injection of fentanyl as part of his death sentence in 2018.
Obviously, the drug is also used for recreational purposes, as well. Many drug dealers actually cut batches of heroin and cocaine with fentanyl, too. This helps them to increase their profit margins.
The drug comes in a range of different forms. When sold as a legal, prescription drug, it’s often found in pill or tablet form. Sometimes, patients are given the drug in lollipop form as an alternative to traditional pills.
Occasionally, it’s administered via injection. This is usually the case when patients receive during or after major surgery.
Some patients also take it in the form of an adhesive transdermal patch that sticks to the arm like a nicotine patch.
Much like heroin, the drug is usually found in powder form on the street. Users snort, smoke, and inject the powder. Sometimes, the powder is formed into pills. Oftentimes, it’s mixed into other drugs.
Fentanyl is an opioid drug. So, it has a similar mechanism of action to other drugs in that family.
Essentially, these drugs allow the user to receive extra dopamine by blocking the opioid receptors in their brain. When the inhibitors are blocked, more of the neurotransmitter is able to flood in.
Opioids also dull a user’s pain by releasing GABA and other neurotransmitters into their system. The main difference between fentanyl and other opioids is that it generates far more neurotransmitters than other drugs. This is what it’s so much more powerful.
This drug has a relatively short half-life, which means it doesn’t stay in the user’s system for too long. That is why it is administered in prolonged-action forms like transdermal patches and lollipops.
When a user takes fentanyl, their body expels roughly 50% of the drug every 90 minutes. If someone were to take 100 micrograms intravenously, for example, roughly 50 of those would pass through their system within the first two hours.
In this sense, the drug is quite comparable to morphine which has a similar half-life.
The drug is intended to ease pain. However, it can cause a number of side effects. Some of them include:
- Back pain
- Chest pain
- Dry mouth
- Limb swelling
- Stomach inflammation
- Rapid heartbeat
- Blurry vision
The drug goes by a variety of different names on the street including China girl, China white, TNT, Tango, Cash, Friend, Goodfella, Jackpot, and Apache.
What We Learned from the CDC Report
The CDC’s report, released in December of 2018, gave us a poignant insight into the way the drug crisis is affecting our country.
In particular, it showed us just how dramatically fentanyl has taken over the country.
Although the drug is responsible for 29% of all overdose deaths today, for example, the report points out that it hasn’t been that way for long. In 2011, just a few years ago, the substance was involved in only 4% of fatal overdoses. At that time, the main culprit was oxycodone.
But, oxycodone’s reign was not nearly as bad as the one fentanyl currently has on Americans. Even at its peak, the drug was responsible for only 13% of overdose deaths.
And today, while drugs like Oxycontin kill roughly 6,100 Americans each year, fentanyl is involved in nearly 18,000 deaths. That’s three times as many fatalities!
It’s almost terrifying, actually, to see how quickly the drug’s popularity has spiked. In just 2015, the drug was only responsible for around 8,000 deaths. And while that’s certainly a lot, it’s not nearly as bad as the almost-20,000 deaths it caused just a year later.
Furthermore, the spread between fentanyl’s fatality count and that of other drugs was startling. Although heroin, the number 2 killer on the list, was involved in roughly 16,000 deaths, crystal meth (the third leader) caused only 11,000 deaths.
Again, those numbers are quite high. But, it’s quite scary to see how much larger the synthetic opioid’s death count is.
A Brief History of the Drug
This drug has been on the market since the mid-1900s. But it only gained popularity in recent years. How did it get to this point?
It’s often quite interesting to take a close look at the history of drugs. After all, most of them exist for decades before they become a large problem in the community.
Oxycodone, for example, existed for nearly a century before it started to be overused on a widespread basis.
Fentanyl has a similar story. Developed in 1960, it took decades for the drug to become a cause for concern. Here’s a brief rundown of the drug’s history:
1960: The Development of Fentanyl
Dr. Paul Jansenn created the first iteration of the drug. Janssen was a chemist from Belgium. His intention was to synthesize a painkiller that was more potent than those offered at the time.
1968-1972: FDA Approval
The United States Food and Drug Administration was hesitant to approve the drug. Many of its detractors argued that it was too powerful for public consumption.
In the end, the FDA decided to approve the drug under one condition: it must be combined with droperidol, a chemical that could limit its potential for abuse.
In 1972, however, the organization approved the drug for use on its own.
1981: Janssen’s Patent Expires
Between 1960 and 1981, Janssen remained the drug’s sole manufacturer. They primarily sold the drug to hospitals for cardiac and vascular surgery purposes.
In 1981, however, Janssen’s patent expired, opening the drug up to new manufacturers. As a result, sales increased by more than 1000% in the United States alone.
1990s: New Fentanyl Products Hit the Market
Once Janssen’s product went off-patent, other drugmakers began to experiment with new iterations of the drug. The ALZA Corporation, for example, developed their adhesive patch in the early 90s. The product remains one of the most popular forms of fentanyl today.
The Anesta company released Actiq, the first painkiller lollipop product, in 1998.
Simultaneously, illegal manufacturers began to produce the drug in laboratories.
2000s: The Spread of Misuse
“While the Actiq lollipop was developed for cancer patients, for example, data showed that less than 20% of users actually had cancer.”
By the early 2000s, the painkiller was widely used both legally and illegally.
It was around this time, however, that officials started to take notice of the high number of overdoses it was responsible for. Between 2005 and 2007 alone, more than 1,000 people died from illicit doses of fentanyl.
But illegal batches weren’t the only problem. The FDA recognized that it was also being over-prescribed by doctors and that patients were overusing it, too.
While the Actiq lollipop was developed for cancer patients, for example, data showed that less than 20% of users actually had cancer.
2010 and Beyond: The Problem Gets Worse
Shortly after 2010, officials took note of climbing overdose rates related to the drug. While the problem seemed to stem from the New England area, it quickly spread to the midwest and southeast.
Although officials were able to pinpoint Mexico as the source of the supply, they also found that much of it was coming from China.
Unfortunately, overdose rates climbed steadily. According to the Centers for Disease Control and Prevention, fentanyl was involved in roughly one-third of all drug overdoses that happened in 2016.
Fentanyl in the Public Eye: Celebrity Overdoses
The drug has killed dozens of stars including Prince, Tom Petty, Mac Miller, and Lil Peep.
When megastar musician Prince died of a fentanyl overdose in 2016, the drug was not yet a household name. Although it had killed a few dozen Americans in that decade alone, people were still blaming the opioid crisis on heroin and Oxycontin.
It Prince’s death, however, that seemed to bring the drug into the public spotlight. With BBC publishing articles with titles like “It led to Prince’s death, but what is the prescription medication fentanyl”, the non-using public started to understand this drug’s effect on culture.
“This is kind of a wakeup call for people around the country about the power and danger of these pills,” said Bob Woodruff, ABC News correspondent.
But while the public has become increasingly aware of the drug’s danger, it still continues to kill people.
Of course, other celebrities have died from it as well. Amongst them was singer-songwriter Tom Petty, who died accidentally from a cocktail of fentanyl with other opioids.
“This is kind of a wakeup call for people around the country about the power and danger of these pills.” – Bob Woodruff, ABC News
As the BBC’s announcement article explains, the artist had been overusing the drug for a period of time before his death. “Many people who overdose begin with a legitimate injury or simply do not understand the potency and deadly nature of these medications,” his family wrote in a Facebook post, taking the opportunity to educate the public.
More recently, the public was stunned when young rappers Malcolm “Mac Miller” McCormick and Gustav “Lil Peep” Ahr both died from an OD on the substance.
Miller was found with the drug in his system, alongside some cocaine and fentanyl. Ahr, on the other hand, tested positive for cannabis, cocaine, Tramadol, and alprazolam in addition to fentanyl.
In both cases, the public speculated that neither of them was aware of what they had taken. Ahr’s brother, for example, suggested that the singer didn’t know his drugs were laced.
“He thought he could take what he did,” Karl Ahr said in an interview with People, “But he had been given something and he didn’t realize what it was.”
Whatever the case, it’s clear that these deaths have greatly increased awareness around the drug’s effects. Although tragic, these celebrity overdoses have started to teach the general public about what these substances are capable of.
Many Users Don’t Even Know What They’ve Taken
“[My nephew’s] story could very well save your child’s life…Please, share his story.”
A recent article, published on WSBTV.com, profiles one Arizona woman who lost her nephew to a fentanyl overdose.
Her nephew, who was only 19 years old at the time, died after overdosing on pills that he thought were Percocet. Like many illegally-manufactured drugs circulating the street today, however, the pills were laced with fentanyl.
Because his body was likely not prepared for the drug, it sent his system into shock. Ultimately, the young man wound up dying.
“[My nephew’s] story could very well save your child’s life,” the woman wrote in a Facebook post, urging parents to warn their children about the prevalence of the drug, “Please, share his story.”
It Happens All the Time…
The story is not uncommon. It’s a regular occurrence for users to take fentanyl by accident.
After all, dealers often use the drug as a “cutting agent”, or filler. They sell it to unsuspecting customers who believe they’re buying something else.
A special report entitled Dope Sick, published on STATNews.com, goes in-depth on this topic.
“Fentanyl is a stealth killer,” David Armstrong, the article’s author writes, “[It’s] often sold to clueless buyers as heroin, prescription pain pills, or the anti-anxiety medication Xanax.”
“In Sacramento, 12 people died after taking what they thought was Norco. In Clearwater, Florida, 9 users died from taking fake anti-anxiety pills with fentanyl in them.”
The article tells the story of two young friends, DJ and Justin, who developed a taste for the drug without even knowing what they were taking. Although the two men experimented with a number of different drugs together, DJ would eventually die from a fentanyl overdose.
Both Justin, who survived, and DJ’s family were surprised to learn from the toxicology report that heroin was not the culprit. At the time, the two best friends had been using the narcotic.
But, as the article explains, “[The toxicology] team didn’t find any heroin. What they did discover was a lethal dose of fentanyl”.
And, as Armstrong illustrates in his piece, this occurs frequently in cities all over America. He points out that, in Sacramento, 12 people died after taking what they thought was Norco. In Clearwater, Florida, 9 users died from taking fake anti-anxiety pills with fentanyl in them.
Obviously, it’s scary to consider such a deadly drug circulating through the market. But, it only proves that increased awareness around the drug is necessary.
Where is All of this Fentanyl Coming From?
Although the drug is responsible for a massive number of deaths each year, it’s actually relatively hard to obtain legally.
While doctors were largely responsible for overprescribing it earlier in the decade, the Drug Enforcement Agency took steps to limit its manufacture and prescription.
So, it appears that we can no longer blame doctors for the crisis. These days, they seem to be prescribing it only to cancer patients and other folks who need intensive pain management meds.
So, where does the fentanyl come from, then? How does it get into the hands of people who abuse it? And how are dealers able to cut their drug batches with it?
Well, according to many news sources, the drug may be entering the country through China. A recent report from the US-China Economic and Security Review Commission breaks it down:
Basically, China’s pharmaceutical and chemical manufacturing industries are somewhat poorly regulated. As a result, many illegal manufacturers are able to fly under the radar. Not only are they able to produce the chemicals necessary to make fentanyl, but they’re also able to ship them to the US, too.
As the report states: “Chinese law enforcement officials have struggled to adequately regulate thousands of chemical and pharmaceutical facilities operating legally and illegally in the country, leading to increased production and export of illicit chemicals and drugs.”
While some production is certainly taking place in the U.S (police recently seized 900 bags in Hartford), the government has taken steps to limit the amount imported from China. In December of 2018, the country’s government announced that it would tighten regulations around the drug. This measure was partially fueled by ongoing discussions between the two countries around the topic.
Although it’s too soon to know, these increased regulations could help to cut down on the number of overdose deaths that occur in the US each year.
A Common Gateway Drug for Heroin Users
These days, it’s an all too common story: a regular person transitions from using opioids into heroin addiction.
We saw it with Tom Petty. We see it with a lot of other people, too.
In fact, research from the National Institute on Drug Abuse shows that nonmusical pain relief users are 19 times more likely to become a heroin user down the road.
Essentially the organization suggests that the prevalence of prescription opioids has created a landscape where heroin use is much more common.
They point out, for example, that 80% of the heroin addicts who started using in the 60s began by taking heroin. In other words, prescription pills were not a “gateway drug” for them.
But these days, it’s much different. According to the organization’s report, roughly 75% of all opioid abusers who began using in the 2000s started with prescription medications. Over time, these users transitioned from legally prescribed drugs like oxycodone and fentanyl to illicit drugs like heroin and illegally-manufactured pills.
The problem, of course, is that this drug is highly addictive. So, many people become hooked on the substance to the point where they need it to get out of bed in the morning.
No one plans to become an addict. Many people become hooked on their prescription and are forced to find a supply elsewhere.
If their doctor happens to cut them off or their insurance stops covering it, however, they’re often forced to find it elsewhere.
In a survey published on the NIH website, the organization reported that 94% of users in treatment stated they transitioned to heroin because the drug was less expensive than prescription opioids.
Hope for Fentanyl Addicts
Just because someone is addicted now doesn’t mean they have to stay that way. There are plenty of resources available to help addicts get sober.
Throughout America, there are a variety of addiction treatment resources available to people suffering from opioid addiction.
We’ll delve into a few of them below to explain how they work and why they’re important.
Detox: Helping Addicts Get the Opioids Out of Their System
Opioids are harsh drugs that have brutal effects on the human brain. Essentially, when someone becomes dependent on fentanyl, heroin, or another drug in that family, they’re brain slowly starts to believe that it can’t survive without them.
This is why addicts “fiend” for their drug. They experience intensely strong cravings because their body is telling them they’ll die without a fix.
So, the first step toward overcoming an addiction is for the addict to flush all of those drugs out of their body. Once the drugs are gone, their system eases up with the cravings a little bit.
This flushing process is known as detox, short for “detoxification”.
Some addicts go through this process alone. They throw all their drugs away, hole up in their bedroom, and wait for the process to run its course.
The problem with this, however, is that detox can be painful…
As one might imagine, the body doesn’t respond kindly when it’s deprived of a substance it’s dependent on. It’s kind of like how a hungry person gets stomach pangs.
Except worse. Way worse.
Throughout the stages of detox, addicts usually experience a number of different side effects. Each of these side effects is a symptom of their body trying to adjust to life without opioids.
The side effects of fentanyl withdrawal may include:
- Stomach aches
- Muscle pains
- Flu-like symptoms
- Shivers and shakes
- Profuse sweating
In order to avoid (or at least ease) the often painful symptoms of opioid withdrawal, many addicts opt to check into a professional detox facility instead of quitting cold turkey.
Addicts don’t have to go through this uncomfortable process alone. There are medical detox facilities all over the country that can offer them comfort and support as they flush the drugs out of their system.
Each of these facilities is staffed with doctors who understand the withdrawal process inside and out. They use this knowledge to limit the pain and discomfort experienced by withdrawing addicts.
Occasionally, a doctor may choose to wean the addict off of their drug of choice. This is a popular alternative to the cold turkey method, where addicts cease using all at once.
Essentially, this helps the user’s body to adjust to having less and less of the chemical in it. Once they’ve become accustomed to taking tiny doses at a time, they can eventually quit using altogether.
Oftentimes, this process can take several weeks. So, the addict lives on-site in the detox center while they undergo treatment. This allows the doctor to monitor their progress and helps to limit the addict’s access to drugs.
5 Reasons Why Professional Detox is Better Than Quitting Cold Turkey:
- Professional Treatment: Doctors make the process much less painful.
- Safety and Security: Specialists will help to ensure the addict is safe.
- Limited Access to Drugs: The addict won’t be tempted to relapse.
- Peace and Quiet: Helps to reduce to reduce the addict’s stress.
- Rehab Pipeline: The user can move directly to rehab treatment afterward.
Rehab Treatment: Treating the Mental Side of Addiction
Fentanyl addiction is more than just a physical disease. The user needs to go through therapy to address the emotional side of their condition, as well.
Too often, naysayers brush off addiction as a matter of will. The subject is often discussed as if the addict could simply quit if they wanted it bad enough.
Although there is some truth to that (addicts must have the desire to quit if they want to get clean), it’s far more complicated.
In reality, addiction is more like an obsessive-compulsive disorder than a simple fault in character. No one chooses to become dependent on a drug, after all. Addicts are just people who encountered a certain substance during the wrong period in their life and slowly became accustomed to using it.
In rehab treatment, drug addicts work toward understanding why and how they developed their addiction. They work with counselors and specialists who help them to comprehend how the drug works in their body and what makes them desire it.
They also work closely with therapists who attempt to address any trauma that caused their addiction.
Obviously, not every addict’s condition is rooted in trauma. Some people just happened to get hooked on their pain medication. But for many people, their condition is deeply connected to their psychological history.
Each day in treatment, addicts work through a regular schedule of individual therapy sessions and group support meetings.
The individual therapy sessions resemble a typical trip to the psychologist. The doctor and patient discuss how drugs altered the addict’s life and how they can get back on the right track. The doctor also helps the patient to develop coping mechanisms for dealing with stress and techniques for avoiding relapse in the future.
In group support meetings, the individual convenes with other recovering addicts to discuss a number of related topics. These meetings often resemble twelve step groups like AA and NA. In these sessions, addicts receive the connection, support, and compassion that’s necessary during such a tough time.
Furthermore, the addict may participate in family counseling sessions with their own loved ones. In these meetings, the addict’s family will discuss how their life has been affected by the presence of drugs. This gives the user the opportunity to gain an understanding of how their behavior impacts others. These meetings are facilitated by a family therapy specialist.
Rehab treatment for fentanyl addicts comes in a few different forms. The primary forms of rehabilitation are:
Inpatient treatment: This is the term for residential rehab programs. In these programs, addicts live on-campus at the treatment center for up to a month or more. The individual spends each day going to counseling sessions. They also meet with doctors for physical check-ups to ensure that they’re recovering safely. Residents eat together and spend time hanging out between therapy and at night.
Outpatient treatment: This is the term for nonresidential programs. Those who undergo outpatient treatment receive all the same benefits as inpatients. However, they leave the campus once they’ve completed their schedule. Depending on the intensity of the program, outpatient residents may spend up to 8 hours each day in treatment. Then, they’ll leave at night.
Inpatient Treatment vs. Outpatient Treatment: Which is Better?
Ask any recovering addict what the best form of treatment is and you’re likely to get a different answer every time.
Some people will tell you that you can’t beat inpatient rehab. It makes sense, considering the fact that 28 straight days in a treatment facility gives you the time and space to focus on recovery. Plus, you get to spend more time with the other residents. Ultimately, this can provide a stronger network of support.
But, most of us don’t have the time to check out of our lives for an entire month. After all, many people have work, school and family responsibilities to attend to. For those people, outpatient rehab is definitely the best option. It allows them to undergo treatment while still giving them time to live their lives.
Ultimately, the best form of rehab is different for everyone. Individuals should give careful consideration to choosing the program for them.
Leaving Home for Rehab: Is It a Good Idea?
Currently, there are around 14,000 rehab treatment centers in the United States. In total, they’ve treated more than 2.5 million addicts.
So, you don’t have to detox in your hometown.
In fact, we believe that it can actually be a positive thing to leave home for drug rehab?
Well for starters, leaving home can be a way to free yourself of the triggers and stressors that exist there. After all, most addicts associate their addiction with the people they used with and the places they used in.
And unfortunately, those things will still be around, even when you get clean. As you might imagine, this can make it difficult to recover completely. It’s tough to fight off the urge to relapse when the drug dealer who lives down the street is calling you to ask if you want to buy some fentanyl.
Rehab can give you the privacy you need to get clean.
When you move to another city, however, those stressors go away. You’ll no longer have to worry about your old friends calling you and your old haunts triggering you.
Then, by the time you go back, you’ll be better equipped to cope with those triggers.
Furthermore, leaving home for rehab can give you access privacy you might not have otherwise.
As a recovery community made up of former addicts, we get that it can be embarrassing to admit you have an addiction. You may not want your neighbors or co-workers to find out about it. That feeling of shame can lead you to relapse.
It’s important to know that you shouldn’t feel ashamed. Admitting that you have a fentanyl problem is the best thing you’ll ever do.
Leaving home to detox can relieve you of some of the embarrassment you feel. When you eventually return, you’ll feel more confident in your new sobriety.
AspenRidge North Wants to Help You Overcome Your Fentanyl Addiction
Are you or a loved one addicted to this prescription opioid? We can offer the help and support you need.
If you or a loved one is currently struggling with opioid addiction, we can help.
AspenRidge North offers a complete, 90-day detox and rehab treatment program. We are located in Fort Collins, Colorado.
Our expert staff takes pride in supporting addicts through the beginning of their recovery journey. It would be our pleasure to offer you assistance.
Not every fentanyl addiction story has to end tragically. It’s possible for even the most severe users to turn their lives around. Through detoxification, counseling, and therapy, we can help you get back on the right path.
Give us a call today to start your recovery journey.