Fentanyl Crisis: What is Fentanyl and Why is it So Deadly?

Man struggling with a Fentanyl addiction

The United States has long been struggling with an opioid addiction wave of epidemic proportions. Now a new opioid has emerged as the new center of abuse and overdose: Fentanyl.

Fentanyl, a super potent synthetic opioid, has presented law enforcement officials with uniquely frustrating challenges due to it being so deadly, versatile and highly profitable.

In fact, according to the Drug Enforcement Administration (DEA), it is 50-100 times more potent than morphine and 25-50 times more potent than heroin.

Sunspire Health

CDC’s latest round-up of fentanyl-related deaths is alarming to say the least.

  • Ohio reported 514 fentanyl-related deaths in 2014, up from 93 the year before.
  • Maryland reported 185 fentanyl-related deaths, up from 58 in a year’s time.
  • Florida reported 397 deaths in 2014, from 185.
  • New Hampshire reported 151 deaths due to fentanyl alone in 2015, five times the number of deaths from heroin. [1]

What is Fentanyl?

Fentanyl is a powerful synthetic opioid analgesic and a Schedule II prescription drug. In its prescription form, fentanyl is known as Actiq®, Duragesic®, and Sublimaze®.

Street names for fentanyl or fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.[2]

Young Blond Woman With Fentanyl prescriptionFentanyl has been around since the 1960s. With such high levels of potency, Fentanyl was considered a miracle worker in soothing extreme pain in cancer patients who are usually prescribed patches or lozenges. But it is just as straightforwardly deadly too.

The influence exerted by Fentanyl on the brain is no different from that of other opioids. It surpasses the blood-brain barrier, similarly to other opioids, and binds with the brain’s μ-opioid receptors. This results in analgesia and euphoria.

“What makes it more or less euphoric than other opioids is how quickly it binds” explained Lewis Nelson, MD, medical toxicologist and emergency physician at NYU’s School of Medicine.

“If I give you morphine intravenously, it circulates in the blood, then it crosses the blood-brain barrier and binds the opioid receptors. But it takes a little while. Heroin crosses much more rapidly–so it’s really euphoric. And fentanyl is very rapid, and therefore very euphoric.”

Other than the euphoric high, Fentanyl also produces several other effects including nausea, vomiting, analgesia, sedation and respiratory depression among others.

Similarly to other opioids, it causes death via respiratory arrest, where the user’s breathing slows to a halt, instead of cardiac arrest. [3]

Illicit versions of the drug have flooded communities across America, and casual users are experiencing powerful highs upon the consumption of their fentanyl pills and powder that are easy to overdose.

Earlier this year, more than 50 people overdosed, but survived, on fentanyl-laced painkillers in Sacramento County, California, where these pills had somehow made their way. However, ten people did lose their lives to this sudden spike. Investigators are still searching for the source.

Similar clusters of fentanyl-related overdoses and deaths are appearing across the United States.[1]

The Deadliness of Fentanyl

Illicit fentanyl is widely popular on the streets and extremely potent than the other opioids. It takes a much smaller amount of the drug to have the same effect as other opioids, even heroin.

The reason so many are dying is due to the dose being relatively uncontrolled when it comes to street fentanyl. Even small excesses can lead to overdoses. Basically, there is nothing more dangerous about street fentanyl in comparison to other opioids except in terms of how it is dosed, distributed and sold.

Fentanyl is so potent that when law enforcement goes in to seize it, officers have to wear level A hazmat suits, the highest protection level made, similar to suits healthcare workers use to avoid contamination by the deadly Ebola virus.

“Just micrograms can make a difference between life and death. It’s that serious,” said DEA Special Agent John Martin, based in San Francisco. “All you have to do is touch it. It can be absorbed through the skin and the eyes.”[1]

The Profitability and Popularity of Fentanyl

Where the profits are considered, commonly sold opioids such as heroin, hydrocodone, OxyContin, and Norco, don’t even fall in the same league as fentanyl.
This is mainly because it’s easier and cheaper to produce than heroin, which is derived from poppy plants. With fentanyl, it’s just chemicals produced in clandestine laboratories.

Stack of cash“You can make it as strong as you want, and in bulk and fast,” said Tim Reagan, a Cincinnati-based DEA agent. Combined with the fact that its high in potency, a little bit goes a long way, making it extremely profitable.

The DEA estimates that drug traffickers can buy a kilogram of fentanyl powder for $3,300 and sell it on the streets for more than 300 times that, generating nearly a million dollars.

Fentanyl is often trafficked into the US through the cartels’ standard maze of routes through Mexico. However, it can also just be simply ordered online and can appear straight from China at the buyer’s doorstep. It is known to mainly manufactured in China and smuggled in through Mexico.[4]

“Everywhere from the Northeast corridor, down to New York, the Midwest and now we’re seeing it here out on the West Coast. Fentanyl is everywhere right now,” Martin said. “It’s feeding America’s addiction to opioids.”[1]

What Can be Done?

Curbing the epidemic fueled by the deadly Fentanyl requires a lot of people working together to transform the nature of use of opioids in this country. It will be a gradual process, and won’t happen overnight.

Since many are still oblivious to the existence of fentanyl and the fact that pills could be laced with it, the first step needs to be raising awareness among the masses of its presence and deadliness.

Narcan, or naloxone, blocks or reverses the effects of opioid-based drugs and is known as a lifesaver in an emergency such as an overdose. Drug users are encouraged to carry it with them and first responders as well. Ultimately, it’s the human loss that needs to be avoided at all costs.

“Constituencies on both sides are lining up. But it’s hard because there are so many players,” says Nelson. “Doctors are involved, patient advocacy groups are involved. Pharma is involved, and the government is involved. The problem is incredibly complicated.”


Sana Ahmed photoAbout the Author:

A journalist and social media savvy content writer with wide research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute focusing on mental health and addiction recovery, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.

Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. The art of using words to educate, stir emotions, create change and provoke action is at the core of her career, as she strives to develop content and deliver news that matters.


References:

[1] http://www.cnn.com/2016/05/10/health/fentanyl-new-heroin-deadlier/index.html
[2] https://www.drugabuse.gov/publications/drugfacts/fentanyl
[3] https://www.forbes.com/sites/alicegwalton/2016/04/09/why-fentanyl-is-so-much-more-deadly-than-heroin/#c68a7b7f6a26
[4] https://www.usatoday.com/story/news/nation/2017/08/31/fentanyl-opioid-fueling-new-overdose-crisis/616826001/

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on April 5, 2018
Reviewed By: Jacquelyn Ekern, MS, LPC on April 5, 2018.
Published on AddictionHope.com