THE FIGHT AGAINST FENTANYL – WHAT YOU DON’T KNOW

Michelle McGinnis, LCSW

As the opioid crisis continues to rage on around the country, drugs such as oxycodone, heroin, and hydrocodone have all seen increases in drug overdose deaths in the past two decades. With that said, one drug has soared above the rest when it comes to overdose deaths- fentanyl, an opioid that is 80 to 100 times stronger than morphine.

The rise of fentanyl in recent years has been frightening and deadly. According to the Center for Disease Control and Prevention, from 2013 to 2016, the number of deaths related to fentanyl doubled annually. If you take a closer look, the problem becomes even more apparent. From 2011 through most of 2013 there were fewer than 500 fentanyl-involved deaths per quarter, this number climbed to more than 5,800 deaths in just three years.

In 2010, fentanyl was involved in 14.3 percent of opioid-related deaths in the United States, this number would jump to 59 percent by 2017.

Despite how potent and dangerous this drug can be, the Food and Drug Administration has found that the drug can have a number of positive benefits when it comes to treating certain types of chronic pain. Moreover, fentanyl is also entering the country illegally by way of Mexican drug cartels that clandestinely produce the drug.

What Is Fentanyl?
Fentanyl is a powerful synthetic opioid, meaning it is derived from the opium poppy plant. As a much more potent drug than morphine and heroin, fentanyl is typically used to treat patients with severe pain, primarily following surgery or a similar operation and chronic pain. Eventually, like other substances, patients build a tolerance to the drug and begin to use it more frequently and/or in higher doses than is recommended.

While prescription fentanyl is available, the fentanyl that is most commonly associated with overdoses is produced in labs and sold illegally as powder, put in eye droppers or nasal sprays, or made into pills that look like other prescriptions.

According to the National Institute on Drug Abuse (NIDA), some drug dealers are mixing fentanyl with other drugs such as heroin, cocaine, methamphetamine, and more. They do this to increase the potency and addictiveness, while also maximizing profits, as fentanyl is a fairly cheap drug to manufacture.

How Does Fentanyl Affect the Body?
Like other opioids such as heroin and morphine, fentanyl works by binding to the body’s opioid receptors found in the brain that controls functions related to pain and emotions. As mentioned before, the more frequently an individual uses a substance such as fentanyl and other opioids, the more the brain adapts, which can weaken the effect of the drug, which diminishes pleasure and results in using larger quantities. This can lead to dependency.

There are a number of harmful symptoms and effects that can occur from using fentanyl. Some of these effects include:

• Drowsiness
• Stomach, back, and chest pain
• Depression
• Anxiety
• Changes in heartbeat
• Seizures
• Itching
• Slow and shallow breathing
• Dizziness
• Confusion and more

Continued use and overuse of this drug can lead to issues such as respiratory depression, fainting and more overdose effects that can cause death.

Naloxone
As fentanyl overdoses have increased in the past few years, first responders, and other medical professionals have had to adapt. The first line of defense against fentanyl is naloxone, an opioid antagonist and medication that is used to treat opioid overdose. It works by binding to the opioid receptors and blocking the effects of opioid drugs.

As overdoses become more prevalent, state and federal legislatures have made moves in the past to make naloxone more widespread and available. According to NIDA, naloxone access increased between 2010 and 2014. During these years:

• Local sites providing naloxone increased by threefold
• There was a 94 percent increase in states with at least one organization providing naloxone
• More than 2.5 times the number of overdose reversals were reported

If you or someone you know uses opioids, it is a good idea to carry naloxone with you and learn how to use it in case of an overdose.

What to Do
One of the biggest problems associated with fentanyl and one of the main reasons we have seen the issue rise to disastrous levels is due to the educational gap that surrounds the drug. Most people are aware of the dangers associated with drugs like heroin, cocaine, and even alcohol; however, many are completely unaware that fentanyl even exists. While the narrative around fentanyl is changing, and people’s eyes are opening to the dangers of the drug, there is still more that can be done to raise awareness.

In fact, the issue is gaining more political traction. President Trump’s administration has made it a top priority to attack the opioid epidemic and cut down on the number of fentanyl overdoses as well as the availability of the drug.

In late 2018, the president signed the SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act into law, a bill that received bipartisan support. The bill used multiple grant programs to curb the drug epidemic by implementing increased monitoring and detection programs and combating other areas of the crisis.

Treatment
While fentanyl is one of the most dangerous and addictive substances you can come across, there are still treatment options for people who are struggling with the substance. People with substance use disorder can take the first steps towards recovery at drug and alcohol treatment centers.

Medication-assisted treatment is one option for those dealing with an addiction to opioids and other substances who have not been successful in maintaining abstinence. Medications like Suboxone and Vivitrol can help patients by blocking their opioid receptors and preventing fentanyl from having an effect.

Likewise, counseling, group and individual therapy, and utilizing evidence-based treatment are common methods to help those struggling with issues related to substance use disorders. One of the most-used methods of counseling is cognitive behavioral therapy which is used to identify and modify triggers and stress that leads to substance use.

Whatever the specific issue that you or your loved one may be dealing with; treatment should be a priority. There are a number of drug and alcohol treatment facilities out there that are dedicated to helping patients. If you’re loved one needs help, you can research to find a facility that will provide them with the care that they deserve.

Michelle McGinnis is the Chief Clinical Officer at Landmark Recovery, a drug and alcohol rehab organization. McGinnis is a Licensed Clinical Social Worker and has been working in the healthcare space since 2007. Before working in healthcare, Michelle graduated from the University of Oregon in 2001 with a Bachelor’s degree in Psychology and Women’s Studies. From there, Michelle graduated from the University of Louisville with a Master’s degree in Social Work. McGinnis works tirelessly to help Landmark achieve their goal of saving a million lives in 100 years.