Fentanyl: the deadly secret ingredient flooding the illicit drug market

This October, for National Substance Abuse Prevention Month we are sounding the alarm on fentanyl — a potent, highly addictive synthetic opioid that is increasingly being found in various illicit and counterfeit drugs.

Up to 100 times stronger than morphine and significantly cheaper to make and ship than most other drugs, many people who’ve been affected by fentanyl never even realized they were taking it.

National Substance Abuse Prevention Month was originally established in October 2012 by President Barack Obama to “call upon all Americans to engage in appropriate programs and activities to promote comprehensive substance abuse prevention efforts within their communities.”

At the time, in 2012, fentanyl contributed to 2,600 overdose deaths in the U.S. By 2020, that number had risen to 42,700.

The shadow of U.S. Sen. Lindsey Graham (R-SC) is cast on a photograph of heroin and fentanyl during a news conference on March 22, 2018 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)

In the latest episode of theGrio explainer series, Cleared Up, clinical inpatient pharmacist Dr. William Amarquaye and educational psychologist Dr. Edwin Witt Powell join host Tatianna Mott to break down this severe increase in accidental overdose deaths.

“One of the biggest misconceptions is that the opioid crisis right now is being fueled by prescription opioids,” Dr. Amarquaye informs. “But we have to make a distinction between pharmaceutical and illicitly manufactured fentanyl.”

Pharmaceutical fentanyl was developed in 1969 by Janssen Pharmaceutica to treat and manage the severe chronic pain of cancer patients. Since then, illicitly manufactured fentanyl has been regularly added to heroin to increase its potency, addictiveness potential, and cost-efficiency. This September, the DEA seized a historic 1.8 million fentanyl-laced counterfeit pills. 

“When I’m dispensing a drug inpatient,” adds Dr. Amarquaye, “we know the manufacturer, we know the dose, we know that it’s made in a lab, and we know the consistency of the batch. If I’m administering or if I’m dispensing 25 micrograms of, say, fentanyl I know that that patient is going to get 25 micrograms of fentanyl. And that’s the danger that we’re seeing because, in the illicit drug supply, you don’t know what you’re getting.”

Unregulated, and with a potential lethality at a minuscule 2mg, it takes just one improperly formatted batch of fentanyl-laced drugs to cause a deadly outcome. In a Public Safety Alert issued on Monday, Sept. 27, for the launch of their One Pill Can Kill campaign, the DEA revealed that two out of every five pills with fentanyl contain a potentially lethal dose.

Although someone need not be addicted to fentanyl or even be a willing user of the substance to potentially be at risk of accidental overdose, fentanyl is also a very short-acting drug which means it can quickly become addictive to users who use or misuse substances laced with it.

“Oftentimes individuals who experience addiction don’t usually go and seek help because of the shame and blame,” asserts Dr. Powell. “So we’ve got to get ourselves together as a society and understand that addiction is a complex brain disorder. It is something that not only the healthcare industry needs to take into account, but also our judicial system needs to start looking at it a little differently as well.”

Check out episode five of Cleared Up for more information on fentanyl and harm reduction tactics we all can use to keep our communities safe.

As long as the sale and use of these substances remain illegal and unregulated, the DEA advises, “the only safe medications are ones prescribed by a trusted medical professional and dispensed by a licensed pharmacist. Any pills that do not meet this standard are unsafe and potentially deadly.”

If you or someone you know are struggling with substance abuse and would like to seek treatment, visit the Substance Abuse and Mental Health Services Administration for outpatient drug addiction treatment.

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