Drug overdose deaths in the United States have significantly increased in the last decade, exacerbating the public health concern that is the opioid epidemic. Fatal overdoses have been linked to illicit synthetic opioids, primarily fentanyl and fentanyl analogs, becoming the leading cause of overdose deaths and further contributing to the fentanyl crisis.
The Rising Threat of Fentanyl in the Opioid Crisis
The opioid crisis, also known as the opioid epidemic, has been a rising public health concern in the United States since the late 1990s. Fentanyl, originating as a potent painkiller, is 100 times more potent than morphine and 50 times stronger than heroin as an analgesic. The third wave of the opioid epidemic began in 2013, with an increase in overdose deaths involving synthetic opioids, specifically illicitly manufactured fentanyl. Due to its synthetic nature, this lethal pain medication can be produced without opium poppy cultivation, unlike natural opioids like heroin. This reduces production costs and complications with external factors, making it an enticing alternative for illicit drug producers.
In recent years, overdose deaths associated with fentanyl have increased due to the influx of it mixed with other illicit drug supplies, including other drugs like cocaine, heroin, or counterfeit pills. In 2022, fentanyl was responsible for 200 overdose deaths a day. Since 2018, over a quarter of a million Americans have died from fentanyl overdose. Even a small amount of fentanyl can cause a fatal overdose, especially for those without an opioid tolerance.
What is Fentanyl?
Fentanyl is a powerful synthetic opioid that is both an analgesic and anesthetic similar to but significantly more potent than morphine. Originally for medical purposes, fentanyl is a prescription for those with severe or chronic pain with a tolerance to other opioids. Pharmaceutical fentanyl comes in several different forms for treating patients with severe pain, including:
- Actiq: Fentanyl “lollipops”
- Fentora: Effervescent buccal tablets
- Abstral: Sublingual tablets
- Subsys: Sublingual sprays
- Lazanda: Nasal spray
- Duragesic: Transdermal patches
Due to its lethal potency, fentanyl has been associated with rising overdose deaths, primarily when illegally produced and mixed with other substances like heroin, cocaine, or counterfeit pills. When used illicitly, users are often unaware of consuming fentanyl, leading to a high risk of overdose and overdose deaths.
The Dangers of Fentanyl’s Deadly Potency
Fentanyl’s deadly potency poses multiple dangers that profoundly affect users and public health. One of the most urgent threats of fentanyl is the small amount needed to cause a fatal overdose. Just a few micrograms of fentanyl can be lethal for an average-sized adult. The dangers associated with fentanyl include severe side effects and symptoms, inconsistent drug mixtures, challenges with naloxone, fentanyl’s synthetic variants, and public health concerns.
Fentanyl’s Effects: Rapid Respiratory Depression
Opioids, including fentanyl, suppress the body’s ability to breathe, along with other side effects, including nausea, confusion, and unconsciousness. Fentanyl respiratory depression can happen quickly, leading to a lack of oxygen, potential brain damage, and death.
Inconsistent Mixing & Unpredictability
When fentanyl is illegally mixed with other substances, there’s often no quality control. This can result in one portion of the drug mixture containing a higher concentration of fentanyl than another, severely increasing the risk of overdose. When illicitly acquired, many users are unaware they’re consuming fentanyl, thinking they’re using heroin or another drug. This significantly heightens the risk as users might consume a ‘safe’ dose of the drug, not knowing that it contains a much more potent drug.
Fentanyl is often illegally mixed with other drugs like cocaine, methamphetamines, or benzodiazepines, either to increase potency or for contamination. Combining these substances can have unpredictable and synergistically toxic effects.
Challenges with Treatment: Naloxone
When successfully administered in time, Naloxone (Narcan) is a medication to reverse opioid overdoses, including heroin, fentanyl, and other prescription opioids. Fentanyl overdoses, on the other hand, are more difficult to reverse due to the potency and often require multiple doses of naloxone.
Synthetic Variants: Fentanyl Analogs
There are several analogs of fentanyl, including carfentanil, an elephant tranquilizer 100 times more potent than fentanyl and 10,000 times more potent than morphine. Fentanyl analogs, like acetylfentanyl, butyrfentanyl, and alfentanil, are all rapid-acting synthetic opioids that magnify the dangers associated with fentanyl.
Public Health Implications & Environmental Exposure
With the extreme rise in overdose deaths associated with fentanyl strains, fentanyl has had broad public health implications, from emergency medical services to drug rehab centers—law enforcement, first responders, healthcare professionals, and the public face the risk of fentanyl exposure. Simply touching or inhaling a small amount of fentanyl can cause harm, highlighting the need for understanding fentanyl’s effects and safety measures.
Fighting the Fentanyl Epidemic in the United States
The alarming rise of the fentanyl crisis has alerted law enforcement, healthcare professionals, emergency responders, and drug rehabilitation centers alike to help address and take preventative measures to combat this lethal epidemic. With an increase in overdoses and addiction to fentanyl, it’s crucial to be informed about the risks and signs of overdose and opioid use disorders. Taking harm reduction initiatives by providing access to naloxone can help save lives by preventing further overdose deaths. Emergency medical personnel and first responders receive education and training on the dangers of fentanyl and how to administer naloxone.
Medical Detox and Drug Rehab for Fentanyl Addiction
Drug rehab centers, understanding the nature of fentanyl addiction, have tailored their approaches to offer personalized treatment programs and plans. Due to fentanyl’s severe withdrawal symptoms, medical detox is often recommended and required before going to rehab. Drug and alcohol detox allows patients to navigate the withdrawal process under expert medical supervision. Following medically-assisted detox, addiction treatment centers apply holistic therapies in rehab to address the psychological and physical foundation of addiction. In this multifaceted battle against the fentanyl crisis, drug rehab centers offer hope and recovery for those struggling with addiction to fentanyl, alcohol, and other addictive substances.
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- National Library of Medicine, 2022. The Rise of Illicit Fentanyls, Stimulants and the Fourth Wave of the Opioid Overdose Crisis.
- United States Drug Enforcement Administration. Fentanyl.
- Centers for Disease Control and Prevention, 2023. Understanding the Opioid Overdose Epidemic.
- USA Facts, 2023. Are fentanyl overdose deaths rising in the U.S.?
- Department of Justice/Drug Enforcement Administration, 2020. Drug Fact Sheet: Fentanyl.
- National Institute on Drug Abuse, 2021. Fentanyl DrugFacts.
- Centers for Disease Control and Prevention, 2023. Lifesaving Naloxone.
- U.S. Department of Veterans Affairs, 2018. Fentanyl & Carfentanil.
- Centers for Disease Control and Prevention, 2023. The National Institute for Occupational Safety and Health (NIOSH): Fentanyl and Work.