This September, as part of National Recovery Month, September 18 through September 24 was declared Prescription Opioid and Heroin Epidemic Awareness Week. With this declaration, President Obama has called on Congress to provide $1.1 billion in new funding to make sure everyone who wants treatment for an opioid use disorder can get treatment.

Each year, more Americans die from drug overdoses than in traffic accidents, and more than three out of five of these deaths involve an opioid. Since 1999, the number of overdose deaths involving opioids, including prescription opioid pain relievers, heroin and fentanyl, has nearly quadrupled in the United States.

Opioid use follows a downward trajectory, as users get hooked on prescription painkillers before moving on to the cheaper and more easily attainable heroin. What users may not know (or choose to ignore) is that heroin is often cut with the highly potent, highly deadly opiate fentanyl. This combination of heroin and fentanyl makes it impossible to know the strength of any single dose, which means every use poses the risk of a lethal overdose.

What is fentanyl and where does it come from?

The most potent prescription painkiller on the market, often prescribed by doctors for extreme pain for those in cancer treatment, is fentanyl, which in its prescription form is known by such names as Actiq®, Duragesic®, and Sublimaze®. More than six and a half million U.S. prescriptions for the drug were issued in 2014.

Like other opioids, fentanyl affects the human brain.

  • It increases levels of dopamine, the neurotransmitter associated with pleasure and reward.
  • This produces intense euphoric and relaxation effects, similar to heroin.
  • Fentanyl is fast-acting and habit-forming. A single dose of fentanyl yields extreme drowsiness, slowed heartbeat and irregular breathing.

Fentanyl is being made to deliver a super high on the illicit drug market.

  • Fentanyl is produced in a lab and mimics the effects of heroin, but is much stronger.
  • It is 25 – 50 times more toxic than heroin and 100 times more toxic than morphine.
  • It is also far cheaper than heroin, according to users.
  • Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.

A medical examination in June 2016 concluded that Prince died of an accidental overdose of fentanyl. Fentanyl-laced pills and fentanyl mixed with heroin are showing up across the U.S. and are big business for drug dealers.

  • A fentanyl pill may look and cost the same as hydrocodone but requires only a fraction of the narcotic to give users an even stronger reaction.
  • Drug traffickers can buy a kilogram of fentanyl powder for $3,300 and sell it on the street for more than 300 times that, generating nearly a million dollars.
  • Comparatively, the opioid hydrocodone sells for about $30 a pill on the street.  
  • Fentanyl is often trafficked through the cartels’ standard maze of routes through Mexico and into the U.S.
  • It can be ordered online from China and go straight to the buyer’s mailbox.

Illicit fentanyl has been entering the U.S. from China in recent years. The Federal Government is establishing enhanced measures in conjunction with the Chinese government to combat the supply of fentanyl and similar substances or analogues from coming to the U.S.

  • Recently, China committed to targeting U.S.-bound exports of substances controlled in the United States, but not in China.
  • Additionally, the U.S. and China agreed to increase the exchange of law enforcement and scientific information with a view towards coordinated actions to control substances and chemicals of concern.

Because of fentanyl’s chemical properties, law enforcement officials don hazmat suits when seizing the drug. Absorbing a pinch of fentanyl through the skin or eyes is enough to end lives.

Who’s using fentanyl?

When prescribed by a physician, fentanyl is often administered via injection, transdermal patch, or in lozenges. Street or illicit fentanyl is sold as a powder, spiked on blotter paper, mixed with or substituted for heroin or as tablets that mimic other, less potent opioids. People can swallow, snort, or inject fentanyl, or they can put blotter paper in their mouths so that fentanyl is absorbed through the mucous membrane.

Infinite Recovery’s staff has found that drug users only actively seek fentanyl when they are deep in addiction and have to use it because it is cheap to purchase and/or because their tolerance is so high that heroin is no longer getting them high.

Why is fentanyl so dangerous?

Opioid receptors are located in the areas of the brain that control one’s rate of breathing. High doses of potent opioids like fentanyl can cause users to stop breathing and die.

  • The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.
  • Fentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers, including stopping breathing.
  • Fortunately, the medication naloxone is an opioid receptor antagonist that reverses opioid overdose and restores normal breathing if administered quickly.

How widespread is the use of fentanyl?

In 2014, the Drug Enforcement Administration reported that U.S. law enforcement agency labs found 3,344 samples of drugs containing fentanyl, more than triple the total in 2013.

It was estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012.

  • Comparatively, an estimated 467,000 were addicted to heroin in 2012.

Data from 2015 includes that some 7.7 million Americans use illicit drugs overall and 600,000 use heroin.

  • Among young adults aged 18 to 25 in 2015, 0.3 percent of the population ages 12+ were current heroin users.
  • 22.3% of past-month illicit drug users are ages 18-25.

Fentanyl abuse is widespread, growing and deadly. At Infinite Recovery, we support families who are experiencing substance use issues and specialize in the treatment of opioid addiction. We offer a confidential hotline at (844) 206-9063 and our admissions team is available 24/7 online. If you or someone you know needs help, please reach out.

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