The Fentanyl Crisis Isn't Over. In Fact, It's Getting Worse.

By The Fix staff 07/02/21

The isolation of quarantine caused a host of issues that negatively impacted mental health, from isolation and anxiety over financial and medical worries to the inability to access proper treatment.

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You may recall reading alarming stories in the media about the synthetic opioid fentanyl in the last few years. The Centers for Disease Control and Prevention noted that the drug was responsible for a spate of overdose deaths that rose dramatically from 2013, when the first cases made headlines, to 2019.

More than 36,000 overdose deaths from fentanyl took place during that year, which federal, state, and local officials battled through resources guides, community action, and efforts to expand access to naloxone, the opioid antagonist drug that can reverse the effects of a fentanyl overdose, to first responders.

By 2020, fentanyl stories appeared to drop from the media spotlight, supplanted by news about the presidential election and the COVID-19 pandemic. But don't think that the drug went away. On the contrary: fentanyl use, and overdose deaths related to the drug, is steadily on the rise again.

According to the CDC's National Center for Health Statistics, synthetic opioids like fentanyl were at the heart of a recent and dramatic spike in overdose deaths during a 12-month period ending in May 2020. Approximately 81, 230 drug overdoses involving synthetic drugs occurred during this time period, which is the largest number of such instances ever recorded. The increase after a relative decline in overdoses from 2017 to 2018, which began to reverse in June 2019 and climbed rapidly by May 2020. Drug overdose deaths increased in more than 25 states and the District of Columbia; in some states and major metropolitan areas like New York City, the increase was between 10 and 19%.

How has fentanyl managed to retain a grip on the U.S. population? Part of the reason is its potency: fentanyl is a legal drug, used to treat severe or "breakthrough" pain, especially after surgery, or for patients who have a tolerance to other opioids. When prescribed by a doctor, fentanyl can be given as an injection, patch, or as a lozenge. Though similar in composition to morphine, it's actually 80 to 100 times more powerful, and equally as addictive. As little as two milligrams of fentanyl has the potential to be fatal.

The other reason for fentanyl's longevity is that it's relatively cheap and easy to produce an illegal street version of the drug, and its potency makes it a frequent choice to be mixed with other opioid narcotics like heroin or cocaine for a cheap and powerful high. Many individuals with substance dependency issues are unaware of the presence of fentanyl in these narcotics, which can overwhelm their systems and lead to an overdose.

While China has been in the past the primary source of fentanyl and dangerous analogues, or imitation drugs, like carfentanil, which were sold primarily through illegal web sites on the "dark web," the majority of fentanyl in 2021 enters the United States through Mexico. U.S. authorities estimate that 90% of all fentanyl entering the country originates in Mexico, where it's produced by drug trafficking cartels who buy the chemicals to produce the drug from China and India.

Data from the United Nations found that while seizures of marijuana smuggled into the U.S. from Mexico dropped in 2020, seizures of fentanyl rose nearly 500%. COVID-19 has done little to halt the cartels' smuggling operations; as the DEA noted, they've simply sent larger shipments of fentanyl and methamphetamine to meet the growing demand in the States.

The third factor in the recent fentanyl surge was undoubtedly the global pandemic. Experts predicted that quarantine conditions would cause a host of issues that would negatively impact mental health, from isolation and anxiety over financial and medical worries to the inability to access proper treatment from both doctors and treatment facilities. Studies corroborated these fears, as did data from the CDC's National Vital Statistics System (NVSS), which found that overdose deaths skyrocketed throughout 2020 before declining at the start of 2021: the center has estimated that the final total of such deaths could ultimately surpass 90,000 – the highest annual number on record. 

How to combat this rising tide of opioid and fentanyl overdose? At Waismann Method, an opioid treatment program and rapid detox center, they believe that mental health care should be accessible not just to those who can afford it, but also to those who need it most. In today's post-pandemic world, in which so many people are dealing with trauma caused by COVID and its attendant restrictions, it is critical that medical treatment for opioid dependence be available in public hospitals along with necessary psychological support. Additionally, we need a stronger commitment to combating the rise of opioids (and the influx of fentanyl in particular) at local and government levels. "We believe that additional resources need to be put into decreasing the availability of fentanyl in our communities and the demand for drugs by our citizens,” Clare Waismann, RAS/SUDCC, founder of Waismann Method and Domus Retreat, explains. “By protecting our borders and focusing on the root causes behind addiction, we can reduce overdose risks, crime, homelessness, and suicide."


Sources:

https://www.ama-assn.org/system/files/2020-12/issue-brief-increases-in-opioid-related-overdose.pdf

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2775991?resultClick=1

http://publichealth.lacounty.gov/lahan/alerts/CDC-HAN-00438%20Opioids12172020.pdf

https://www.commonwealthfund.org/blog/2021/spike-drug-overdose-deaths-during-covid-19-pandemic-and-policy-options-move-forward

https://www.ft.com/content/a667a8b6-a306-4656-b153-b83897df323e

https://www.wilsoncenter.org/publication/mexicos-role-the-deadly-rise-fentanyl

https://www.camh.ca/-/media/files/guides-and-publications/straight-talk-fentanyl.pdf

https://www.kqed.org/news/11874651/fentanyl-is-killing-more-people-in-the-pandemic-in-santa-clara-county-victims-are-getting-younger

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