Heroin Is Being Replaced With Fentanyl Across East Coast, Midwest

By Maggie Ethridge 05/23/19

The surge of fentanyl availability in these parts of the country is putting long-time heroin users at risk for overdose. 

boy with a heroin addiction sitting down in a midwest city

In some places in the United States, heroin is becoming scarce or has even disappeared entirely.

Throughout the East Coast and in parts of the Midwest—where heroin fueled addiction, overdose, medical injury and death—availability of the drug is receding. Instead, the New York Times reports, it is the deadly drug fentanyl that is within reach.

Fentanyl is a powerful synthetic opioid, said to be able to cause overdose and death with just a small amount. In medical settings, fentanyl is used only for the most intractable and unbearable pain, such as late stage cancer. Fentanyl is cheaper to produce than heroin, while giving more bang for the buck.

For those who use it, knowingly or unknowingly, fentanyl is "more addictive than heroin," reports the Philadelphia Inquirer. Many who use fentanyl find that afterward, heroin alone is not strong enough to stop all their withdrawal symptoms and cravings. 

Looking at a concentrated area, the U.S. Drug Enforcement Administration (DEA) released a 2017 report on Pennsylvania. The report stated that in Philadelphia, fentanyl was found in 84% of 1,217 fatal overdoses in 2018, and in 67% of the state's 5,456 overdose deaths in 2017.

The surge of fentanyl availability has affected long-time heroin users who have been able to manage their drug use so that it does not kill them, the Times reports.

Along the East Coast and in the Midwest, people with long-term heroin addiction who have turned to fentanyl are dying of overdoses, unable to manage the potency and unpredictability of fentanyl exposure.

Narcan (naloxone), the opioid overdose-reversing drug, works by blocking opioid receptors in the brain. Narcan can last for 30 to 90 minutes in the body.

Fentanyl lasts for hours in the body. For some people overdosing on fentanyl, multiple doses of Narcan are required over a period of time, and it still may not be enough to save the person’s life.

Researchers are working on a naloxone-based antidote that might be able to sustain prolonged results in the body, even blocking the effects of a fentanyl overdose for hours.

A study presented at a meeting of The American Chemical Society by the Allegheny Health Network Research Institute and the Edgewood Chemical Biological Center showed promising results in lab animals. 

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.