Fentanyl Adds a Deadly Twist to the Opioid Epidemic

Fentanyl Adds a Deadly Twist to the Opioid Epidemic

The Richmond Times-Dispatch
March 10, 2018
Newt Gingrich and Lee Habeeb

The tragic stories keep coming. Across age and class categories, the crisis is tearing apart families and communities. According to the Centers for Disease Control and Prevention’s most recent 12-month estimate, opioid overdoses are killing 123 Americans every day. That’s right. Every day.

In 2016, drug overdoses killed more than 64,000 Americans — exceeding the death toll of the entire Vietnam War.

Worse, the carnage shows no sign of stopping, due to the changing nature of America’s opioid epidemic. Synthetic drugs, such as fentanyl have overtaken both prescription opioids and heroin as the epidemic’s dominant killer.

In fact, fentanyl is now present in more than half of opioid-related overdoses in the United States.

The explosion in deaths from fentanyl overdose — up 540 percent in just three years, from 3,000 to more than 20,000 — is largely due to the drug’s incredible toxicity. Fentanyl is 50 to 100 times more potent than morphine. Just a few grains of the white powder are enough to kill a 180-pound man.

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While prescription pain pills and fentanyl are both opioids, lumping fentanyl in with prescription drugs fails to properly address its contribution to this epidemic.

Fentanyl’s medical use is largely limited to surgical anesthesia and palliative care for advanced cancer patients. However, the CDC does not attribute the explosion of fentanyl on our streets to physician over-prescription or diverted prescription medication.

It is illicitly manufactured and imported from overseas, largely coming from Mexico and China. This is the overwhelming driver of the recent increase in synthetic opioid overdoses. Since Thanksgiving week, U.S. Customs and Border Protection has seized close to 100 pounds of fentanyl before it crossed the U.S.-Mexico border.

Perhaps more worrisome is the ease with which the drug can be acquired. Small packets of fentanyl pass relatively undetected through the mail. A recent Senate Homeland Security subcommittee investigation uncovered more than 500 order-by-mail transactions from Chinese drug traffickers in the past year. Just “$20 and 20 minutes and they’ve got the drug,” Greg Manning told “Our American Stories,” a national radio show doing a long-form series on the subject.

Greg and his wife Lisa lost their 19-year-old son Dustin to illicit fentanyl last year. On the very same night Dustin died, so too did an old childhood friend of Dustin’s named Joseph Abraham. The two died from the very same fentanyl.

“He was popular, he was good-looking, he was an athlete, he had lots of friends, he was home-schooled,” Lisa Manning, who hails from a suburban town just outside Atlanta, said about her son while fighting back tears. “He grew up in the church, he was a person who told me at the age of six he wanted to be a minister. How could it happen to my kid?”

Unfortunately, the Manning’s story is not unique: The ease of online fentanyl sales contributed to a seven-fold increase in synthetic opioid overdoses in teenagers in 2015.

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There are several factors that have contributed to the rise of fentanyl beyond the ease of distributing and acquiring the drug. It is also very cheap to produce and very potent — so much so that illicit drug dealers are increasingly mixing this deadly substance with other drug products to save money.

Drug overdoses involving cocaine, for instance, had been on a sharp decline until fentanyl hit the streets around 2013, after which they began to climb again. The statistic seems to belie a disconcerting trend: Overdoses are the result of people taking fentanyl unknowingly.

With authorities in agreement that fentanyl is typically produced and added to other drug products abroad, punitive anti-fentanyl measures, like those passed in 25 states in the past two years, are unlikely to stem the tide of overdoses.

The U.S. postal service is “working aggressively” to increase advance electronic data (AED) on inbound mail, which can make it easier to flag mail to and from persons of interest (UPS and FedEx can already require AED on all packages), but more needs to be done.

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Bill Bennett, the former director of the Office of National Drug Control Policy, is urging policymakers to learn from the successes of prior attempts to combat drug use, namely better border enforcement, better monitoring of international mail services, a crackdown on cartel activity, and a focus on treatment and education.

Furthermore, when it comes to treatment, we should follow the overwhelming evidence that recovery medication, when combined with behavioral therapy like counseling, is vastly more effective than behavioral therapy alone.

Opioid addiction is different than other forms of addiction. Statistics show that people with opioid addictions are more likely to die from an overdose after attending a behavioral therapy-only treatment program than if they had not sought treatment at all.

Unfortunately, there exists a bias against medication-assisted treatment in our justice system — and in some pockets of the recovery community. This bias is literally getting people killed.

Ultimately, Americans must take the lead on prevention in their communities. For the sake of almost 24,000 families devastated by a fentanyl overdose each year, parents, teachers, pop culture icons, political and religious leaders, and health care professionals must take an active role to dissuade young Americans from taking illegal drugs in the first place.

But in order for the message to get out there, and to prevent more senseless tragedies like the one the Manning family experienced, the media must recognize that fentanyl has become the new face of America’s opioid epidemic.

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