Nearly 200 people a day died from drug overdose in the United States in 2017. This record-breaking number was nearly a 10% increase from the already record-breaking statistics in 2016.
What’s driving this increase? Opioids.
Opioids were involved in nearly seven out of 10 of overdose deaths in 2017. In particular, overdose from synthetic opioids (other than methadone) have increased 51% since 2016 and 500% since 2013.
It’s easy to conclude that, in the war against opioids, we are currently losing.
Fentanyl is to Blame
Fentanyl (common brands Duragesic, Subsys, Abstral) is available as a prescription for pain. As a narcotic, it is a controlled substance and carries a high risk for dependence and addiction.
Fentanyl binds to opioid receptors in the brain, boosting the level of dopamine, a neurotransmitter associated with feelings of relaxation, pleasure, and reward. Users experience intense, but short-lived, feelings of euphoria.
Unfortunately, Fentanyl can also lead to seizures, nausea, slowed breathing, a drop in blood pressure, and fainting, as well as death due to respiratory distress. Fifty to one hundred times stronger than morphine and 50 times stronger than heroin, Fentanyl was implicated in the deaths of singers Prince and Tom Petty.
Prescription Fentanyl typically takes the form of a patch or an IV injection; however, it’s the illegal versions of Fentanyl that are behind the record-breaking increase in overdose deaths.
Numerous other illicit drugs including cocaine, heroin and synthetic marijuana are being cut with Fentanyl. Over a two-day period in August of this year, 70 people overdosed in a Connecticut park on synthetic marijuana (known as K-2) that was laced with Fentanyl. Luckily, authorities were on the scene to administer treatment and prevent any deaths from occurring.
K-2 itself is dangerous. Despite the moniker “synthetic marijuana,” it isn’t really marijuana. It’s a mixture of chemicals designed to give the user the same feeling as smoking marijuana, only K-2 is much more potent. It’s cheaper than marijuana and increasing in popularity. Unwanted effects from K-2 include vomiting, seizures, coma and bleeding from the nose and eyes. Because its makeup is ever-changing, the effects of K-2 are unpredictable…and the drug can also be easily laced with Fentanyl.
Why are drug dealers cutting Fentanyl into other street drugs? It could be to grow demand for what they are selling – Fentanyl is highly addictive, and it only takes a little to deliver a powerful punch.
Too often, though, that punch proves to be deadly. It only takes a few grams to kill someone.
Compounding the problem is that there is no way to tell if street drugs have been laced with Fentanyl by simple visual inspection. This means that users are literally putting their lives in jeopardy every time they use an illicit substance.
Where is Fentanyl Coming From?
China has been implicated as a major supplier of Fentanyl in the U.S. In fact, it is readily available from the Internet via Chinese pharmaceutical companies, according to Senate findings earlier this year. In some cases, components are shipped from China to Mexico (or even from other locations in the U.S.) to be chemically assembled.
There has been swift action by all branches of government to stop the flood of the dangerous drug coming into the country to continue.
Measures aimed at controlling the amount of Fentanyl prescriptions written in order to prevent addiction and stop the illegal use of the drug appear to be working. From a high of 255 million prescriptions in 2012, the rate has fallen to 191 million in 2017, the lowest in a decade. However, with an increase in overdose deaths due to opioids, the illegal market is apparently taking up the slack – and then some.
Prosecutors are stepping in to combat the illicit drug market by holding dealers responsible for overdose deaths, with Fentanyl prosecutions increasing dramatically. In another bold move, the Justice Department even brought charges against Chinese nationals who were accused of dealing in “large quantities” of the substance to U.S. citizens.
In September, the Senate passed a bill to improve international package tracking using digital means. The U.S. Postal Service, along with Customs and Border Protection, have also joined in the effort to stem the tide of Fentanyl crossing our borders. Case in point: 110 pounds of Chinese-provided Fentanyl were seized in Philadelphia in June of this year. This quantity was enough to kill the entire population of the state – twice.
In addition, the federal government is putting its money where its mouth is. In 2018, Congress approved the FY 2018 Omnibus Appropriations Bill which contained a provision dispatching nearly $4 billion toward the opioid crisis. The CDCP received just under a half million dollars of that money, while a handful of states such as New Jersey – one of the highest states in the nation for opioid overdoses – are receiving $1 billion grants.
What Do We Do Now?
Even with government efforts and funding, opioid overdose rates are still climbing. Clearly, it will take a more multipronged approach to rid ourselves of this unfortunate crisis.
What is missing? An education and grassroots movement among all Americans.
We all need to know more about how to identify who’s at risk for drug addiction so that we can intervene to prevent drug use. We all need to realize that our very lives are at stake should we choose to partake of an illicit substance. Hopefully education will stop drug use before it starts; however, those who are using drugs also need to be aware that any drug, at any time, can contain a lethal dose of Fentanyl. If they are unable to stop using drugs on their own (the biology of addiction makes doing so extremely difficult), they also need to receive treatment for their addiction.
Changes to the Brain Drive Addiction Makes Treatment a Necessity
Research has shown that long-term drug use changes the neurochemistry of the brain. Because opiates flood the brain with good feelings from artificial endorphins, the brain stops (or slows down) its production of the hormones.
What this means is that people who’ve taken opiates before are driven to use again – and again and again. In fact, they can feel very ill, anxious, stressed and depressed whenever they are not high on opiates. This is the hallmark of addiction – the person is now trying to stop the bad instead of chasing the good, and using drugs is no longer a choice, but reflective of a disease.
As you can see, it’s not about the individual’s discipline or lack thereof. The biology of addiction makes treatment a necessity.
Ongoing, specialty treatment has been shown to be effective in treating this disease. According to Drugabuse.gov, the best programs provide a combination of therapies and other services to meet an individual patient’s needs.
Not only has treatment been shown to be effective in achieving recovery, continuing with a support network (such as an addiction treatment center alumni group) or other ongoing support (therapy, for instance) can help maintain sobriety.
In other words, rehab treatment works especially when ongoing evaluation and modification are part of the program.
It’s a similar approach to the one taken to treat chronic diseases such as diabetes and heart disease – and addiction is indeed a chronic disease. Thus, ongoing care is the key to maintaining recovery.
Addressing the Treatment Gap
Treatment is badly needed for those suffering from opioid addiction. Unfortunately, these individuals are subject to the same limitations as those addicted to other drugs.
According to a study done by the Center for Behavioral Health Statistics and Quality (2016), only 1 in 10 people who have a substance use disorder receive treatment for it. Four in ten of those also have a mental health condition, but less than half (48%) get treatment for either disorder.
The problem of denial is common as well. Approximately 40% of those who are aware that they have an alcohol or drug problem are ready to deal with it. They may feel that they don’t “need” treatment, possibly because of the changes in their brain due to the drug use affecting priorities, motivation, and judgement. These changes could be hindering individuals from realizing they need help, and this is where intervention can come into play.
Another critical component is that in our society, there is a sense of shame surrounding drug and alcohol addiction which can prevent people (and their friends and family members) from reaching out for help. We need to work to remove this stigma so that more people seek the treatment that they need.
Even those who would like to receive treatment may not be able to access care due to lack of insurance coverage or the funds for private pay. Many treatment options are available; however, people may be unaware that help is out there.
Treatment Saves Money
Research has shown that treatment more than pays for itself in reduced healthcare and other costs.
It is estimated that every dollar spent on addiction treatment returns $12 in savings due to a reduction in healthcare, crime, and criminal justice costs. On the job, there are savings realized through greater productivity, fewer accidents, and decreased absenteeism and turnover.
Treatment shouldn’t be looked at as a “one and done” occurrence, as relapse rates are similar to those with other chronic diseases. Instead, treatment should be long-term in many cases, with multiple checkpoints and interventions to prevent relapse (and to recover if relapse does occur).
Likewise, relapse should not be looked at as failure; rather, it’s an indication that adjustments are needed to get back to a point of sobriety and to maintain it. Again, addiction recovery parallels the treatment of other chronic diseases. Such diseases can be under control for periods of time and punctuated by relapses which are then treated in order to reach baseline levels again.
The important part (and sometimes the hardest) is to take the first step to get into treatment. If you or someone you know is suffering from drug addiction, consider giving our drug addiction treatment center a call. We will do whatever we can to help you, your friend, or your loved one get the treatment