The Fentanyl and the Synthetic Opioid Crisis

I believe my first blog post about fentanyl was this past September, titled What Should We Do About Fentanyl? It included a 10-point plan from the controversial Dilbert creator Scott Adams. Whatever you might say about the list, it's a discussion starter. The issue is a huge one now, and it appears to be unrelenting.

I know of several new deaths in the past six weeks from fentanyl, including one too close to home, and as a result I've spent a lot of time thinking about it. 

In mid-February I looked into the manner in which the Vietnam War was covered as opposed to the coverage of our fentanyl scourge. I remember watching the news back then and almost every night they gave a body count of American kids who had died "over there." When I learned that almost twice as many Americans died in a single year from fentanyl, a synthetic opioid 50 to 100 times as strong as morphine, as died in all of the ten years of the Vietname War, I was surprised and appalled. 

Yesterday NPR did another story on the Ukraine conflict, citing Russian missiles killing 8 Ukrainian civilians. On this very same day there were hundreds of fentanyl deaths, and the day before and no doubt today. Where is the media coverage on this?

OK, yes, there are stories in the news, but it's absolutely nothing like the coverage on the Russia-Ukraine war this past year, not even close. Nor anything like the coverage of our activities in Southeast Asia in the 60's.

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This week I heard rumors of an excessive number of fentanyl deaths here in Duluth. And from another source I heard that it's a "bad batch of fentanyl" killing a lot of people from Ohio to the Northland. Where are the police in all this? Where is the media?

One of the things I've been pondering is why there has been such a demand for these synthetic opioids? I'm not ignorant of the drug scene. I grew up at a time when it seemed drug experimentation was part of growing up. It feels like something more sinister is happening. There's been a significant cultural shift. Is it a loss of hope?

Duluth distributes more than 500,000 needles to users to help them inject drugs "safely" without having to share needles (and pass around diseases like hepatitits). Does this activity imply that injecting drugs is OK and has governmental approval?

What follows are links to stories about fentanyl from this week's Google alerts. Yes, there is some media coverage, but nothing like many other stories that are being broadcast daily. 

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California driver busted in Michigan with enough fentanyl to kill 3 million people
https://nypost.com/2023/03/09/californian-busted-in-michigan-with-enough-fentanyl-to-kill-3m-people/

Mexican president to US: Fentanyl is your problem

https://apnews.com/article/mexico-fentanyl-epidemic-overdoses-26f735a54ee0ba075c394ce85aef03d0

Reason to worry about fentanyl in American schools https://www.cnn.com/2023/03/07/politics/fentanyl-crisis-american-schools-what-matters/index.html Mexican president to US: Fentanyl is your problem https://apnews.com/article/mexico-fentanyl-epidemic-overdoses-26f735a54ee0ba075c394ce85aef03d0 CNN Watch “America Addicted: The Fentanyl Crisis” tonight at 9 p.m. ET. CNN —. The addiction epidemic driven by fentanyl that has cost more than 100,000 ... CNN goes inside Mexico's fight to stem flow of fentanyl CNN's David Culver traces the path of fentanyl from Chinese chemical factories to Mexico, where cartels back the production of the deadly drug. https://www.cnn.com/videos/world/2023/03/08/fentanyl-pipeline-mexico-china-pkg-culver-vpx.cnn Karine Jean Pierre Claims Fentanyl at Border at 'Historic Lows!' | National Review Fentanyl abuse, trafficking, and overdoses are not at historic lows. There is a strong case that .. https://www.nationalreview.com/corner/karine-jean-pierre-fentanyl-at-the-border-its-at-historic-lows/  18K fentanyl pills disguised as oxycodone seized in Oakland County drug bust arrest  'These pills had the strength to kill a single person with just one dose.' https://www.wxyz.com/news/18k-fentanyl-pills-disguised-as-oxycodone-seized-in-oakland-county-drug-bust-arrest

Fentanyl crisis: Bay Area schools step up training for Narcan - The Mercury News The Mercury News Fentanyl crisis: Fury grows over Bay Area school districts that still aren't ready to save an overdosing student. The good news: Many schools are ...

Exclusive: What's driving record high fentanyl deaths in the Tri-Cities area? Tri-City Herald Fentanyl overdoses killed a record number in 2022 in Tri-Cities WA, partly because prescription opioids are harder to get.

 

Authorities concerned about new form of fentanyl turning up in Montana | KECI NBC Montana Officials report a shocking increase in fentanyl seizures in Montana -- up nearly 11000% since 2019.Montana Attorney General Austin Knudsen says ... California Lawmakers Told Treatment, Not Punishment, Will End Fentanyl Crisis Davis Vanguard SAN FRANCISCO, CA – California lawmakers heard testimony urging treatment, not punishment, should be used to resolve the fentanyl crisis after ... Officer names fentanyl as 'leading cause of overdose deaths' following Southern Utah arrest St George News According to the Drug Enforcement Administration, fentanyl is the deadliest drug threat the nation has ever encountered. File photo for illustrative ... * * * *  The Guardian Like many people, my patient was completely unaware of the way that his opioid medication was working. Renewed hope for combating the opioid crisis in Arizona 12News.com The Banner Health Foundation is using a recent influx of funding to help put a stop to opioid deaths across the state. Author: Trisha Hendricks. 'It's health discrimination'; Staten Island addiction expert criticizes lack of funding in NY ... SILive.com ... it doesn't adequately allocate money needed to fight the opioid crisis. ... on its website detailing the sales of opioids sold in New York; ... * * * *  Cause of death: Washington faltered as fentanyl gripped America https://www.washingtonpost.com/investigations/interactive/2022/dea-fentanyl-failure/ FENTANYL IS NOW THE #1 CAUSE OF DEATH AMONG AMERICANS UNDER 49. What are your thoughts on this?  Has it touched your family or circle of friends yet?  Please leave a comment. Illustration by the author, A.I. modified version of one of my paintings

The Opioid Crisis: National and Local--Something to Be Concerned About

The opioid crisis. How serious is it? What's really going on?

Opioids--we hear a lot of buzz but don't always know how to process it all. For example, when we learned that Prince died from a high dosage of Fentanyl, most of us had no idea what it was. When Philip Seymour Hoffman overdosed on heroin, we assumed it was the same old heroin of the 70s. Little did we know that there are new opioids on the market that are 50 to 100 times more powerful than the old fashioned kind.

For this reason the book Dopesick by Beth Macy caught my eye when I was at the library a couple weeks back. I wanted to learn more, and Macy does provide some understanding of how the new pain meds work and the destructive effects of the new synthetic opioids. I will comment further on Macy's book in a moment. First, for local Twin Ports readers...

WDSE WRPT has produced a six-episode miniseries that is airing on Channel 8 called Opioids: Crisis in the Northland.

The first episode was last week, and it was informative. The first thing I learned was that the problem is much worse than we realize because the newspapers do not report opioid deaths of children under 18. A couple people on the show said there have been way more than people are aware of. According to the stats, St. Louis County leads the state in opioid overdoses. You can watch the first episode here:  https://www.wdse.org/highlights/opioids-crisis-northland

This six-episode miniseries, co-produced by Ramona Marosas, explores different aspects of the epidemic:
1 - Tracing an Epidemic – The Roots of Opioid Use and Abuse
2 - Stories of Addiction
3 - Treatment – How Do We Judge what Works?
4 - Law and Addiction – Enforcement and the Drug Courts
5 - The Case – Accountability
6 - Solutions – What’s Next?

This is a locally produced show with an eye-opening local focus. Part 2 airs tonight at 7:30 on channel 8.

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The opioid crisis is but one branch of a much larger and more complicated issue. That issue has to do with alleviating pain. I'm fairly certain that one of the reasons many people fear death is due to the suffering that accompanies that transition from health to deterioration, the pain that follows surgeries and other procedures intended to "help" us. And then there's cancer.

And so we have companies striving to solve the problem of pain while having to deal with the misuse of these self-same products that actually do bring relief. It's a very complicated matter.

The author of Dopesick seems to have a vendetta against Big Pharma for making a product that effectively deals with pain and profiting from it while countless thousands become addicted to it. This seems like an oversimplification.

Some people call addiction a disease, which may comfort the consciences of addicted people, as if to say, "It's not your fault," but this also seems an oversimplification. Are addicts thereby absolved from responsibility? Are doctors too quick to prescribe pain meds? Are the pharmaceutical companies intentionally creating addicts in order to increase profits as author Beth Macy alleges?

The book does have insights that are helpful. The author shows how different this "epidemic" is from previous crises. And yet, there are critics who say it's only an epidemic when it touches the white community. Crack cocaine has been an inner city problem in the black community for decades.

After watching the first segment, I'm confident that our local program on the opioid crisis will also offer some insights, synthesizing insights from a variety of angles. Whether you agree or disagree I promise that you will be more informed than beforehand.

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I remember a news story some ten years ago or so regarding the robbery of a truckload of meds from a warehouse in Connecticut (or somewhere out East between New York and Boston.) The scale of the heist is what struck me. By truckload, I'm referring here to a semi, a big over-the-road truck, not a Ford F-150. This was no small operation. I'd be curious to know how far the products went before the source dried up.

The problem is complicated. Solutions begin with awareness. 

Related Links
National Institute on Drug Abuse Opioid Statistics
7 Staggering Stats About the Opioid Crisis
CNN on the Opioid Epidemic