The True Deadly Scope of America’s Fentanyl Problem – JAMA April 2018 – by Nora Volkow, the director of the National Institute on Drug Abuse (NIDA)
Ms. Volkow seems to understand that our problem is with fentanyl, not prescriptions opioids. I wish she could convince other government agencies and bureaucrats of this truth.
A year ago I wrote on this blog about the escalating numbers of people dying from overdoses involving the extremely potent synthetic opioid fentanyl and its analogues.
Today, a new analysis in JAMA, by epidemiologists at NIDA and the Substance Abuse and Mental Health Services Administration reveals the scope of the crisis, and the rapidity with which the opioid problem has broadened from prescription opioids and heroin to include their much more deadly synthetic cousins.
Using mortality data from the National Vital Statistics System, the researchers were able to show that involvement of fentanyl in opioid overdose deaths rose from 14.3 percent in 2010 to 46 percent in 2016.
That is nearly half of opioid-related overdoses. Fentanyl is now involved in more deaths than prescription opioids (40 % in 2016) or heroin (36.6 % in 2016). (The drug categories are not mutually exclusive—in many deaths, more than one drug is involved.)
There is preclinical data to suggest that combining fentanyl with heroin may even further enhance its lethality.
Although some users seek out fentanyl, it is often ingested unintentionally.
Fentanyl is so strong that even a tiny amount of it could contaminate the other drugs being handled (heroin, cocaine, methamphetamine, etc), turning them lethal.
Drug dealers have even bought pill presses to create counterfeit tablets of Vicodin or Adderal that can contain fentanyl. You’ll never know until you pass out and stop breathing.
It is commonly used to adulterate heroin as well as counterfeit prescription pain pills and sedatives that are purchased on the street.
Increasing numbers of overdose deaths among cocaine users may also be related to fentanyl-adulterated cocaine. Because it is so highly potent, fentanyl is more easily smuggled into the country, and because it is so cheap to produce, drug traffickers have increasingly turned to fentanyl as a profitable product.
According to a report released by the Centers for Disease Control and Prevention last month, two thirds of the 63,632 drug overdose deaths in 2016 involved some kind of opioid. Unfortunately, comprehensive toxicological testing is not performed in many cases, or the results are not recorded on death certificates, so the reported numbers of fatal opioid overdoses and overdoses due to fentanyl might not capture the full scope of the epidemic.
So the government is making policies based on deliberately biased information. The CDC recently admitted counting some overdoses twice. (see CDC Over-Counting Rx Opioid Overdose Deaths)
Instead of searching dangerous hideouts to find armed drug dealers/distributors who are strengthening (and inadvertently poisoning) their wares with cheap fentanyl, the DEA is running amok taking pain medications away from patients. (It’s so much easier to simply follow a paper trail than track down an elusive criminal. The DEA proves again that it’s clueless and cowardly.
It’s hard to believe how twisted the “opioid crisis” story has become in the media, which keeps repeating how “prescription opioids” are “causing” the overdoses.
The opioid crisis has proved to be a rapidly moving target for public health officials, policymakers, and the healthcare system.
The escalating death toll from fentanyl and its analogues adds to the urgency of addressing the problem in multiple ways, from:
- wider access to medication-assisted treatment and overdose reversal,
- to improved provider education about pain management and addiction,
- to community investment in prevention programs.
The new study also underscores the need for ongoing and accurate data collection to rapidly identify the source of the most important drug threats at any given time.
The CDC’s corrupted method of counting has misdirected all efforts to stem overdoses, which are now directed at restricting prescribed opioids while concealing the role of illicit drugs.
Pain medication has less and less to do with the opioid crisis – it’s been “all about fentanyl” for years now.
Original article: The True Deadly Scope of America’s Fentanyl Problem