What To Know About the Fentanyl Epidemic in the US

In the United States, fentanyl abuse has become a major epidemic. Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. Doctors can prescribe it for patients in severe pain, but it’s also being made and sold illegally.

Key takeaways:
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    Fentanyl is a synthetic opioid drug that’s up to 100 times more potent than morphine, so even tiny amounts can be deadly.
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    Fentanyl is often mixed with other illegal drugs without the user’s knowledge, which increases the risk of overdose.
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    The US fentanyl epidemic began in 2013 with a significant surge in overdose deaths.
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    To address the root causes of the fentanyl epidemic, we must invest in prevention and harm reduction strategies and address the social and economic factors contributing to drug use.

The abuse of the drug can be fatal, even in tiny amounts, and it’s often mixed with other illicit drugs like heroin or cocaine without the user’s knowledge. As a result, overdoses from fentanyl are on the rise, and it is now one of the leading causes of death from drug overdoses in the US.

Here’s what you need to know about fentanyl and the current epidemic of abuse in the United States.

What is fentanyl?

Fentanyl is a powerful opioid drug similar to but much more potent than morphine. Opioids, sometimes called narcotics, include illegal drugs like heroin and prescription pain relievers such as oxycodone, hydrocodone, and codeine.

Fentanyl is a Schedule II prescription drug, meaning it has a high potential for abuse but can be used under medical supervision for severe pain relief.

Doctors use fentanyl to treat people in severe pain, such as cancer patients, terminally ill people, or those recovering from extensive surgery or trauma.

However, fentanyl is also made and sold illegally. It’s often mixed with other recreational drugs like heroin or cocaine, increasing their potency and amplifying the potential for overdose.

Illicit drugs can contain deadly levels of fentanyl, and the person using them wouldn’t be able to see, taste, or smell it. As a result, it’s almost impossible to know if drugs are laced with fentanyl unless you use test strips to detect its presence.

What are the effects of opioids like fentanyl?

Opioids exert their effect by binding to and activating proteins called opioid receptors. These specialist proteins exist throughout the body, including the:

  • Brain
  • Spinal cord
  • Immune cells
  • Pituitary gland
  • Skin
  • Gastrointestinal tract

When the opioid binds to the receptor, it blocks pain messages sent from the body through the spinal cord to the brain. This triggers various effects, including pain relief, sedation, and feelings of pleasure.

While opioids can effectively relieve pain, they can cause several potentially harmful side effects, including:

  • Drowsiness
  • Nausea and vomiting
  • Constipation
  • Confusion and dizziness
  • Slowed breathing

Tolerance is another major concern with opioids. This means a person needs to take higher doses over time to get the same pain-relieving effect. Tolerance can lead to dependence and addiction.

Physical dependence means that a person’s body adapts to the presence of an opioid and becomes used to its effects. This can cause withdrawal symptoms, such as anxiety, sweating, muscle aches, and nausea, when they suddenly stop taking the drug or reduce their dose. The severity of withdrawal symptoms can vary depending on the dose and length of time a person takes opioids.

The other major concern with opioids is addiction. Addiction is a chronic, relapsing brain disease characterized by compulsive drug-seeking behavior and use despite harmful consequences. People addicted to opioids may continue to use them even when they’re unable to afford them or when doing so causes relationship or work problems.

Although the risks of opioids, in general, are well-known, the dangers of fentanyl are often underestimated because of its potency. Even a tiny variation in dose can be the difference between a therapeutic effect and a deadly one.

Why is fentanyl so dangerous?

Fentanyl is especially dangerous because it’s incredibly potent, up to 100 times more than morphine. There are also multiple analogs, or variations, of the drug that are even more potent. They include acetylfentanyl, furanylfentanyl, and carfentanil. Carfentanil is an incredible 10,000 times more potent than morphine.

Opioids like fentanyl slow down breathing rate. Recent research has found that fentanyl causes clinically significant respiratory depression long before the person is sedated. Taking even a small amount can cause shallow breathing, and too much can stop a person’s breathing altogether.

Without oxygen, the brain and other vital organs can be damaged, and the person can die of an overdose, even if it’s their first time taking the drug.

Signs of an opioid overdose include:

  • Constricted ‘pinpoint’ pupils
  • Sleeping or losing consciousness
  • Slow, weak, or no breathing
  • Choking or gurgling sounds
  • Limp body
  • Cold, clammy skin
  • Bluish skin, particularly the lips and nails

A fatal dose of fentanyl could be as low as 2 mg, which is about the size of a few grains of salt. Because it’s often mixed with other drugs, people may not realize they’re taking it and are unaware of the potential dangers.

When did the fentanyl epidemic begin?

The US fentanyl epidemic can be traced back to 2013, following the introduction of illicitly manufactured fentanyl. As the drug flooded communities, the number of related overdoses began to rise, and there was a spike in deaths.

Since 1999, around 500,000 people have died from overdoses involving prescription or illegal opioids.

The rise in opioid overdoses has had three waves. The first began in the 1990s with prescription opioids. These included natural opioids like morphine and codeine, semi-synthetic opioids like oxycodone and oxymorphone, and synthetic opioids like methadone.

The second wave began in the early 2000s with the rise of heroin. Finally, the third and current wave began around 2013 with a significant surge in overdose deaths following the introduction of illicitly manufactured fentanyl.

In 2020, almost 60,000 deaths in the US involved synthetic opioids like fentanyl. This alarming number increased nearly 60% from the previous year and was more than 18 times higher in 2020 than in 2013.

What can be done?

To address the root causes of the fentanyl epidemic, we need to invest in prevention and harm reduction strategies. This includes expanding access to naloxone, which can reverse an overdose, and increasing access to evidence-based treatment for substance use disorders.

We must also address the social and economic factors contributing to drug use, such as poverty, racism, and trauma. Only by addressing these underlying issues can we hope to put an end to the fentanyl epidemic.

The fentanyl epidemic has had a devastating impact on communities across the US. The drug is incredibly potent, and even a small dose can be deadly. It’s also often mixed with other drugs, increasing the overdose risk.

If you or someone you know is struggling with addiction, help is available. You can call the National Helpline at 1-800-662-HELP (4357) to speak with a trained addiction specialist.