Fighting back: The dangers of fentanyl addiction

May 24, 2016 | by David Lott, M.D.
Categories: Healthy Driven Minds

When people in the community ask me what drugs in our area make me nervous, one of the first to come to my mind is fentanyl. Fentanyl is a powerful drug, and it’s extremely dangerous. The Centers for Disease Control and Prevention (CDC) estimates fentanyl is 50 to 100 times more potent than morphine and is also many times more potent than heroin.

Our community is experiencing the dangers of fentanyl firsthand. As The Naperville Sun reported, Naperville had its first fentanyl-related death in April 2016. The Will County coroner told the newspaper, "… if this trend continues, we’re going to be on track for a catastrophic year" and possibly a record number of fentanyl-related deaths in 2016.

I completely agree with this assessment. At our Linden Oaks facilities, we’re hearing more of our patients talk about using fentanyl. I’ve heard more people talk about buying illicitly manufactured fentanyl than I ever have before. Until recently, I can’t remember anyone buying illicitly produced fentanyl on purpose, but that’s what’s happening today.

Our area’s residents are in danger from fentanyl now more than ever. But many people don’t know anything about it. It’s important to know the facts about fentanyl and the risks of abuse so you can keep yourself and your loved ones safe.

What is fentanyl?

Fentanyl is an opioid pain reliever. It’s in the same family of drugs as heroin, morphine, hydrocodone and oxycodone. But while those drugs are either totally or partially derived from the poppy plant, fentanyl is an entirely synthetic substance that’s made in a lab.

Fentanyl was developed to be a potent alternative for patients who are in a lot of pain. Doctors typically prescribe this medicine to patients with advanced cancer or to patients who have taken other pain relievers for so long that they’ve developed a tolerance to the less-potent medications. It’s also used as an anesthetic during surgery.

Fentanyl was introduced in the 1960s. Since then, people have often abused fentanyl by getting it through prescription drug channels — either abusing their own prescriptions, stealing medicine from friends and family members, or stealing medicine from healthcare facilities. However, the surge we’ve seen in fentanyl use beginning in 2015 seems to come from fentanyl being made in illegal labs.

Why is illegally manufactured fentanyl more dangerous?

Pharmaceutical fentanyl can be difficult to get without access to a prescription, but that doesn’t stop the illegal manufacture of the drug. A report in 2015 by NPR noted that drug cartels in Mexico have increased production of a fentanyl variant. This variant, called acetyl fentanyl, is not approved for medical use in the United States, and it’s not included in many screenings for illegal drugs.

We know from experience that fentanyl and derivative drugs can be deadly if not taken exactly as prescribed and supervised by a medical doctor. From September 2005 to April 2007, Cook County had a rash of deaths linked to fentanyl overdoses — 350 in all, with 47 deaths per month in May and June 2006. This fentanyl was reportedly traced back to a lab in Mexico and was sold by local drug dealers.

One of the big dangers of this sort of fentanyl is that people may not know they’re taking it. Once it’s made in a lab, this illicitly created fentanyl can be mixed with other illegal drugs such as heroin; disguised and sold as heroin itself; or disguised and sold as counterfeit versions of legitimate drugs. So drug users may have no idea what they’re actually taking.

And that can lead to an overdose very easily, especially because of its extreme potency. According to the European Monitoring Centre for Drugs and Drug Addiction, just two milligrams of fentanyl — a very small amount — can be lethal.

How is fentanyl addiction treated?

At Linden Oaks, we’ve had success treating patients for fentanyl addiction, including patients using illicitly produced fentanyl.

Like many other substance use disorders, the first step with such patients is to stabilize the withdrawal symptoms. We most often do that with the help of buprenorphine, which is one of the most effective treatments for addiction available. We initially use the medication buprenorphine to manage withdrawal symptoms for fentanyl and other opioids. We were one of the earliest treatment programs in the Chicagoland area to offer buprenorphine routinely for medication-assisted treatment (MAT) and we continue to lead the way in this treatment method.

Once we have a patient’s withdrawal symptoms under control, we work on helping him or her make behavioral changes to manage the intense cravings fentanyl can produce. Depending on a patient’s individual needs, we have different behavioral therapy options available, including counseling, daily therapy groups, residential treatment and more. We also urge our patients recovering from fentanyl and other substance use disorders to join support groups such as Narcotics Anonymous or Smart Recovery.

What are signs and symptoms of fentanyl abuse?

Of course, the best way to deal with fentanyl addiction is to address the problem early. Family members, friends and loved ones are often in the best position to do that, because they’re usually the ones to notice behavior changes that could be linked to fentanyl abuse.

Some of the general warning signs of fentanyl abuse (or abuse of any opioid) include:

  • Depression
  • Drowsiness
  • Extreme irritability
  • Instability or lack of functionality at work or school
  • Problems with money and finances
  • Relationship problems

If your loved one takes prescription fentanyl, take notice if they start having problems getting the prescription filled, changing doctors to get new prescriptions, or running out of prescribed medicines early. Those are big red flags that could be signs of drug abuse and addiction.

How can we get the word out on the dangers of fentanyl?

We aren’t helpless against this new wave of opioid drugs like fentanyl making its way into our community.

In my recent blog article about Prince’s death and the questions it raises about prescription drug abuse, I wrote about how emergency treatment with the drug naloxone can save lives when people have overdosed on opioids.

At Linden Oaks, we’re expanding our efforts to get naloxone available to the people who walk through our doors and to talk about it with family members. If someone’s already known to have an opioid problem, we know there’s a risk for an overdose, whether that’s from fentanyl or some other opioid.

We’re also trying to get the word out in our greater community through the media, such as when local TV station NCTV17 aired a report about fentanyl in our area. And we recently published a study in The American Journal on Addictions on how we educate people about overdoses and naloxone as part of our substance use disorder treatment program.

Hope for the community

I worry about the drug problem in our community. Opioids are especially dangerous — more than many other drugs. And fentanyl is even more dangerous than most opioids.

I worry about people who don’t know they’re taking fentanyl or don’t know the risks. I worry about the high fatality rate from overdoses.

But I’m also hopeful.

I’m hopeful because of the good partnerships we have with members of law enforcement, first responders, emergency doctors, city health officials, and others in the community. They help us bring this problem to the forefront.

I’m hopeful that we can save more lives with emergency doses of naloxone in cases of fentanyl overdose.

And I’m hopeful that we can get the word out about fentanyl and the risks it can pose to our citizens if it’s taken improperly. We don’t have to sit around and wait for fentanyl to claim the lives of our children, our family members, our friends and our neighbors.

We can fight back — together!

If you or your family needs help to deal with addiction, fill out this assessment form online, and one of our team members will contact you. You can also call us at 630-305-5027

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