The opioid abuse and drug overdose crisis has veered into a frightening new phase in which the rise of the easy-to-make, exceedingly powerful synthetic painkiller fentanyl is causing multiple, interconnected deaths at one time.
The nation’s capital already has experienced this grim situation, which only shows signs of worsening, the Washington Post reported on April 12:
“Ten people in two neighborhoods in Northeast Washington have now died from a lethal batch of fentanyl, police said .. the second mass-casualty incident involving the deadly opioid in the District this year. Police said at least 17 people overdosed on cocaine laced with fentanyl in Trinidad and Ivy City from [April 9-11] and seven of them survived. In January, nine people died after taking a similar concoction in a neighborhood near Nationals Park. Authorities arrested two people in that case and said they do not believe the most recent incidents are connected to the earlier overdoses.”
The newspaper also noted this:
“Opioid deaths in the District nearly doubled from 2018 to 2021, according to statistics from the city. The D.C. medical examiner has identified fentanyl in more than 90% of the overdose deaths in 2020 and through March 2021. Statistics for a comparative period this year were not yet available.”
Authorities in the District, like their counterparts nationwide, are warning users of illicit drugs to be wary that criminal dealers may taint even street drugs like marijuana with fentanyl, which can be overpowering in tiny doses and can turn deadly fast. They also discussed efforts to increase the availability of naloxone, a nasal spray that can quickly revive a person who is overdosing, the Washington Post reported:
“All first responders in the District carry the antidote. Police said officers have administered about 1,900 doses since March of 2019. The city has also distributed 58,800 naloxone kits, which are available at locations throughout the District and by texting “livelongDC” to 888-811. Officials also have test strips available so people can check their drugs for the presence of fentanyl. D.C. police say that at least one person a day in the District dies of an opioid-related overdose, but rarely are they confronted with two events with so many deaths so close together [as occurred recently].”
The U.S. Drug Enforcement Agency has sounded the alarms, telling the public that mass, fatal overdoses may become tragically more common, saying in a news release:
“[The DEA has] sent a letter to federal, state, and local law enforcement partners warning of a nationwide spike in fentanyl-related mass-overdose events. Administrator Anne Milgram outlined the current threat and offered DEA support to law enforcement officers responding to these tragic incidents. ‘Fentanyl is killing Americans at an unprecedented rate,’ [Milgram said]. ‘Already this year, numerous mass-overdose events have resulted in dozens of overdoses and deaths. Drug traffickers are driving addiction, and increasing their profits, by mixing fentanyl with other illicit drugs. Tragically, many overdose victims have no idea they are ingesting deadly fentanyl, until it’s too late.’ Fentanyl-related mass-overdose events, characterized as three or more overdoses occurring close in time and at the same location, have happened in at least seven American cities in recent months, resulting in 58 overdoses and 29 deaths. Cities impacted include Wilton Manors, Fla.; Austin, Texas; Cortez, Colo.; Commerce City, Colo.; Omaha, Neb.; St. Louis; and Washington, D.C. …
“These mass-overdose events typically occur in one of the following recurring scenarios: when drug dealers sell their product as ‘cocaine,’ when it actually contains fentanyl; or when drug dealers sell pills designed to appear nearly identical to legitimate prescriptions but are actually fake prescription pills containing fentanyl. This is creating a frightening nationwide trend where many overdose victims are dying after unknowingly ingesting fentanyl.”
As the DEA reported, the opioid crisis increasingly is fueled by deadly fentanyl:
“Fentanyl is driving the nationwide overdose epidemic. The CDC estimates that in the 12-month period ending in October 2021, more than 105,000 Americans died of drug overdoses, with 66% of those deaths related to synthetic opioids like fentanyl. Last year, the United States suffered more fentanyl-related deaths than gun- and auto-related deaths combined.”
The opioid crisis, which worsened during the coronavirus pandemic, is taking a stark toll on young people, Stat, the health and medical site, reported:
“After staying flat for a decade, the overdose death rate among U.S. adolescents nearly doubled from 2019 to 2020 — an alarming climb that continued into 2021, a study released [April 12] showed. The reasons do not include a surge of children in this group — ages 14 to 18 — using drugs, researchers said. If anything, survey data indicate that fewer teens experimented with drugs during the pandemic. Rather, a main factor is that the supply of increasingly deadly drugs, which has driven overall overdose deaths to more than 100,000 per year, has trickled into what adolescents are using. What teens may think is an opioid painkiller or Xanax diverted from the legal supply is now more likely to be a counterfeit tablet containing fentanyl or similar synthetic opioids …
“According to the paper, published in the journal JAMA, 518 adolescents died of an overdose in 2010, a rate of 2.40 per 100,000 individuals. In 2019, the rate had changed little, at 492 deaths or 2.36 per 100,000. In 2020, 954 adolescents fatally overdosed, a rate of 4.57 per 100,000. For the first six months of 2021, the rate increased another 20%, to 5.49 per 100,000.”
Stat reported that experts are still digging into the pandemic’s effects on drug abuse by the young:
“Experts … had different interpretations of how the pandemic contributed to the spike in teen deaths in 2020. Some researchers believe the pandemic, by disrupting shipping networks and closing borders, may have only accelerated how toxic the drug supply was growing. There’s also the question of whether Covid’s accompanying disconnection and isolation played a role. Teens have reported large increases in depression and anxiety. Scott Hadland, the chief of adolescent and young adult medicine at Massachusetts General Hospital, who did not work on the new study, said the pandemic worsened mental health issues among teens who do use drugs and may have caused more frequent use, raising the risk of tragic outcomes. The pandemic also interrupted treatment programs.”
In fact, an independent, expert U.S. panel on medical testing has advised that all kids ages 8 to 18 should be screened by their pediatricians for anxiety, the New York Times reported:
“The worsening state of mental health among children has prompted an influential group of experts to recommend for the first time screening all children ages 8 to 18 for anxiety, one of the most common mental health disorders of childhood. A draft of the new guidelines, which is open to public comment, will most likely be finalized later this year. It was issued [April 12] by the U.S. Preventive Services Task Force, a panel of volunteer experts appointed by a federal government agency to make recommendations to health care providers about clinical preventive care. The task force, created in 1984 by Congress, has no regulatory authority; however, their recommendations carry weight among clinicians. Screening more children for anxiety is ‘really important,’ said Stephen P. H. Whiteside, a child psychologist and director of the Pediatric Anxiety Disorders Clinic at the Mayo Clinic in Rochester, Minn., who is not on the task force. ‘Most kids in need of mental health care don’t get it.’”
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by dangerous drugs, notably opioids.
Communities across the country have been devastated by the overwhelming problems of addiction, debilitation, and death linked to opioids, their exceedingly powerful synthetic variants like fentanyl, and the street drugs that surged as part of the crisis. The abuse of opioids has led to spiking, deadly overdoses that killed 500,000 Americans over a decade.
The opioid crisis took time to blow up, fueled by Big Pharma and abetted by doctors, nurses, hospitals, insurers, regulators, and many others in health care. It also is growing clear that others, including big name consultancies, bear responsibility in this mess, too, blurring lines more than has been known in advising drug companies and federal regulators at the same time. Those harmed by the crisis — despite what critics may say — have sought remedies in the civil system with reason. They put their faith in lawsuits, not always the fastest approach, not only to secure the financial and other resources required to deal with this crisis but also to deal with systemic problems.
While progress appeared to have been made in dealing with this mess, this public health menace exploded anew during the pandemic. It demands a full-on, urgent response to put down. By the way, it is unhelpful, big time, for political partisans to exploit the death and debilitation of this crisis by throwing up catchy, “gotcha” blame-spreading points about complex issues like immigration to distract from the heavy lift necessary to deal with opioids. We have much work to do to halt one of the major health crises confronting the country.