The state of the synthetic opioid epidemic
Synthetic opioid-related drug overdoses have been exponentially increasing in Georgia over the past several years, partially due to fentanyl-laced drugs posing severe risks to recreational drug users. The issue surrounding this epidemic is that the reason for this is way more convoluted than one may assume.
With the regional drug task force seizing pounds of fentanyl in Northeast Georgia alone, officials only see its prevalence growing in the near future. The city of Athens, home to the University of Georgia and bustling nightlife, is naturally a target for counterfeit pills and illicit drugs. With fentanyl seizures, overdoses, and deaths all on the rise, it is becoming a matter of if, not when, for drug users.
For many, it may seem like the nation’s fentanyl epidemic appeared out of nowhere. However, its origin story is very similar to that of other narcotics that made it to the street; it escaped the hospital. Medicinally, fentanyl is a highly active, potent synthetic opioid used to treat severe pain during surgery and is prescribed to patients that have built a tolerance to other opioids. Dr. Randall Tackett, a clinical and administrative pharmacy professor at UGA, explains that fentanyl is not to be administered to an “opiate naïve” patient or someone who has very little opiate tolerance.
Tackett describes that patients who are typically prescribed fentanyl “have been on morphine, hydrocodone and oxycodone for a little bit of time, and it’s not working, so then we move to fentanyl. And typically, we start off very, very low.”
One contributing factor to the increase in illicit fentanyl use is the over-prescribing of highly addictive pain killers by doctors that Tackett describes as “pill mills.” Many of these patients end up on fentanyl and are left with a crippling addiction. Because of this, many of these “pill mills” in the Northeast Georgia area have been arrested and shut down.
The U.S. Centers for Disease Control and Prevention states that fentanyl is 100 times stronger than morphine and 50 times stronger than heroin. Depending on an individual’s weight and tolerance, just two milligrams of fentanyl can be lethal, according to the Drug Enforcement Administration. However, officials have seized kilograms of the drug in Northeast Georgia, having the potential to kill over 500,000 people. Due to the drug’s small size, some users may be deceived into believing they are using less than they really are.
Rich McDougald, commander of the Northeast Georgia Drug Task Force, says that the synthetic opioid market in the area has surged over the last two years, with fentanyl being the most prominent. McDougald is personally aware of 20 synthetic opioid-related overdoses in the Athens area from July 2021 to March 2022. He says that 12 of the 20 died.
Pinpointing where this fentanyl is coming from gets a bit messy. Although a small portion is created in the U.S., investigative journalist and author of “Fentanyl.Inc,” Ben Westhoff claims that most fentanyl precursors are sourced from chemical labs in China. They are then sold to Mexican cartels. McDougal describes the cement-mixer-sized containers that the cartels use to blend the mass quantities of fentanyl unevenly mix the drug, causing it to vary in potency.
Once fentanyl makes it to the U.S., American drug dealers will combine it with other common drugs to sell on the street. With the public becoming increasingly aware of the potentially fatal risks that come with the opioid, it begs the question why a dealer would cut their cocaine with fentanyl as opposed to baking soda.
The world of drug use is a system that rewards the more powerful substances. Drug dealers cutting their controlled substances with other materials to extend their product and increase profit margins have always been common practice. However, the use of fentanyl as a filler not only meets these needs but also provides a more potent high to the drug they are combing it with. This incentivizes dealers to cut it into a wide variety of illicit drugs. Tackett explains that fentanyl is a versatile filler because it may enhance what users feel, or provide a slightly different high that is desirable.
This practice alone is heavily affecting the Athen’s community as McDougald states that about half of the area’s fentanyl overdoses are instances where the individual has no intention of using it in the first place. He claims that more likely than not, if someone purchased a pharmaceutical pill off the street in Athens, “it is probably a fake pill, and it most likely has fentanyl in it.”
Regardless of what a seasoned recreational user may say, there is no way to tell if a substance is laced with fentanyl by looking at it, hence the high instances of fentanyl poisonings.
A UGA student and part-time drug dealer, who requests anonymity to protect their identity, attests to this as they describe a related circumstance with their supplier, “He was one of the guys that I picked up weed from. He sold fentanyl and had gotten it mixed up with one of his bags of coke and actually wasn’t sure which one was which.”
What makes fentanyl such an immense and never-ending feat for law enforcement is the variations of the drug that are out there. Tackett refers to these as “designer drugs” that chemists will create that are essentially the same as fentanyl but are altered just enough to where they are not recognized as the same drug. This ensures a cat and mouse game among chemists and law enforcement to preserve the continuation of illicit fentanyl sales.
For those that choose to partake in drug use, Health Affairs notes that fentanyl test strips are an inexpensive and reliable method one can use to test for the presence of fentanyl, but there are limitations. The strips do not test for fentanyl potency, so users cannot know how much they are taking. Since unregulated drugs are not mixed evenly, there could be concentrated spots of fentanyl in some areas and none in others.
Naloxone, commonly referred to as the brand Narcan, is a narcotic antagonist widely used to counteract an opioid overdose. It is highly effective; however, it currently requires a prescription. If an individual knows someone struggling with opioid addiction, it is wise to speak to a doctor about obtaining Narcan.
Additionally, recognizing the signs of a fentanyl overdose is crucial in potentially saving one’s life. According to Addiction Center, the most common symptoms of an opioid overdose is the “opioid triad,” which is a combination of pinpoint pupils, decreased respiration, and unconsciousness. If someone is experiencing these symptoms, it is essential to take them to a hospital immediately, as Georgia has a medical amnesty law that provides immunity from arrest and prosecution to people experiencing an overdose and those helping the individual.
With undoubted concerns that the synthetic opioid epidemic will only exacerbate, many people are struggling to find a solution to a problem rooted in so many causes. Tackett argues that a potential solution would be to crack down on fentanyl precursors, making it easier to regulate the process in which the fentanyl variants are made. Until then, prescribers monitoring prescriptions with narcotics to prevent forming a dependency and working to make Narcan more available are areas that may help curb the epidemic. However, one consistent belief among experts is that education surrounding the risks of synthetic opioids is pivotal in improving the nation’s desperate state.
