What is fentanyl and why is it behind the deadly surge in US drug overdoses? A medical toxicologist explains

As a result, it is much more profitable to cut a kilogram of fentanyl compared to a kilogram of heroin. According to the DEA, 42% of pills they tested for fentanyl contained at least 2 mg of fentanyl, a potentially lethal dose. In Bakersfield, a 2-year-old died from acute fentanyl toxicity, and his father has been charged with murder. In California, there were 11 fentanyl-related deaths for children younger than 5 in 2023, according to preliminary data.

Will having a high tolerance to another opioid protect you?

• We find it extremely difficult to detect these substances because they’re so small.
• So, we have a bigger cultural acceptance in Europe of the idea that let’s just do what’s effective without doing the moral judgment.
• Other strategies to prevent overdose deaths include lowering the entry barrier to addiction treatment, fentanyl test strips, supervised consumption sites and even prescription diamorphine (heroin).
• In 2022, there were 590 reported deaths on the island of 3.2 million people linked to fentanyl, a number that rose to 635 last year.

The fact that fentanyl does not require access to opium poppy plants, but rather requires the synthesis of chemicals that can be purchased online, makes it easier to manufacture (CCSOT, 2022; Sullum, 2023). The Well is Northwell Health’s commitment to the future of health care. In this time of information overabundance, much of which is inaccurate, unhelpful, or even difficult to understand, Northwell Health is on a mission to make a difference as an honest, trusted, and caring partner.

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This is because it costs less to produce than other opioids, and because a small amount goes a long way. Illicitly manufactured fentanyl is internationally synthesized in China, Mexico and India, then exported to the United States as powder or pressed pills. Additionally, the emergence of the dark web, an encrypted and anonymous corner of the internet that’s a haven for criminal activity, has facilitated the sale of fentanyl and other opioids shipped through traditional delivery services, including the U.S. For example, carfentanil, a fentanyl analog formed by substituting one chemical group for another, is 100 times more potent than its parent structure.

Fentanyl: A Potent, Synthetic Drug

In March 2023, the Food & Drug Administration approved the first over-the-counter naloxone nasal spray, and it’s expected to https://ecosoberhouse.com/ be available by summer 2023. In addition, many organizations and many pharmacies in New York state currently dispense naloxone without a prescription. The bottom line is that any illicit drug that’s being sold today has the risk of having fentanyl mixed into it, and because it’s so potent, the amount of fentanyl could be enough to cause a fatal overdose.

The vast majority of people reported their willingness to use rapid test strips to detect the presence of fentanyl in drugs or urine at home or utilize drug-checking services at supervised injection clinics47,48. A newly developed lateral flow immunoassay was also evaluated for effectiveness in the detection of fentanyl analogs53. Digestive symptoms, such as nausea, vomiting, and constipation, are common in patients who repeatedly use fentanyl55,56. Immunosuppression was also shown to be precipitated by analgesic opioid drugs, including fentanyl, in preclinical and clinical studies.

Fentanyl and its analogs

Naloxone (Narcan) is an antidote for fentanyl and other opioid overdoses. Naloxone can help prevent fentanyl-related deaths when it is given within a short period how long does iv fentanyl stay in your system of time after an overdose. The nasal spray form of naloxone does not require a prescription and can be obtained from pharmacies. Naloxone acts quickly to reverse the effects of an opioid overdose, but opioids last much longer than naloxone. People who receive naloxone still require an emergency medical evaluation, as overdose symptoms can return. Once the heart and brain have gone without oxygen for a while, naloxone will not work.

Prevention Tips

Other examples of harm reduction services include overdose prevention centers. So, places where people who are going to use drugs can go and do so in a more safe environment, so that if they do overdose they can receive oxygen, naloxone if they need it, and they don’t die. But fentanyl first made its way into the illicit drug supply about 10 years ago, particularly in areas east of the Mississippi River. Drug dealers started mixing the two drugs as a way to stretch their heroin supply. Fentanyl also started showing up in non-opioid drugs, such as cocaine and fake versions of prescription pills.

Illegal drug manufacturers create fake opioid pills to look exactly like the real ones. You cannot tell if a pill, powder, nasal spray or injection bought off of the street contains a deadly dose of any drug just by looking at it. But I think we should learn from the success of dealing with the first wave. We need to get more people into treatment—that reduces the drug-related death rate. And we need to invest in harm reduction services that we know will keep people away from the most dangerous patterns of use.