Health

Fentanyl: The Next Wave of the Opioid Crisis

 

Communities across the country have felt the devastating effects of the opioid epidemic. It knows no bounds and takes a crippling hold on families in our very own neighborhoods.

We’re in the midst of a rampant opioid epidemic that has surged in three successive waves. The first involved prescription opioids. The second saw increased usage of heroin as many of those addicted to prescription opioids sought a different source of pain relief, for various reasons. The third wave has been fentanyl. The drug that killed Prince has been linked to a soaring amount of overdoses and deaths across the country.  

Fentanyl is a staggering 50 times more potent than heroin and 100 times more potent than morphine. It has a high potential for abuse and can be fatal in incredibly small amounts.  

Drug traffickers frequently mix fentanyl with more expensive drugs such as heroin, cocaine, and counterfeit pills advertised to be a more common opioid. Often times, individuals do not specifically seek out fentanyl and do not know that they are taking something containing fentanyl.

Fentanyl is uniquely dangerous because of its high potency and the speed with which it reaches the brain. Emergency medical personnel have reported finding patients dead with needles still in their arms. Rescues more frequently involve not one, but multiple administrations of the overdose reversal drug Naloxone.

In March 2015, the Drug Enforcement Administration issued a nationwide alert on fentanyl as a threat to health and public safety. A year later, the DEA sent another alert calling the spike in fentanyl seizures “an unprecedented threat.” Sadly, in the past year, fentanyl overdoses and deaths have only grown – signaling urgency in how we address the epidemic.

The fentanyl killing Americans is not one chemical entity, but includes up to 19 chemical variations or analogues currently scheduled by the DEA. Yet, the number of potential fentanyl analogues is far higher. There is no exhaustive list of fentanyl analogues due to the existence of numerous chemical variations of fentanyl according to recent scientific literature. One of the known variations is carfentanil, a drug 100 times more deadly than fentanyl. Carfentanil is so dangerous that it is classified by international treaty as a chemical weapon. While carfentanil has been legitimately used to tranquilize large animals, such as elephants, the drug must be administered and handled in a hazmat suit because just a few granules the size of salt can be lethal.  

Since late 2013, fentanyl and its analogues have contributed to at least 5,000 overdose deaths in the United States. Due to gaps in data collection and the fact that fentanyl is difficult for labs to detect, it is likely that the number of overdose deaths in the United States is actually much higher.  

The business model of fentanyl illustrates why this drug is quickly becoming the driver of our nation’s drug overdose epidemic and why overdose deaths will continue to surge. The DEA estimates that a kilogram of heroin purchased from Colombia for roughly $6,000 can be sold wholesale for $80,000. However, a kilogram of pure fentanyl, purchased from China for less than $5,000, is so potent that it can be stretched into 16 to 24 kilograms when using cutting agents like talcum powder or caffeine. Each kilogram of fentanyl can be sold wholesale for $80,000—for a total profit in the neighborhood of $1.6 million.  

The low-cost, high-profit, hard-to-detect profile of fentanyl is increasingly more attractive to traffickers. It is relatively easy for traffickers to manufacture or obtain on the street or Internet, especially from the dark web. An emerging threat is the illicit manufacturing of fentanyl in China, which is primarily shipped directly into the U.S. or to Mexico where it is processed at clandestine labs and then smuggled into the U.S by drug cartels such as El Chapo’s Sinaloa group.

Although national data does not track fentanyl specifically, the sharpest increases in fatal opioid overdoses are in regions experiencing distribution of illicit fentanyl. This trend is consistent with statistics from the handful of states tracking fentanyl-related overdoses in 2015.  

Without a distinctive and systematic response to the unique threat of fentanyl, law enforcement and our health care system may soon be overwhelmed. Other countries have realized to their horror that they were slow to react to the emergence of the fentanyl crisis. America must not make that mistake — we need to act now.

Today, we will hold a hearing kicking off the next phase of our efforts — examining this growing public health threat. The fentanyl crisis needs our immediate attention, and together we will work to strengthen our federal response.

 

Rep. Tim Murphy (R-Pa.) is chairman of the House Energy and Commerce Oversight and Investigations Subcommittee.

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