Six years ago, fentanyl was a relatively new and unheard-of drug. Developed in 1959, it was primarily used as an anesthetic and pain reliever for medical purposes without the side effect of nausea. It is 100 times more potent than morphine and 50 times more potent than heroin.
In 2015, however, fentanyl started to make its way into the United States in noticeable doses. As a synthetic drug, it is cheaper to produce than drugs like heroin, which require cultivation. Because of its potency, people require far less fentanyl to get high.
In the years since, drug dealers started using fentanyl as a cheap substitute to cut their drugs and stretch them farther. Today, according to the CDC, fentanyl is the leading cause of death for adults ages 18-45 in the United States.
“We are in the worst overdose crisis we’ve ever been in in the United States,” said Lisa Raville, executive director of the Harm Reduction Action Center in Denver. “In a magical world there would be no drugs, but we live here.”
In the year ending in April 2021, fentanyl claimed the lives of 40,010 Americans ages 18-45. That’s more than car accidents (22,442), suicide (21,678), COVID (21,335), and cancer (17,114).
“What is driving these behaviors in the illicit market is clearly just profit. It’s greediness,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse.
Because fentanyl is used as a cheap cut, it has managed to find its way into nearly every drug supply in the United States.
The National Institute on Drug Abuse says that last year, 75% of cocaine overdose deaths were mixed-use with fentanyl; the same goes with 50% of methamphetamine overdose deaths.
“We have public health evidence-based interventions that we can be doing today for healthier and safer communities,” said Raville. “For example, when we talk about prevention, we need to talk about harm reduction and realistic education to teens.”
As Raville said, in a perfect world drugs would not exist, but they do, and that is where she and Dr. Volkow agree that solving the overdose issue is different from addressing the drug use issue.
Both women agree that improving things like education about contaminated drugs, addiction help, Naloxone access, and drug testing strip access are all vital.
If people are going to use drugs, mitigating harm is imperative.
"If they are going to be taking a drug that has fentanyl, how to use that drug in ways that is going to minimize the risk,” said Dr. Volkow. “And that includes, for example, never taking drugs alone. Why? Because if you take these drugs alone and you overdose, no one can give you the Naloxone."