SAFE Glen Cove Coalition: On Fentanyl and Synthetic Opioids

According to the Centers for Disease Control and Prevention (CDC) death rates involving synthetic opioids (other than methadone), which include drugs such as tramadol and fentanyl, doubled from 2015 to 2016. In 2016, more than 19,000 deaths involving synthetic opioids (other than methadone) occurred in the United States, which is more deaths than from any other type of opioid. Also in 2016, the largest increase in synthetic opioid overdose death rates was in persons aged 25-44, specifically males aged 25-44.

These deaths have increased across all demographics, regions, and numerous states. The CDC maintains that increases in synthetic opioid-involved deaths have been associated with the number of drug submissions obtained by law enforcement that test positive for fentanyl but not with fentanyl prescribing rates. These reports indicate that increases in synthetic opioid-involved deaths are being driven by increases in fentanyl-involved overdose deaths, and the source of the fentanyl is more likely to be illicitly manufactured than pharmaceutical.

There are also fentanyl analogs, such as acetylfentanyl, furanylfentanyl, and carfentanil. Estimates of the potency of fentanyl analogs vary from less potent than fentanyl to much more potent than fentanyl. Carfentanil, the most potent fentanyl analog detected in the U.S., is estimated to be 10,000 times more potent than morphine.

Non-pharmaceutical fentanyl is frequently referred to as illicitly manufactured fentanyl (IMF) and is often mixed with heroin and/or cocaine or pressed into counterfeit pills—with or without the user’s knowledge.

Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. Pharmaceutical fentanyl is primarily prescribed to manage severe pain, such as with cancer and end-of-life palliative care and comes in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States. However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.

According to the National Institute on Drug Abuse (NIDA) An analysis of opioid-related overdose deaths found that synthetic opioids, such as illicit fentanyl, have surpassed prescription opioids as the most common drug involved in overdose deaths in the U.S. and nearly half of opioid-related deaths in 2016 involved fentanyl.

A lack of awareness about the potency of fentanyl, along with its variability, availability and increasing contamination of the illicit drug supply, poses substantial risks to people who use drugs. The need for widespread public health education and training of clinicians and first responders about fentanyl risks, suggest they be equipped with multiple doses of naloxone to reverse overdose, and call for expanded access to medication-assisted treatment for opioid addiction.

For more information about the Centers for Disease Control and Prevention (CDC) and their research on fentanyl, please visit https://www.cdc.gov/drugoverdose/data/fentanyl.html.

For more information about The National Institute on Drug Abuse (NIDA) please visit http://www.drugabuse.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled, "Keeping Glen Cove SAFE," in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencove or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.