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What is Fentanyl? It sounds like something found in the produce section of the local grocery store, stuck somewhere between arugula and radicchio. But its not. Fentanyl is a synthetic, or manufactured opioid, similar to morphine, except that it’s up to 100 times more potent and deadly.
When prescribed in a hospital setting for post-surgical pain management, you may have heard it called by such brand names as Durageisc® or Actiq®. On the street, where it is often produced and sold illegally, it goes by such names as Apache, Dance Fever, Goodfellas, or China Girl, that last name referring to a variety of the drug manufactured and smuggled in from China, a major supplier to the American street drug market.
Fentanyl and other similar synthetic opioids are now the leading factor in drug overdose deaths in the United States, with roughly 60% of opioid-related deaths traced back to their use, as of 2017. In case you are wondering, in 2010, that percentage was only about 14 percent.
Closer to home, in Massachusetts, there is both good and bad news about the opioid crisis. While overall, the fatal count of opioid overdoses fell slightly in 2019, down about 11% in the first 6 months of this year, illegally manufactured fentanyl was found to be present in 92% of those who did succumb to an overdose, reflecting the drugs’ growing presence in the state. The African American community continues to be the most heavily impacted, with the overdose rate continuing to climb, even as it falls for whites and Hispanics.
In Boston, one substance abuse treatment provider notes that fentanyl has virtually replaced heroin in the city, largely due to fentanyl’s higher potency and ease of manufacture. He noted that it is becoming uncommon for Boston area heroin addicts to NOT have fentanyl in their toxicology screens, whether the user is aware of it or not.
Drug dealers often use fentanyl to “cut”, or dilute other illegal drugs, like heroin or cocaine, to increase their profits on the street. Cocaine especially is much more dangerous when mixed with fentanyl. Many cocaine users may not be opioid users and will have a much lower tolerance for the powerful drug, greatly increasing their potential for an overdose. Cocaine has surpassed heroin in tests of those who have fatally overdosed, prompting the state to alert treatment providers that cocaine users are now equally at rick of an opioid overdose.
The state of Massachusetts is working hard to turn the tide of opioid addiction and, beginning in late 2017, appears to be having some success. Programs in use include:
These, and other programs are helping the Commonwealth win their battle against opioid overdose.
There are also many community based resources available to the public including acute treatment services (ATS), opioid detox, structured outpatient programs (SOAP), to a variety of Medication-Assisted Treatment (MAT) programs offering outpatient treatment. Health Care Resource Centers offer MAT with methadone and substance use counseling in Massachusetts, Maine, Connecticut and New Hampshire.
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