When I think about purple in August, I used to think about the wildflowers’ colors blooming in the summer and fall in Texas. Now, I think more about the lives lost to overdose and National Overdose Awareness Day on August 31st.
As a board certified Addiction Medicine physician specializing in Opioid Use Disorder, I want to take time this month to discuss the burgeoning epidemic of opioid use and overdose, specifically in light of the rise in synthetic opioids, often used through “pressed pills” made by way of clandestine operations.
Over the next few weeks we will spend time focusing on a few topics. First, let’s talk about FENTANYL.
Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. Illicitly manufactured fentanyl is a major contributor to both fatal and nonfatal overdoses in the US. According to the CDC, over 150 people die everyday due to synthetic opioids like fentanyl: that equates to 1 person every 9 minutes. Someone will have overdosed by the time you finish reading this article.
Newest research shows that teen overdose rose last year  for the first time in a decade, likely due to the contamination of drug supplies with illicitly manufactured synthetic opioids and counterfeit pills or “pressed pills”. These pills are difficult to distinguish from pharmaceutical pills and often mistaken for the drug of interest.
We often see individuals purchasing illicit alprazolam [xanax] or amphetamine/dextroamphetamine [adderall] that is contaminated with this highly potent synthetic opioid fentanyl, leading to overdoses in individuals not intending to use opioids at all.
Other times, individuals intending to use opioids such as oxycodone or hydrocodone are actually purchasing these “pressed pills” thinking they have received the pharmaceutical grade medications.
Not knowing they are ingesting these very dangerous counterfeit versions of the ‘medications’ with widely varying amounts of fentanyl from pill to pill, a lethal dose can be ingested.
Additionally, other illicit substances are seen with similar contamination, such as amphetamines, methamphetamines, cocaine, MDMA [ecstasy] and marijuana. FENTANYL AS A SOURCE OF UNINTENTIONAL CONTAMINATION AND POTENTIAL OVERDOSE IS A COMMON OCCURRENCE AND SHOULD BE NOTED AMONG PROBLEMATIC AND RECREATIONAL SUBSTANCE USERS AS A SIGNIFICANT HAZARD [ EVEN IN MARIJUANA ].
We are seeing these numbers increase, not decrease or plateau. No doubt, illicitly manufactured fentanyl has a large part to play in overdose deaths. There are more potent illicit synthetic opioids in our communities besides fentanyl and we should all be aware to remain vigilant as we continue to fight this crisis. Naloxone is the next subject I will discuss this month, and we should all be armed to aid someone in need.
Remember that harm reduction saves lives. Opioid use disorder can and should be successfully treated. Treatment saves lives. If you or a loved one has problematic use, speak to a professional trained in addiction medicine to start a journey towards recovery. Not one more life needs to be lost to this disease.
Dr Kathryn Rutland MD FASAM