Jan. 2, 2023

Fentanyl

Show Notes

Dr. Dziwe Ntaba joins Stan and Clarence in a conversation about fentanyl and the scope of the fentanyl crisis.

Dr. Ntaba is an emergency medicine physician at M Health Fairview University of Minnesota Medical Center, 2021 Bush Fellow, Assistant Professor at the University of Minnesota Department of Emergency Medicine, and has a background in global health.

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Research

What is fentanyl?
- Many users think they are buying heroin when they are really buying fentanyl
- It is nearly impossible to tell if drugs have been laced with fentanyl unless tested with fentanyl test strips
- Illegal fentanyl tablets are made to look exactly like prescription medications
- Even in small doses it can be deadly
- DEA reports that 6/10 illegal tablets sold on US streets contain a potentially lethal dose of fentanyl
- Pharmaceutical → prescribed by doctors to treat severe pain
- Illicitly manufactured → distributed through illegal drug markets for its heroin-like effect
- Small and constricted pupils
- Falling asleep or losing consciousness
- Slow, weak, or no breathing
- Choking or gurgling
- Weak or limp body
- Cold, clammy, and/or skin

A synthetic opioid 50x stronger than heroin and 100x stronger than morphine
Pharmaceutical fentanyl was developed for pain management in cancer treatments
Added to heroin (and other drugs) to increase potency or disguised as more potent heroin
Effects include relaxation, euphoria, pain relief, sedation, confusion, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression
Street names for fentanyl include apace, china girl, china town, china white, and dance fever
Major contributor to fatal and nonfatal overdoses in the United States
Pharmaceutical fentanyl v. illicitly manufactured fentanyl
Signs of an overdose

Scope of the fentanyl crisis

One of the most common drugs involved in overdose deaths
150+ people die everyday from overdoses related to synthetic opioids like fentanyl
107,000 Americans died of drug overdoses in 2021 (two-thirds of those deaths were caused by fentanyl)
More than 56,000 deaths involving synthetic opioids occurred in the United States in 2020 (more deaths than from any other type of opioid)

Research shows that source of fentanyl is more likely to be illicitly manufactured than pharmaceutical

DEA recently reporting seizing more than 380 million potentially fatal doses of fentanyl within the past year
- Only part of the total fentanyl seizure → doesn’t include seizures from Customs and Border Protection(CBP), which detected over 14,000 pounds of illegal fentanyl this year

Mostly because of increase in mexican drug-trafficking organizations
Confiscated more than 10,000 pounds of fentanyl powder and 50.6 million illegal fentanyl tablets (2x the number of tablets seized in 2021)
The seizes reported are enough to “kill everyone in the United States” (Anne Milgram, DEA administrator)

Illegal fentanyl has become the leading cause of death for Americans 18-49

Fatal overdoses from fentanyl have increased 94% since 2019
Fentanyl kills more people than car accidents, gun violence, and suicide (in the United States)

US authorities estimate they are only catching 5-10% of illegal fentanyl that crossed the southern border
Fake pills (illegal fentanyl tablets) are now readily available on social media

“No pharmaceutical pill bought on social media is safe…the only safe medications are ones prescribed directly to you by a trusted medical professional and dispensed by a licensed pharmacist.” (DEA)