Fentanyl drives soaring hike in ODs
Overdose deaths from fentanyl-laced drugs have soared in Central Florida during the COVID-19 pandemic, outpacing the increase for the state as a whole and killing an average of more than 50 people in Orange, Osceola and Seminole counties each month, a new report on the crisis shows.
The report, slated to be released Wednesday, is the first comprehensive examination of the region’s problem since the pandemic began. It found victims of overdoses are now younger, more likely to be Black, more likely to be male, and much more likely to have died of fentanyl than in 2015.
In Orange, Osceola and Seminole, it said, 616 people died of drug overdoses between March 2020 and March 2021 — the vast majority of them due to fentanyl or fentanyl mixed with other illicit drugs or alcohol.
“The volume is staggering. The number of people dying is absolutely heartbreaking,” said the report’s author, Kendall Cortelyou, an associate professor at UCF’s School of Global Health Management and Informatics. “Fentanyl not only is deadly on its own, but fentanyl mixed with other drugs makes them more deadly — and a lot of these people likely didn’t even realize what they were taking.”
The yearlong investigation was paid for by Project Opioid, the nonprofit initiative founded in 2018 to help community leaders respond to what was initially a prescription opioid and heroin crisis. The organization has held educational sessions with local government, business and faith leaders, advocated for changes in state funding to address a lack of treatment options, and helped distrib
ute naloxone, the nasal spray that can reverse the effect of an opioid overdose.
Andrae Bailey, founder and CEO of Project Opioid, called the latest numbers “unthinkable.”
“We already thought we had a crisis in 2019, but in 2021 overdoses are up another 40 to 50%, depending on what community you’re in,” he said. “The drug crisis as we knew it in this community and around America is no longer the same. Drug dealers have figured out that fentanyl is the most profitable and powerful drug ever distributed in human history.”
Where fentanyl was once mixed mainly with heroin, Cortelyou-Ward said, it is now mixed with baking soda and pressed into pills to masquerade as the painkillers Oxycontin, Percocet and Vicodin and even Adderall, the attention deficit hyperactivity disorder medication.
“It’s so much cheaper to make,” she said. “Instead of miles and miles of poppy fields, fentanyl is stirred up in a barrel in the middle of the Mexican desert with ingredients they get from China. Compared to heroin, it costs pennies on the dollar.”
For months, authorities have blamed the pandemic for increased drug and alcohol use fueled by isolation, job loss and stress. But Cortelyou-Ward said her research led her to conclude that the pandemic only accelerated the inevitable.
“Honestly, I have changed my opinion on this,” she said. “The more I talked to my contacts at the [federal] Drug Enforcement Agency, the more I hear that drug dealers in China were going to do whatever needed to be done to sell the U.S. more opioids. The origins of this were all developed before the pandemic set in.”
Under international pressure, the Chinese government banned the production and sale of fentanyl and many of its variants in May 2019. But the country has continued to be a source of the precursor agents used to manufacture fentanyl, and, according to U.S. Customs and Border Protection, India has also emerged as a leading source of the drugs, often via Mexico.
Two weeks ago, the U.S. Centers for Disease Control and Prevention reported that more than 100,000 Americans died of drug overdoses in the 12-month period ending in April 2021, a record increase of 28.5% over the previous year.
The increase was nearly the same in Central Florida over the same period, although Florida as a whole was slightly lower, with a 26% rise.
Locally, Brevard and Volusia counties had the highest overdose death rates, with nearly 57 deaths per 100,000 residents — compared to 31 per 100,000 in Lake, 29 in Seminole, 27 in Orange and 23 in Osceola.
Cortelyou-Ward said she could not explain why the coastal communities had higher rates but that “clearly, fentanyl has really infiltrated their drug supply.”
She also cited a notable rise in overdose deaths among Black residents. While whites still account for 82% of overdose deaths in Central Florida, overdose deaths in the Black population have increased over 200% between 2015 and 2021, compared to 144% during the same time for whites.
“The Black community did not get addicted to prescription opioid pills the way that others did because they, overall, don’t go to the doctor as much and they don’t trust the medical community as much — with good reason, historically,” she said.
Even when Blacks do seek medical attention, though, researchers have found they are less likely to receive adequate pain medication.
A study published in July’s New England Journal of Medicine found that, on average, white patients received 36% more pain medication by dosage than Black patients, even though both groups received prescriptions at similar rates.
“So a lot of Black Americans are what we call opioidnaïve, meaning they haven’t had opioids in their system and they have zero tolerance for it,” Cortelyou-Ward said. “Now that fentanyl is being put into all these other drugs ... they’re overdosing and dying.”
That’s why Bailey supports a public education campaign that “there is no safe pill” when it comes to buying drugs on the street, he said. The romanticism of recreational drug use, he said, now has potentially deadly consequences.
The report also calls for the distribution of more potent naloxone to counter more potent fentanyl and a dramatic increase in access to medically assisted treatment for those addicted to opioids.
“If you’re a parent, and you have kids using drugs, you should be scared,” Bailey said. “This is one of the times when you can’t scream loud enough.”