Teach kids to fear fentanyl; control hypertension before pregnancy

Q: I keep hearing about how something called fentanyl is making recreational drugs really lifeand-death risky. I want to give my teen and young adult children a profound scare. So what are the facts? — Gerry G., Philadelphia

A: The federal government has a website called “One Pill Can Kill,” and if that doesn’t sum up the horrors of fentanyl, I don’t know what does. You can visit it at www.dea.gov/onepill. Their sections on parental advice and the difference between legit and fake “prescription” drugs are very helpful. Here’s the scary data they share:

■ Fentanyl is a powerful synthetic opioid, similar to morphine but 50 to 100 times more potent.

■ Criminal drug networks are mass-producing fake pills and falsely marketing them as legitimate prescription pills, often on social media and e-commerce platforms.

■ Many counterfeit pills are made to look like prescription opioids such as oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin) and alprazolam (Xanax); or stimulants like amphetamines (Adderall).

■ Drug Enforcement Administration labs find that four out of every 10 pills they test are laced with a potentially lethal dose of fentanyl. (These are not obtained from legitimate pharmacies.)

■ Fentanyl is also being mixed with heroin, cocaine, methamphetamine and MDMA.

So far this year, the DEA has seized 20 million pills laced with fentanyl, but that has not prevented numerous mass-overdose incidents. Just last month, the DEA sent a letter to law enforcement partners in local, state and federal agencies warning of a nationwide spike in fentanyl-related mass-overdose events. The DEA administrator cautioned “many overdose victims have no idea they are ingesting deadly fentanyl until it’s too late.”

In 2021, there were over 80,000 drug-overdose deaths involving opioids, and more than 71,000 of them involved illegally manufactured fentanyl. Please, share this with your kids and make it clear — just trying it (whatever pill, powder or patch it is) once could be “just” dying once. Nothing is worth that risk.

Q: I’m 37 and have high blood pressure. My new husband and I want to have a child, but my OB-GYN says I have to get my blood pressure under control without medication first. That seems extreme. What do you think? — Alyese D., Manhattan, Kansas

A: High blood pressure during pregnancy, whether from a preexisting condition or developed during pregnancy, has potentially far-ranging negative effects on the mother, including pre-eclampsia, stroke, induced labor and placental abruption (the placenta separating from the wall of the uterus). A third of women who died in childbirth in 2019 had a high blood pressure disorder. It also affects the fetus and newborn, causing preterm delivery (before week 37), low birth weight (less than 5 pounds, 8 ounces) and even congenital malformation of the penis.

The Centers for Disease Control and Prevention has just sounded an alarm that those risks are now impacting one out of every seven deliveries! So why is your doctor saying you should use lifestyle changes to control your blood pressure? I cannot know for sure, but I think it’s a vote of confidence that you can beat this on your own. There are antihypertensive medicines that are considered safe to take while you are pregnant, but angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and renin inhibitors are generally avoided. And lifestyle changes can lower blood pressure by at least as much as a single antihypertensive drug, according to a study in the British Journal of General Practice.

I bet you can tick off the lifestyle steps to take: Eat a plant-based diet — seven to nine servings of fruits and vegetables daily. Slash saturated and total fat consumption. Get 10,000 steps daily or the equivalent. Maintain a healthy body weight. Get enough restful sleep nightly. And practice stress-reduction techniques like meditation. If those don’t work, ask your doc to help you with medication.

For a truly wonderful pregnancy and new motherhood, act now to get control of your blood pressure.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@greatagereboot.com.