Officials: Fentanyl ‘driving’ overdose deaths
About 1,524 people in Connecticut died from drug overdoses in 2021, according to the latest data from the Office of the Chief Medical Examiner.
This is more than the population of the towns of Canaan, Colebrook, Union or Warren. It’s 150 more fatal overdoses than in 2020.
This increase can be attributed to “the prolonged isolation during the height of the COVID-19 pandemic” as well as the rise in the use of fentanyl and other synthetic opioids, according to Art Mongillo, a spokesperson for the state Department of Mental Health and Addiction Services.
The Centers for Disease Control and Prevention describes fentanyl as a synthetic opioid, 50 times stronger than heroin and 100 times stronger than morphine. While fentanyl is prescribed for pain, the CDC said most cases of fentanyl-related overdoses are linked to illicitly manufactured fentanyl, sold through illegal drug markets for its “heroin-like effect.”
“It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous,” the CDC added.
Fentanyl played a factor in 86 percent of Connecticut’s overdose deaths last year, putting the state’s total higher than the national average and prompting officials to stress the need to continue to monitor the drug’s prevalence on the illicit market.
Fentanyl continues to kill
In an April 6 letter to law enforcement agencies, DEA Administrator Anne Milgram addressed a nationwide increase in fentanylrelated mass overdose incidents so far this year, citing examples in Florida, Texas and Colorado in
which people thought they were ingesting cocaine. Milgram said at least seven confirmed incidents have been reported across the nation, leading to 59 overdoses and 29 deaths in the last two months.
Christopher Boyle, a spokesperson for the state Department of Public Health, said while multiple overdoses do occur in Connecticut — where two or more people are taking drugs together and overdose — the state has not seen anything on a largescale like what was described in the DEA letter.
Milgram called fentanyl “highly addictive,” adding that it is found in every state in the nation. She said drug traffickers mix fentanyl with other drugs, in powder and pill form, to drive up addiction and attract repeat customers. Pills that may look like Adderall, Xanax or oxycodone could be pressed to resemble the prescriptions, but really contain other chemicals like fentanyl or methamphetamine.
As of December 2021, the Drug Enforcement Administration seized 20.4 million fake pills that were often laced with fentanyl. Of the pills that contained fentanyl, 42 percent contained a potentially lethal dose.
Only a very small amount of fentanyl is considered potentially deadly — about 2 milligrams, or enough to fit on the tip of a pencil.
“DPH is trying to get the message across that when illicit drugs are obtained from the street, it is very likely that those drugs contain fentanyl,” Boyle said. “We have evidence that drugs such as cocaine and counterfeit pills such as Vicodin or Percocet also have fentanyl in their contents, among other contaminants.”
Boyle said individuals ingesting illicitly obtained drugs should use harm reduction methods and assume that fentanyl is in their drugs.
Milgram said many victims in the mass overdoses incidents thought they were ingesting cocaine.
Connecticut is no different. The OCME data showed that 561 deaths were tied to both cocaine and fentanyl last year, up from 447 in 2020.
Fentanyl has quickly become the leading cause of fatal overdoses in Connecticut in the past decade. In 2012, fentanyl was involved in about 4 percent of that year’s 357 overdose deaths. By 2015, overdose deaths rose to 728, fentanyl being involved in about a quarter of them. In the next year, fentanyl was involved in more than half of the year’s 917 overdose deaths.
Rising overdose rates
Data from the CDC’s National Center for Health Statistics, released in November 2021, indicates there were about 100,306 drug overdose deaths in the United States between April 2020 and April 2021.
That number was a 28.5 percent increase from the 78,056 deaths during the same 12-month period a year prior, the data showed.
Statewide, overdoses killed 1,038 people in 2017, 1,017 in 2018, 1,200 in 2019, 1,374 in 2020 and 1,524 in 2021.
“Fentanyl is the driving force and is overwhelmingly responsible for these increases,” said Dr. James Gill, the state’s chief medical examiner, on Wednesday. “Fentanyl is so potent that it is very difficult to dose it accurately. The people who sell drugs on the street are not chemists or pharmacists.”
Preliminary data from DPH shows there have already been 166 overdose deaths in 2022 — 144 of which involved fentanyl or a fentanyl analog, accounting for about 87 percent.
While the overall number of overdose deaths have risen, Mongillo noted that the percent increase year over year in Connecticut isn’t as big as it used to be. From 2019 to 2020, there was a 14.5 percent jump, while the jump from 2020 to 2021 was 11 percent.
Overdose events with more than one victim are not entirely uncommon in Connecticut. Boyle cited an incident at a Hartford magnet school earlier this year that led to the death of one student and a similar incident in New Haven at the correctional facility.
The Department of Corrections did not immediately respond to a request for additional information regarding the overdose incident at a New Haven facility.
While the state hasn’t seen any mass overdose incidents recently, that wasn’t the case a few summers back.
One day in August 2018, the New Haven Green turned into a makeshift triage center for scores of individuals overdosing on a batch of synthetic marijuana laced with fentanyl, officials said. At least 71 people overdosed in the Elm City during that mass overdose incident, with first responders scrambling to keep up with everyone falling ill with symptoms.
More recently, Sport and Medical Sciences Academy in Hartford was closed for several days for decontamination in January after a seventh-grader fatally overdosed on a substance that contained fentanyl.
Authorities said the 13year-old boy died after he was rushed to the hospital in grave condition following his overdose on the drug inside the school during gym class. Two other seventh-grade students were also hospitalized after police said they came into contact with the substance. Those two students recovered.
Keeping people alive
One expert said the 13year-old boy’s death highlighted the importance of making naloxone available at schools.
Hartford school officials confirmed after the boy’s overdose that the district did not have the drug supplied or staff trained in its use prior to the incident. Officials said the district would explore the possibility of getting it in schools.
Naloxone, commonly known by the brand name Narcan, is the opioid overdose-reversal drug used by first responders for years. It is administered in cases of suspected opioid overdoses and comes in an easy-to-use nasal spray.
The state Department of Education surveyed 178 school districts in February and found that 107 of them — or roughly 60 percent — had the medication on hand in at least one school within those districts. Seventy-one districts said naloxone was not available in any schools.
To combat the rising number of overdoses, DMHAS has prioritized the distribution and access of naloxone.
Naloxone can be prescribed by a primary care provider, family doctor, any doctor who is able to prescribe an opioid, and certain pharmacists. The drug can also be provided through certain organizations and harm reduction and needle exchange programs.
These needle exchange programs provide sterile needles and syringes as a way to prevent the spread of HIV and AIDS. They also facilitate the safe disposal of used syringes and connect people to services and programs such as substance use disorder treatment programs. Needle exchange programs additionally provide fentanyl test strips, which use a minuscule amount of the drug to check if it has fentanyl.
Medication assisted treatment has provided a more long-term solution. This treatment uses medications such as methadone, Suboxone and Vivitrol to reduce cravings and manage pain and withdrawal symptoms. The treatment also includes counseling and behavioral therapies to help combat opioid use disorder.
“This treatment approach has been shown to improve survival, increase retention in treatment, decrease illicit opiate use and other criminal activity among people with substance use disorders, increase patients’ ability to gain and maintain employment, and improve birth outcomes among women who have substance use disorders and are pregnant,” Mongillo said.
As of Monday, there were 11 beds available at medically monitored withdrawal management facilities, according to the DMHAS Addiction Services Availability website.
Mongillo said DMHAS is continuing to expand its harm reduction efforts, “which are important in directly lowering the number of overdose deaths.” This includes media campaigns and information that address issues related to stigma and asking for help.
“Whatever we can do to create low-barrier treatment opportunities in the community is also an important strategy,” he said.
Signs of a possible overdose include loss of consciousness, slowed breathing and narrow pupils.
Call 911 if you suspect an individual is suffering from an overdose.
To find treatment or other resources, call DMHAS’ access line at 1-800-563-4086. Help is available 24/7.