Of­fi­cials say opi­oids can lead to il­le­gal sub­stance abuse

The Sentinel-Record - - FRONT PAGE - MAX BRYAN

EDI­TOR’S NOTE: This is the sec­ond in­stall­ment of a mul­ti­part se­ries on opi­oids, considered to be the fastest-grow­ing abused sub­stance in Gar­land County by lo­cal health of­fi­cials.

Com­monly pre­scribed opi­oids like hy­drocodone have the po­ten­tial to lead to il­le­gal sub­stance abuse, ac­cord­ing to Qua­paw House Di­rec­tor Casey Bright and Hot Springs Po­lice Chief Ja­son Stachey.

Bright said re­cently that oxy­codone, hy­drocodone, mor­phine and fen­tanyl are the most com­monly abused opi­oids in Gar­land County. Fen­tanyl, which was orig­i­nally man­u­fac­tured as a re­liever of ex­treme pain, is 50 times more po­tent than heroin.

Though it can be pre­scribed for pain by doc­tors, fen­tanyl is also man­u­fac­tured as a street drug and sold il­lic­itly. In a pre­sen­ta­tion at the Pre­scrip­tion Drug Sum­mit Nov. 9 at the Hot Springs Con­ven­tion Cen­ter, Stan Jones, a Drug En­force­ment Agency special agent from Nashville, said fen­tanyl has a re­turn in­vest­ment of $20 on the penny for its man­u­fac­tur­ers.

Jones said il­licit fen­tanyl pills are branded with Rx let­ter­ing to give them a gen­uine ap­pear­ance.

“As long as there’s that profit mar­gin, there’s gonna be peo­ple that are gonna make that kind of profit, and as long as we have the dis­ease of ad­dic­tion that we have, we have the per­fect storm,” Jones said in his pre­sen­ta­tion.

With ad­dicts, Bright said syn­thetic opi­oids are of­ten taken with il­le­gal sub­stances and can lead to the use of more dan­ger­ous opi­oids.

‘A place that’s il­le­gal’

Stachey says his of­fi­cers have seen users tran­si­tion from pre­scrip­tion opi­oids to il­le­gal drugs.

“From what they’ve re­ceived from their physi­cians, they will move onto heroin,” Stachey said. “That’s what we’ve seen.”

“With opi­ates, it’s a road that leads them to a place that’s il­le­gal,” Bright said.

On July 2, The Sen­tinel-Record re­ported the emer­gence of the syn­thetic opioid car­fen­tanil in Arkansas. Car­fen­tanil, an ana­log of fen­tanyl that was orig­i­nally man­u­fac­tured for the pur­pose of tran­quil­iz­ing ele­phants and other large mam­mals, is 100 times more pow­er­ful than fen­tanyl. In his pre­sen­ta­tion, Jones said an amount of car­fen­tanil “that can fit in Pres­i­dent Lin­coln’s ear on a penny” can kill a hu­man be­ing.

Bright cited car­fen­tanil for one in-state over­dose in 2017. The user was treated at the Univer­sity of Arkansas for Med­i­cal Sciences in Lit­tle Rock.

LifeNet Hot Springs Gen­eral Man­ager Ja­son Gart­ner said the amount of Narcan, a sub­stance used for treat­ing opioid over­doses, that his team has ad­min­is­tered in cer­tain in­stances in 2017 has been con­sis­tent with car­fen­tanil use.

In the field, Gart­ner said the ad­min­is­tra­tion of Narcan has some­times proven in­ef­fec­tive, even if all of the user’s signs point to opioid abuse.

“It’s not un­com­mon for pa­tients to take more than one drug if they’re over­dos­ing,”

he said. “Narcan only re­verses opi­oids. So if they’ve taken other non-opioid drugs, the Narcan doesn’t do any­thing for that.”

‘The gamut’

The sto­ries Gart­ner has heard from his first re­spon­ders re­gard­ing opioid abuse reach into ev­ery area of the abuser’s life.

“Some of the head­line, catchy stuff, is peo­ple are dy­ing, and that is cer­tainly true. But it’s so much more than that,” Gart­ner said.

He said his teams have of­ten re­sponded to in­ci­dents that are not exclusive to sub­stance abusers to find the sub­ject of the in­ci­dent is dis­play­ing signs of opioid use. His team has also re­sponded to trau­matic opioid with­drawal episodes sim­i­lar to those that Bright men­tioned.

“From an an­a­lyst’s per­spec­tive, how it’s show­ing up for us is ev­ery­thing from mov­ing ve­hi­cle ac­ci­dents to sim­ply not feel­ing well to over­doses,” he said. “It’s the gamut.”

Gart­ner said it is not un­com­mon for his teams to re­spond to mul­ti­ple calls in ref­er­ence to dif­fer­ent sit­u­a­tions in­volv­ing the same opioid abuser.

“The pri­mary com­plaint might not be, ‘I’m tak­ing opi­oids,’” Gart­ner said. “That’s just part of the story that’s in­ter­wo­ven in why we’re in­ter­act­ing with them.”

Bright called opioid abuse “a sore sub­ject” among the Gar­land County pop­u­la­tion, not­ing it is ev­i­dent at his speak­ing en­gage­ments.

“When I tell them, ‘Your real prob­lem is pre­scrip­tion drugs in gen­eral, opi­ates, ben­zos and al­co­hol,’ They go, ‘Well, what about metham­phetamine?’” he said. “You have peo­ple in that room who are us­ing a high num­ber of pre­scrip­tion drugs.”

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