Program focuses on fighting back against fentanyl Experts say awareness, education best tools against the drug
Those attending Tuesday’s fentanyl awareness program who might have thought it was a problem only for major metropolitan areas were left with no illusions regarding the devastation the highly addictive substance can reap on not just individuals but families and communities as well.
“Sometimes we think that we’re a small town and it’s not happening here,” said Arlene Brown, the recovery support navigator for Northern Inyo Healthcare District’s addiction treatment program. “But it is and so we wanted to just raise awareness, give education and hopefully help save lives and prevent any future overdoses.”
The program held at the Calvary Baptist Church in Bishop provided the facts about fentanyl, strategies to stay safe, what youth are facing, and treatment options. It included a panel of area experts, training on recognizing signs and symptoms of an opioid over
dose as well as training on opioid overdose reversal kits, or Narcan. There also was a special celebration for people in recovery.
Fentanyl
Dr. Anne Goshgarian, an emergency and addiction medicine physician at
NIHD, said fentanyl is an opiate and opiates are pain medications, which are medications that block pain receptors.
She said fentanyl “is extremely potent and works very well for that purpose.” However, it’s often associated with a feeling of euphoria and that’s part of the reason that it’s become a “drug of abuse.”
Goshgarian said if fentanyl, or any opiate, is used for a long time and then stopped suddenly, the user can go into physical withdrawal. Symptoms of withdrawal are “really uncomfortable” and include body aches, nausea, vomiting, runny nose, diarrhea, among others. The withdrawal also is associated with extreme dysphoria, melancholy, a lack of motivation and inability to do anything.
Goshgarian said opiates themselves have been around for a long time, having first been synthesized from a poppy plant around 3000 BC. It has since been cultivated by different cultures throughout the centuries.
An epidemic evolves
In 1959, Goshgarian said, Dr. Paul Janssen, a Belgian physician, chemist and the founder of Janssen Pharmaceuticals, synthesized or created a compound called fentanyl.
Fentanyl, she said, was immediately noticed to be about 100 times stronger than morphine, it acts fast and has a short half life, meaning it goes away really quickly as well.
She said in 1974, Janssen, who created other medications, developed another drug called carfentanyl, which is about
10,000 times more potent or stronger than morphine. Janssen marketed the fentanyl derivative as an elephant tranquilizer
“It’s helpful for those large animals,” she said. “Unfortunately, humans are not so large and carfentanyl is really lethal to humans because of how potent it is.”
She said it would only take as much carfentanyl powder to cover Abraham Lincoln’s nose on a penny to be fatal.
Goshgarian said in about 1995 Purdue Pharmaceuticals introduced another opiate, OxyContin, which was widely prescribed because, at the time, pain management was considered a top health priority.
In about 2005, the “medical pendulum” swung back and a crackdown on opiates began, which reduced their availability but not the demand for them, she said.
The international black market discovered that producing fentanyl was much cheaper than running a poppy cultivation operation to create heroin.
“So we are seeing a huge change in the supply of illicit drugs coming into the country,” she said. “More are actually fentanyl but fentanyl that’s being sold as heroin, fentanyl is being sold as OxyContin and other drugs. So we’re seeing a huge influx of fentanyl.”
This has led to fentanyl contamination of other drugs, which has led to more overdose deaths because people aren’t aware of what they are taking, Goshgarian said.
She said since 2016 the rate of accidental overdose deaths due fentanyl increased dramatically and it continues to climb.
“Accidental overdoses surpassed motor vehicle collisions as the most common cause of accidental death in 2016,” Goshgarian said. “And they still hold that top spot today. The vast majority of those accidental overdoses include fentanyl and many of them also are poly substance, meaning it’s fentanyl and methamphetamine or fentanyl and heroin. So it’s a really, really dangerous time to be using.”
A personal story
During Tuesday’s program, Maria, whose last name wasn’t used, talked about her husband who overdosed and the pain that it caused at the time and how it continues to impact her and her family, including six children.
Maria said at the time her husband overdosed, one of her daughter’s was having a sleep-over with a friend and her husband had locked himself in a bathroom to get high.
Maria said she had to break the bathroom door in to get to her husband, who already had overdosed and died. She said she could see her husband’s smile through the vomit from his last high.
Maria said she knew the “friends” who sold her husband the drugs that ultimately killed him and feels “betrayed” when she sees them.
She said she found her husband’s drug stashes after he died, which also posed dangers to herself and her children.
Maria said she is angry because “I really do not believe this drug is going away. It’s going to be here and it’s going to get worse.”
Goshgarian said amidst all the doom and gloom of the increase in accidental overdose deaths, it has brought the issue to national attention.
“We’ve got huge support in trying to create new pathways to find treatment strategies to help patients who are struggling with addiction,” she said. “As an addiction medicine provider, we have great medication treatment options that are FDA approved for treatment of opiate use disorder. They’re safe, they’re effective, and they work.
“There’s a lot of hope, even though it sounds very scary,” Goshgarian continued. “The opioid epidemic in the fentanyl era is real. And we’re in it but we do have good ways to combat that.”
(Editor’s note: See the Saturday edition for a story on the panel discussion from Tuesday’s program.)