The following was compiled by our guest, Mimi Harder’s friends prior to her interview today 3/31. It’s a subject that needs to be discussed. If it only helps one person, we should all be grateful. The info is compiled from many sources including articles from credible sources found online and in the UT Health Sciences Library. We thank them for all their support, and we’re hopeful that those who need help and support are able to get it.
*** As of June 21, 2017, Mimi’s new site is up. It’s a resource site as well as a blog where she posts about relevant issues regarding this epidemic. It’s www.doitforshelby.com
Some other helpful organizations are below; there are many more in Memphis.
Not a New Problem
As early as 2009, the use of painkillers was becoming recognized as a gateway to opioid addiction. Author of the Peabody award winning documentary “The OxyContin Express”, Mariana van Zeller, reported the following in 2011: “Prescription drug abuse is worse than the ’80s crack epidemic. Overdose deaths from prescription painkillers more than doubled between 2000 and 2007. Painkiller addicts are turning to heroin, which is cheaper and easier to obtain.”
Heroin is no longer just cheaper and easier to obtain. Heroin has been being ‘cut’ with fentanyl, a deadly synthetic stronger than morphine or heroin. Fentanyl is often illegally manufactured. Now, heroin is being cut with carfentinal, a veterinary pharmaceutical 10,000 times more potent than morphine. Not approved for use in humans, carfentanil is deadly not only to the addict, but presents a very real danger to first responders and anyone exposed.
In 2006 the National Drug Intelligence Center reported the following: “Fentanyl is a powerful synthetic opiate approximately 50 times more potent than heroin and 100 times more powerful than morphine. It is typically prescribed to treat severe or chronic pain. In recent years, clandestinely produced fentanyl in combination with heroin or cocaine has been linked to hundreds of deaths and overdoses. Because fentanyl is an opiate and specialized testing is required to detect it in biological samples, many fentanyl overdoses were initially classified as heroin overdoses.”
“Overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, increased by 72% from 2014 to 2015. Roughly 9,500 people died from overdoses involving synthetic opioids other than methadone in 2015.”
In June, DEA released a Roll Call video to all law enforcement nationwide about the dangers of improperly handling fentanyl and its deadly consequences. Acting Deputy Administrator Jack Riley and two local police detectives from New Jersey appear on the video to urge any law enforcement personnel who come in contact with fentanyl or fentanyl compounds to take the drugs directly to a lab.
“Fentanyl can kill you,” Riley said. “Fentanyl is being sold as heroin in virtually every corner of our country. It’s produced clandestinely in Mexico, and (also) comes directly from China. It is 40 to 50 times stronger than street-level heroin. A very small amount ingested, or absorbed through your skin, can kill you.”
Fentanyl has also been reported in cocaine, Xanax, and Norco. In 2014, an estimated 80 people per day died of an opioid overdose in the US, according to the Centers for Disease Control. “Fentanyls will continue to appear in counterfeit opioid medications and will likely appear in a variety of non-opiate drugs as traffickers seek to expand the market in search of higher profits,” concludes the report. “Overdoses and deaths from counterfeit drugs containing fentanyls will increase as users continue to inaccurately dose themselves with imitation medications.”
Carfentantil, “Crazy Dangerous”
“September 22, 2016: DEA has issued a public warning to the public and law enforcement nationwide about the health and safety risks of carfentanil. Carfentanil is a synthetic opioid that is 10,000 times more potent than morphine and 100 times more potent than fentanyl, which itself is 50 times more potent than heroin. DEA, local law enforcement and first responders have recently seen the presence of carfentanil, which has been linked to a significant number of overdose deaths in various parts of the country. Improper handling of carfentanil, as well as fentanyl and other fentanyl-related compounds, has deadly consequences.”
“Carfentanil is surfacing in more and more communities.” said DEA Acting Administrator Chuck Rosenberg. “We see it on the streets, often disguised as heroin. It is crazy dangerous. Synthetics such as fentanyl and carfentanil can kill you. I hope our first responders – and the public – will read and heed our health and safety warning. These men and women have remarkably difficult jobs and we need them to be well and healthy.”
“Carfentanil and other fentanyl-related compounds are a serious danger to public safety, first responder, medical, treatment, and laboratory personnel. These substances can come in several forms, including powder, blotter paper, tablets, and spray – they can be absorbed through the skin or accidental inhalation of airborne powder. If encountered, responding personnel should do the following based on the specific situation:
Exercise extreme caution. Only properly trained and outfitted law enforcement professionals should handle any substance suspected to contain fentanyl or a fentanyl-related compound. If encountered, contact the appropriate officials within your agency.
Be aware of any sign of exposure. Symptoms include: respiratory depression or arrest, drowsiness, disorientation, sedation, pinpoint pupils, and clammy skin. The onset of these symptoms usually occurs within minutes of exposure.
Seek IMMEDIATE medical attention. Carfentanil and other fentanyl-related substances can work very quickly, so in cases of suspected exposure, it is important to call EMS immediately. If inhaled, move the victim to fresh air. If ingested and the victim is conscious, wash out the victim’s eyes and mouth with cool water.
Be ready to administer naloxone in the event of exposure. Naloxone is an antidote for opioid overdose. Immediately administering naloxone can reverse an overdose of carfentanil, fentanyl, or other opioids, although multiple doses of naloxone may be required. Continue to administer a dose of naloxone every 2-3 minutes until the individual is breathing on his/her own for at least 15 minutes or until EMS arrives.
NARCAN / Naloxone
Naloxone, sold under the brandname Narcan among others, is a medication used to block the effects of opioids, especially in overdose. “Narcan™ (naloxone) only affects people who are using opioids. If a person is not having an overdose but has been using opioids, Narcan™ (naloxone) will put them into immediate withdrawal. This can be very uncomfortable for the person, but is not life threatening.”
Personally, I believe a person in withdrawal should be in a medically monitored situation. If you have a loved one who has been revived with naloxone they need to be admitted to a rehabilitation facility before they acquire drugs cut with fentanyl or carfentanil. (TH)
Saving Our Community and Our Kids
Accidents, injuries, and surgeries put us ALL at risk of addiction to prescription medication. Those who struggle with depression, anxiety, PTSD, and ADD are also at risk. a recent study published in the Journal of Child & Adolescent Substance Abuse reveals that some of those most at risk for getting hooked on pain pills are high school athletes. Dr. Lisa Fortuna, MD, MPH, explains what signs a parent can look for. “It becomes more and more difficult for a teen who regularly takes these pills to manage withdrawal (which included a combination of aches, flu like symptoms, sweats and dysphoric/ irritable moods). Medical intervention such as detoxification becomes necessary but also treatment to address the underlying psychological issues of addictions and mental health disorders if also present is usually needed.”
Prescription painkillers are often diverted into the community and to peers for recreational use. “Among people who become addicted to prescription painkillers, studies suggest 1 in 15 will try heroin within 10 years. Prescription drug abuse can lead to teen heroin addiction.”
“The problem is not a deficit in morals or values on the part of teens, parents or families. This is a growing public health and medical problem that we now know crosses racial and socioeconomic lines.” (Fortuna)
All ages, races, and communities are affected by this epidemic and we must become educated and involved in stopping it. Even if you do not have an addicted loved one, even if your business is not affected by addiction, you could be exposed to the substances fentanyl or carfentanil. We need to start having conversations.
van Zeller, Mariana. “Painkillers are a Gateway to Heroin” CNN June 23, 2011
Fortuna, Lisa. MD, MPH “Addictions to Rx Pain Medication in Teens: What Parents Need to Know and What They Can Do” http://prescription-drug.addictionblog.org/addictions-to-prescription-pain-medication-in-teens-what-parents-need-to-know-and-what-they-can-do/
“Survey Says High School Athletes More At Risk for Prescription Abuse Problems” Narconon http://www.narconon.org/blog/narconon/survey-says-high-school-athletes-risk-prescription-abuse-problems/
DEA Special Report, Fentanyl, 2003–2006 https://www.deadiversion.usdoj.gov/nflis/fentanyl.pdf
CDC, Opioid Overdose, Fentanyl https://www.cdc.gov/drugoverdose/opioids/fentanyl.html
The Guardian, “Pills laced with deadly opioid infiltrating drug market, DEA says” https://www.theguardian.com/us-news/2016/jul/24/counterfeit-prescription-pills-laced-deadly-opioid-fentanyl
DEA, Carfentanil Warning to Police and Public: Dangerous opioid 10,000 times more potent than morphine and 100 times more potent than fentanyl
van Zeller, Mariana. “The OxyContin Express” Peabody Award Winning Documentary 2009
View here: https://www.youtube.com/watch?v=IwKqTAqm6Ww
DEA Roll Call – Fentanyl – View here: https://www.dea.gov/video_clips/Fentanyl%20Roll%20Call%20Video.mp4
“OxyContin: The New Gateway Drug to Heroin” Novus Medical Detox Center https://novusdetox.com/oxycontin-heroin-detox.php
“How is heroin linked to prescription drug abuse?” The National Institute on Drug Abuse
“A series of forensic toxicology and drug seizure cases involving illicit fentanyl alone and in combination with heroin, cocaine or heroin and cocaine.” PubMed https://www.ncbi.nlm.nih.gov/pubmed/25217552
“The Potential Threat of Acetyl Fentanyl: Legal Issues, Contaminated Heroin, and Acetyl Fentanyl “Disguised” as Other Opioids” The Annals of Emergency Medicine
“Death matters: understanding heroin/opiate overdose risk and testing potential to prevent deaths.” PubMed
For recent news regarding this epidemic and other important issues, we encourage you to frequently visit the CDC, FDA, and DEA online.