Nationwide deaths linked to black market fentanyl pills are on the rise. Many victims are people who have become addicted to pain relievers as a result of medical procedures.
STEVE INSKEEP, HTE:
For the first time ever, the United States could exceed 100,000 overdose deaths in a single 12-month period. A big culprit here is black market fentanyl. It is a strong synthetic opioid, and it now contaminates most street drugs. NPR addictions correspondent Brian Mann followed this. Brian, hello.
BRIAN MANN, BYLINE: Hello, Steve.
INSKEEP: And we’re also joined by Madelyn Beck from the Mountain West News Bureau in Boise, Idaho. Hello to you.
MADELYN BECK, BYLINE: Hello.
INSKEEP: Thanks for getting up early. Brian, I want to start with you. I still think we got our hands on this problem as a country. The public is attentive. People know it. People are trying to fix it. Lawmakers are trying to remedy this. Things seem to be getting better. How does it really get worse?
MANN: Yeah. Public health expert Steve points to two big factors – the pandemic, of course, which has put a lot of stress on millions of Americans struggling with drug addiction. The pandemic has made it difficult for people recovering to find treatment, leaving people deeply vulnerable. And on top of that, we’ve seen this rapid spread of fentanyl, this synthetic opioid, that Mexican drug cartels are now injecting into almost every drug on the street, including bogus pain relievers. I spoke about it with Dr Bradley Stein, who seemed genuinely afraid of these trends.
BRADLEY STEIN: I think it’s going in one direction. I think the increase in overdose deaths is tragic.
MANN: Stein is a researcher at the RAND Corporation and directs the Opioid Policy Center at RAND. And, Steve, he points out that the devastation caused by fentanyl goes far beyond these deadly overdoses.
STEIN: The harm to families, the harm to individuals who can get and keep jobs – with the number of deaths making the headlines, sometimes we don’t pay enough attention to these things as well.
MANN: So when we talk about this devastating 100,000 dead milestone that we’re approaching, it’s really just the tip of a very painful iceberg.
INSKEEP: Yeah, the ripple effects, you could talk in the millions. And of course, that’s 100,000 deaths in a year, and it’s an ongoing problem. Now, Madelyn Beck, this has been particularly bad in Colorado, Nevada and New Mexico, where fentanyl-related deaths more than doubled last year. Do we know why it gets worse and worse where you are?
BECK: So one of the reasons is excessive prescriptions. Like everywhere else, pain relievers have been over-prescribed. People have developed an addiction. Now, due to pressure from federal regulators, there are fewer written prescriptions. So, as Brian alluded to, the Mexican cartels are responding to the needs of people with fake pills. They look like OxyContin and other opioids, but they’re fentanyl, which is much cheaper and unfortunately easier to overdose. Jonathan Ellington developed an addiction after injuring his knee in high school in Kentucky. He overcame this addiction, but when he got injured again living in Colorado years later, he ended up buying OxyContin-like pills from the wrong person. It was fentanyl, and he died. Dave Ellington is his father.
DAVE ELLINGTON: It was in a bottle that was a medicine bottle, like it came from a drugstore. It had a person’s name on it, the person who actually sold it to him.
BECK: His story is not unique, unfortunately. The DEA says about a quarter of the fentanyl pills they seized contain enough of the drug to kill. And they say the amount of fentanyl from Mexico has doubled every year for the past four years.
INSKEEP: Now that’s a tricky question because, of course, one way to avoid being killed by illegal drugs is to not take them, but people buy them, people take them. And if they are in this situation, is there a way to know if the drugs are contaminated?
BECK: So starting in April, states could start using federal grants to pay for things called fentanyl test strips to stem these overdoses. These can be dipped into a solution of drug residue and water, and they act much like a pregnancy test where one line means it probably contains fentanyl, two means it probably isn’t the one. case. Jacqueline Goldman, a researcher at Brown University, says they can actually change people’s behavior.
JACQUELINE GOLDMAN: We found the overwhelming majority that people viewed the test strips as a really important tool and that many of them took overdose prevention measures afterwards because they knew that fentanyl was in their medication.
BECK: Goldman is currently doing follow-up research on this, but in some states like Idaho and Utah, these test trips are still technically considered illegal drug paraphernalia, although efforts are being made to change that.
INSKEEP: Brian, this sounds like a familiar story where there is a solution that could save lives, but it’s illegal.
MANN: Yeah, that’s a really complicated and painful part of this story. Just as the solutions to the COVID-19 pandemic have become truly political, the solutions to this addiction crisis are polarizing. Most of the medical experts we’ve spoken to believe that drug addiction should be treated as a disease, something we respond to with harm reduction, like these test strips. It could also mean providing people with clean needles, even safe places to take drugs, better access to treatment and health care. And there is strong evidence that these programs keep people alive and give them a chance to recover. But because of the politics of that, we see a lot of these programs curtailed or banned, even in places like West Virginia, where drug-related deaths have ravaged entire communities. In many parts of the United States, the frontline response to this crisis is still the police and prisons, not health care providers and hospitals.
INSKEEP: Madelyn, is that true in Mountain West where you are?
BECK: I mean, there are certainly police officers in Mountain West who have told me that they have started to view the alleged fentanyl overdoses specifically as homicide. That way, they stay on the scene longer, collect more evidence than they give to prosecutors, who over the past two years have started to sentence fentanyl traffickers to mandatory minimum sentences of 20 to life. Now groups like the Drug Policy Alliance believe it’s just a continuation of the war on drugs – that people of color and people living in poverty will be hit the hardest. They’re largely arguing, you know, that if there’s a demand, there’s going to be a supply. But just about every source I’ve spoken to, including the police and groups like the Drug Policy Alliance, are more supportive of addiction treatment, mental health resources, and education. The 32-year-old daughter of Andrea Thomas died from a pill containing fentanyl. She says her daughter left behind an 8 year old son.
ANDREA THOMAS: You hear about overdoses all the time, but the difference between what happened to my daughter and all these stories that I have heard before about overdoses is that she hasn’t had an overdose. ‘overdose. She was poisoned.
BECK: Thomas wants it to be talked about everywhere, including schools and colleges. Groups like Song for Charlie have sprung up specifically to highlight the risks to young people.
INSKEEP: Brian, how is the country approaching what is clearly a national problem?
MANN: Yeah. The Biden administration has asked Congress for more than $ 10 billion to boost drug treatment programs like the ones Madelyn was talking about. They also made it easier for doctors to prescribe buprenorphine. This is a drug that relieves cravings for opioids in people who are recovering. Efforts are being made across the country to improve drug treatment and attract more traditional physicians to this field. But, you know, Steve, there is no quick fix. There is no equivalent of the COVID vaccine for this problem. My sources at the DEA say that more and more fentanyl is coming in, and they don’t really know how to stop it. So, for now, public health experts and the police seem to be really shocked by this. An expert I spoke to in the background said he believed this wave of drug-related deaths could reach 160,000 deaths in a 12-year period before this peak.
INSKEEP: Breathtaking. Brian, thank you very much.
MANN: Thanks, Steve.
INSKEEP: Brian Mann is NPR’s Addiction Correspondent. Madelyn Beck reports for the Mountain West News Bureau, a collaborative public radio station. Madelyn, thank you.
BECK: Thanks.
[POST-BROADCAST CORRECTION: In this report, we say that the Drug Enforcement Administration says about a quarter of the fentanyl pills it seizes contain enough of the drug to be lethal. That was true in 2019. The DEA says more recently published numbers show that the figure increased to 42% in 2020.]
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