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Harm Reduction: Experts Call for Urgent Action as Fentanyl-Related Overdose Death Toll Climbs

More than 120 medical experts, public health departments, and drug user health advocates have called on the federal government to take more aggressive steps to deal with a wave of overdose deaths caused by heroin cut with fentanyl, an opioid pain medication 50 to 80 times stronger than heroin. The call came in an open letter to US Health and Human Services Secretary Mike Leavitt drawn up by the Harm Reduction Coalition, a national health and human rights advocacy group working to reduce drug-related harm.

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fentanyl
The ongoing epidemic -- Drug War Chronicle reported on it in June -- has killed more than 750 injection drug users this year from Chicago to the East Coast. Chicago, Detroit, and Philadelphia all have around 200 fatalities.

The actual number of deaths may be far higher because many jurisdictions near these large cities may lack the resources and expertise to monitor overdose trends. "This wave of overdose deaths poses an acute public health emergency and immediate threat to the lives of opiate users, while highlighting persistent weaknesses in health officials' response to the increasing epidemic of both legal and illegal opiate overdose," said Dr. Sharon Stancliff, medical director for the Harm Reduction Coalition.

The letter makes five recommendations, calling on Secretary Leavitt to ensure that:

  1. The Centers for Disease Control (CDC) create surveillance systems to monitor overdose trends and threats.
  2. The National Institute of Drug Abuse (NIDA) provide emergency funds for research projects to answer urgent questions that will allow jurisdictions to immediately and effectively address the overdose epidemic.
  3. The Substance Abuse and Mental Health Services Administration (SAMHSA) rapidly replicate existing overdose prevention programs, and fully fund them.
  4. The Drug Enforcement Administration (DEA) inform CDC of levels of purity and presence of fentanyl and other hazardous contaminants in local drug supplies so CDC can notify the public.
  5. The Department of Health and Human Services (HHS) prepare an emergency report of the current overdose epidemic for Congress. This report should make emergency recommendations for prevention measures including: Supporting community-based responses to overdose, including the use of naloxone, a legal medication that reverses opioid overdoses, by users and their loved ones; improving police and emergency medical services responses to overdoses; and enhancing the availability of substance abuse treatment.

"A client told us she watched her friend die in front of her and there was nothing she could do," said Corey Davis, legal services coordinator at Prevention Point Philadelphia. "If she had naloxone and was trained to use it, she could have saved her friend's life. We've lost a lot of our people due to fentanyl. This has to stop."

Detroit Deaths From Fentanyl-Laced Heroin Could Be Reduced By Medical Treatment

Press Release Source: Reckitt Benckiser Pharmaceuticals Inc. Detroit Deaths from Fentanyl-Laced Heroin Overdoses Could Be Reduced by Medical Treatment Tuesday October 3, 7:30 am ET Physician training sessions will increase patient access to medical office-based treatment for opioid addiction DETROIT, Oct. 3 /PRNewswire/ -- A recent string of opioid overdoses and deaths in Detroit and elsewhere in Wayne County highlights the devastation of a dangerous new illegal drug mixture: the combination of heroin with fentanyl, a powerful opioid painkiller used in anesthesia and to treat cancer pain. According to the Medical Examiner's office, so far there have been at least 122 fatal overdoses in the Detroit area attributable to heroin laced with fentanyl, while several times this many have occurred nationwide. ADVERTISEMENT "Fentanyl-related overdoses in the Detroit area serve as a tragic reminder that there is a need for better patient access to aggressive and effective medical treatment for opioid addiction," said Mark Menestrina, MD, addiction medicine physician at Brighton Hospital. "Opioid addiction is a chronic disease that can afflict anyone and needs to be treated much like we treat other chronic conditions. Medical treatment is oftentimes prescribed in the privacy of a doctor's office, creating a confidential, convenient, and respectful atmosphere. Currently, there are not enough certified doctors in Detroit available to handle the increasing number of people seeking help for opioid addiction. It is critical that office-based medical treatment become more widely available in order to contain this crisis and prevent more deaths throughout the greater metropolitan Detroit area." Addiction to opioids, which includes heroin as well as the prescription painkillers oxycodone, hydrocodone, fentanyl, and morphine, is a growing public health problem that affects people from all walks of life. In Michigan, misuse of prescription opioid painkillers continues to be a major problem and, in Detroit, heroin remains widely available, according to a report by the U.S. Drug Enforcement Administration (DEA). And as evidenced by the current surge in fentanyl-heroin use, drug dealers are targeting this mixture in the Detroit area. The recent problems in Detroit and throughout Michigan reflect a national public health crisis -- according to the most recent National Survey on Drug Use and Health (2006), published last month by the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 4.7 million people currently misuse prescription pain relievers, second only to marijuana use. Among young adults, nonmedical use of prescription drugs increased from 5.4 percent in 2002 to 6.3 percent in 2005. In addition, in terms of new users, in 2005 more people 12 years and older -- 2.2 million -- misused opioid painkillers for the first time than any other drug, including marijuana and cocaine. Many people do not fully understand the danger of misusing opioid painkillers such as fentanyl. A recent national survey on the public's perceptions of opioid addiction, Prescription Painkiller/Heroin Addiction and Treatment, revealed that nearly half of the U.S. public does not know that misusing prescription opioid painkillers is as harmful to the body, and fully as addictive, as heroin abuse. Physician Certification Training Available at Sessions and Online Any doctor may become certified to treat opioid dependence in his or her private office using an FDA-approved medicine called buprenorphine. Many patients prefer the privacy, convenience, and discretion that office-based treatment offers. According to Dr. Menestrina, access to buprenorphine treatment for patients addicted to opioids is vital to reduce the number of deaths due to drug overdoses. Doctors will find information about becoming certified to treat with buprenorphine at http://www.docoptin.com. Additionally, information about online and CD-ROM training options may be obtained from 1-877-782-6966. "An increase in the number of doctors certified to treat opioid addiction is an important step in the fight against the problem we're facing in Detroit," said Dr. Menestrina. "It is unfortunate that patients seeking buprenorphine treatment are turned away simply because not enough doctors are certified to prescribe this medication. This is especially upsetting considering the great success I have seen in my practice with buprenorphine. I strongly urge other physicians to learn about this treatment option and seriously consider becoming certified to treat the exceedingly high number of chemically dependent individuals in the Detroit area." Resources for Opioid Dependence and Its Treatment Addiction to opioids is defined as a long-term brain disease by the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA). It is a treatable medical condition that is caused by changes in the chemistry of the brain. This dependence can start with use of medicine that a doctor prescribes for serious pain but that a person continues to use after the medical need for pain relief has passed. Or it may begin as recreational drug use that spins out of control. Individuals who need more information about opioid dependence and its treatment, either for themselves or for someone they are concerned about, have several options. Educational materials on opioid dependence are available to answer questions about this often-misunderstood disease and the treatments that are available for it. To receive a free educational Resource Kit on these topics, visit http://www.turntohelp.com or call 1-866-455-TURN, both provided by Reckitt Benckiser Pharmaceuticals. Additionally, the non-profit patient advocacy group NAABT -- National Alliance of Advocates for Buprenorphine Treatment -- is dedicated to helping educate the public on opioid dependence and treatment in a private doctor's office. NAABT now offers a nationwide confidential matching service to pair individuals seeking buprenorphine treatment with available doctors. "Increasingly more people are contacting NAABT for information on opioid dependence and treatment and for help finding doctors who can prescribe buprenorphine," said Timothy Lepak, president of NAABT. "This is a disease that does not discriminate. It affects people from all walks of life and all socioeconomic and demographic levels." For more information on Detroit-area physicians who can prescribe medicine to treat opioid dependence in a private medical office, visit http://naabt.org. SAMHSA's Web site also provides a physician locator and other valuable information at http://buprenorphine.samhsa.gov. In the United States, buprenorphine is marketed as Suboxone® (buprenorphine HCl/naloxone HCl dihydrate) C-III Sublingual Tablets and Subutex® (buprenorphine HCl) C-III Sublingual Tablets, the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for treatment of opioid dependence in a doctor's office. Suboxone and Subutex are manufactured by Reckitt Benckiser Pharmaceuticals. About Reckitt Benckiser Pharmaceuticals Inc. Reckitt Benckiser Pharmaceuticals Inc. is a specialty pharmaceutical company that manufactures and markets Suboxone® (buprenorphine HCl/naloxone HCl dihydrate [2 mg/0.5 mg and 8 mg/2 mg]) C-III Sublingual Tablets and Subutex® (buprenorphine HCl [2 mg and 8 mg]) C-III Sublingual Tablets, formulations of buprenorphine used to treat opioid dependence. Suboxone and Subutex are the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for office-based treatment of opioid dependence. Reckitt Benckiser Pharmaceuticals Inc. is committed to expanding access to medical therapies for patients suffering from the chronic, relapsing brain disease of opioid dependence. For more information, visit http://www.suboxone.com or http://www.opioiddependence.com. Reckitt Benckiser Pharmaceuticals Inc. is a wholly-owned subsidiary of Reckitt Benckiser PLC, a publicly traded UK firm. Important Safety Information Intravenous use of buprenorphine, usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone® and Subutex® have potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted population receiving buprenorphine. There are no adequate and well-controlled studies of Suboxone or Subutex (a pregnancy category C medication) in pregnancy. Due caution should be exercised when driving cars or operating machinery. The most commonly reported adverse events with Suboxone have included headache (36%, placebo 22%), withdrawal syndrome (25%, placebo 37%), pain (22%, placebo 19%), nausea (15%, placebo 11%), insomnia (14%, placebo 16%), sweating (14%, placebo 10%). See full prescribing information for complete information. Suboxone and Subutex are registered trademarks of Reckitt Benckiser Pharmaceuticals Inc. Media Contact: Cory Tromblee 617-761-6715 [email protected]
Location: 
Detroit, MI
United States

The Heroin Overdose Wave Continues...

WFMZ-TV in Allentown, Pennsylvania, has reported another overdose from the fentanyl-laced heroin batch that is ravaging drug injecting communities in cities around the nation. Meanwhile, officials in South Jersey are trying to figure out what is causing the rash of overdoses in Vineland and are wondering if something may be contaminating the heroin supply there -- five people had to be rushed to the South Jersey Healthcare Regional Medical Center on Tuesday, according to The Press of Atlantic City. We need legalization! Heroin use can't be stopped, at least not in this way -- only a legal, regulated supply will allow for any reliable degree of control over the drug supply -- until prohibition is ended, drug users will always be at risk of this kind of often fatal harm, especially the addicted ones. It is indecent that we are subjecting these people to this kind of situation -- and it certainly means longer emergency room waits when the rest of us need the help. WMFZ-TV accepts comments here. The Press has information on submitting a letter to the editor, or a longer guest column, online here. Also click here to take action to support of a bill sponsored by Sen. Richard Durbin (D-IL) to fund overdose prevention. And click here for a Drug War Chronicle report on the heroin/fentanyl overdose outbreak.
Location: 
Atlantic City, NJ
United States

Overdose Deaths Outpacing Homicides in Philadelphia

The Philadelphia News reported Monday that despite the city having seen one of its deadliest weekends, drug overdoses, particularly from a batch of heroin laced with the even more powerful opiate fentanyl are claiming even more lives. The important thing to remember is that heroin users aren't dying simply because fentanyl is more potent than heroin. They are dying because the substance they are buying on the black market is more powerful than they believe it to be -- they think they are getting heroin, or if they're not sure they crave their fix so strongly that they are willing to take the chance. The illegal drug supply is uncertain in this way, because it is illegal, and for no other reason. Among legalization's many benefits will be increased safety for users, particularly addicts, and fewer accidental deaths. Send a letter to the editor to [email protected].
Location: 
Philadelphia, PA
United States

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