Heroin Mixed with Fentanyl is Now Sweeping the Streets

Since the early 1960’s, the street drug known as heroin has ravaged cities across the country. Heroin, also known as diamorphine among other names, is an opioid most commonly used as a recreational drug for its euphoric effects. It has fueled prostitution and crime that remain rampart in many neighborhoods. But lately, despite heroin’s entrenched history, drug users claim it has become nearly impossible to find.

The presence of heroin has been drying up and down the Eastern coast, from factory towns to the farmlands and in parts of the Midwest. It remains prevalent in many of the Western states but even N.Y. City, the nation’s biggest distribution hub for herion has seen less of it this year.

The dwindling supply should really be a victory for public health, law enforcement and first responders alike. Instead, longtime drug users who managed to survive decades injecting heroin are now at an even greater risk of dying from an overdose. That’s because synthetic fentanyl, a deadlier opioid, is more potent than heroin and it's much cheaper to make and distribute than heroin and it has all but replaced it.

FENTANYL DEATHS REACH EPIDEMIC PROPORTIONS

Whether consumed alone or in combination with other drugs, fentanyl has topped the list of the nation's deadliest drugs for the third year in a row, causing the rate of drug overdose deaths to more than quadruple since 1999.

The sharp rise of fentanyl, which can be 30-100 times stronger than heroin, has been well documented. According  to the National Institute in Drug Abuse, American deaths linked to fentanyl grew more than 50 percent to 29,406 from 19,413 in 2016.  But its effect on many older urban users of heroin who had been able to manage their addiction for years, has been less noticed. The shift from heroin to fentanyl in cities has contributed to surging overdose deaths among older people and African Americans.

Upon injection, the effects of fentanyl are almost immediate and it is instantly killing many people across this country. This claim is backed by federal data showing that the rate of overdose deaths involving fentanyl increased by nearly 54% in 2017 for people ages 55 to 64 – more than for any other age group.

ECONOMICS 101

The reason fentanyl is everywhere is due in part to economics. A tiny amount of fentanyl can boost a drug's potency, profitability and increase a customer base. Dealers and traffickers can also make far more money from it than heroin. Instead of waiting for poppy crops to mature and farmers to harvest the gum, which gets refined into powder, traffickers can order fentanyl from China or forge chemicals to make it in underground labs, generating far more doses with far less labor and cash.

EXPOSURE : OVERRATED OR JUSTIFIED?

Law enforcement officers, emergency medical technicians and first responders have been warned to handle fentanyl with extreme caution; some have fallen seriously ill after getting it on their skin or clothing. As the opioid epidemic continues, it is creating challenges for the first responders on the scene of potential opioid-related overdose calls and it’s referred to as Transdermal fentanyl exposure, or opioid toxicity.

Transdermal toxicity is under scrunity by the American Academy of Clinical Toxicology  (AACT) and the American College of Medical Toxicology (ACMT). Research studies and position papers basically state that Trandermal toxicity is overrated to humans but not canines (REALLY?). But there's two side to every story and here's some facts that need to be considered.

WHAT'S THE SCENARIO?

It is important to point out that these associations represent the medical field and are not criminal toxicologists. There is no mention or claims that actual first responders particiapted in any of these projects and these researchers have never been on a drug investigation or on an overdose call. It is important to realize they are comparing results from pharmaceutical fentanyl and not the type nor quantities of the drug officers are encountering on the street. Many officers are encountering analogs that are far more potent than pharmaceutical fentanyl which is measured in micrograms when officers are encountering analogs that are measured in kilograms. 

They suggest to workers who may encounter fentanyl or fentanyl analogs be trained to recognize the symptoms and objective signs of opioid intoxication, have naloxone readily available, and be trained to administer naloxon.  It is our opinion that no matter how grave the threat, we owe it to trained personnel to get them home safely everyday and that means finding them the best P.P.E. available for the task.

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Featured in Buffalo News /Sunday May 19, 2019 National News - New York Times/Abby Goodnough