Just what is Fentanyl that has people more than concerned about the dramatic increase in overdose deaths that involve this drug? Fentanyl is a synthetic opioid that is used in medical settings, often for the treatment of severe pain. It can be up to 100 times stronger than morphine. This means it takes a much smaller amount to cause an overdose. The presence of illicit fentanyl, and its involvement in opioid overdoses, has shot up in Iowa in recent years. Officials are searching for solutions to this problem.
Iowa has one of the lowest drug overdose rates in the country, but now the rate has been increasing, mostly due to opioids with deaths going up 34% between 2019 and 2021. Fentanyl was involved in 83% of the state’s 258 opioid deaths last year according to the Iowa Department of Public Health records of 470 overdose deaths in 2021. Most of the deaths were due to opioids. Drug overdose deaths have increased 120% among Iowans under 25 years of age in the last two years.
Iowa will receive more than $9 million in federal funding to target opioid treatment and prevention. The state estimates at least 1,100 Iowans will receive treatment and/or recovery support during the next two years from the grant, and another 11,000 will receive prevention and harm reduction services.
According to the Sioux City Police Detective Paul Yaneff, fentanyl is so deadly that investigators have to wear additional latex gloves and N95 masks when handling a substance that they suspect could be fentanyl. Any little residue that touches your skin could kill you instantly and therefore it is very crucial that you have the protective gear when you handle any substance that could be fentanyl.
Fentanyl is often found in illicit pills that are sold on the black market and disguised as real pharmaceutical drugs like OxyContin and Zanax. It is also mixed into what’s being sold as heroin, cocaine and methamphetamine.
Pills containing fentanyl are not coming from legitimate pharmacies, but by criminal organizations to look like pharmaceutical drugs. The fentanyl being found in illicit pills and substances is made in clandestine (hidden or secret) labs which means the potency and purity can vary widely.
The Iowa Poison Control Center in Sioux City stress that illicit fentanyl is not the same fentanyl that is in a patch prescribed by and ER physician. The Center doesn’t know who made it, as opposed to the drug companies’ fentanyl that is not in an illicit market. Asked if medical fentanyl can be abused—yes, but that is not what the Poison Center is seeing.
Illicit fentanyl doesn’t rely on the opium poppy for production that was originally used as an adulterant in heroin. Now it is taking the place of heroin. Drug traffickers like the synthetic opioid because of its high potency. Drug traffickers can make a greater amount of this product more easily at a reduced cost and still take in higher profits. Those counterfeit pills are in Iowa where they resemble Percocet or Oxycodone. They resemble Alprazolam or Xanax that are other prescription drugs. This situation is alarming.
The Iowa Poison Center (IPCC) recorded 24 human fentanyl exposure calls from January to August of this year. In 2021, the IPCC tallied 35 of those calls and found a 191% increase from 2020, when there were only 12 calls recorded. Since people are not required to call poison control centers after every exposure, data only captures a portion of the fentanyl exposures that are occurring.
IPCC states that hospitals are unable to test for new and novel drugs that are being abused like synthetic opioids. When providers become comfortable managing those patients who have taken the drug, they stop calling the Poison Control Centers.
A spokesperson for Rosecrance Jackson Centers (in Sioux City) tells that illicit fentanyl is extremely addictive and 100 times more potent than morphine. Even after a person has received life-saving Narcan, that person could die from a fentanyl overdose since the drug is still in their system. People are using illicit fentanyl any way they can get it into their bodies—including snorting and injecting it. There are some people that come to Rosecrance Jackson Center seeking treatment and are now even identifying fentanyl “as their drug of choice”.
There was a person referred to the Jackson Center who was on a Narcan drip. She had to be on this drip in the hospital all because she did try one of the blue 30’s. Narcan is a drug administered to “reverse” an opiod overdose including illicitly manufactured fentanyl. All officers in Sioux City carry doses of Narcan. A person could have the initial dose of Narcan, but might have to be on Narcan drips in a hospital for quite some time. The biggest risk is for a person to not know what they have taken, where it came from and what they might have cut it with.
A Sioux City Fire Rescure EMS director said his department’s main objective is treating overdose symptoms rather than identifying a drug and its origin. There just isn’t enough Narcan on hand to deal with the really serious cases involving fentanyl or carafentanil, an opiod analgesic 100 times more potent than fentanyl.
Now a new word “carafentanil” has come into the drug picture. Just what is carafentanil? Carafentanil is used in veterinary medicine to anesthetize elephants and other large animals and has been present in illicit U.S. drug markets according to the DEA (Drug Enforcement Administration).
The DEA has warned the public about counterfeit pills. They are often light blue and marked with “30” in an effort to imitate oxycodone. It was just a month ago that the public was made aware of the color of fentanyl. Now they can be brightly colored or have “rainbow” colors. The DEA has called the fentanyl pills and powder, “a deliberate effort by drug traffickers to drive addiction amongst kids and young adults.”
A detective tells where he has seen cases involving illicit fentanyl “accelerate” in the metro. One of his cases involved a person using marijuana that was laced with fentanyl, while another person died from a fentanyl overdose after purchasing what was thought to be cocaine. He is starting to see more and more of it and hear of it, who said the drug is predominately coming acaross the U.S.—Mexico border. It’s not solely people buying the actual fentanyl but the problem is that it is accidentally being laced or having it being laced with addirtional drugs.
People buying pills off the street can be tricked thinking they are getting legitimate prescription drugs. Fentanyl test strips have been shown to be effective at detecing the presence of fentanyl in drug samples, but some states classify the strips as drug paraphernalia.
Now we have another new item, “Fentanyl test strips”. These test strips are illegal in Iowa and South Dakota. Iowa law, which carries a simple misdemeanor charge, is punishable by a fine of up to $855 and 30 days in jail. However, Nebraska doesn’t include fentanyl test strips or testing kits in its definition of drug paraphernalia, so these these materials are allowed. Would it help if there was a way for drug users, who are not trying to take fentanyl, to avoid consuming deadly amounts? Would legalizing testing strips be helpful?
Those struggling with fentanyl addiction shouldn’t be afraid to reach out for help. There is help at Rosecrance Jackson Centers for them. Treatment begins with stabilizing the patient and helping them through the withdrawal process. This withdrall process is very, very uncomfortable. In the end, it is worth it. The Jackson Center stabilizes, detoxes and then start therapy to find what is going on and how to think, feel and react differently after a final treatment. Treatment with opiate use disorder includes medication assisted therapy and Suboxone and Vivitrol are used.
There are some people who remain on medication assisted treatment for the rest of their lives. At the present time, the Jackson Center has 150 patients on Suboxone to treat opiod addiction. What an addicted patient doesn’t want to hear when coming for help is, “You cannot have any more of what you are on” but we are going to meet you where you’re at, and help you.”
The flow of deadly illegal drugs across our borders has created a public health crisis and a national security emergency. Iowa law enforcement is dedicated to working with our elected officials to stem these deadly drugs and ensure the safety of Iowans.
Iowa’s Governor Reynolds has directed the Department of Health and Human Services to include information about fentanyl in an awareness ad campaign targeting youth. However, there is still the problem of “how” are these drugs able to come into the United States from Mexico? Not having our southern borders secure could be the answer to this question. But, that could be another problem that isn’t going to go away overnight.
This drug, Fentanyl is an introduction to a story on a family whose son used this drug but not for “physical pain”. It should be in next week’s paper if there is room.