HUNTINGTON — In 2017, fentanyl became the new layer of the opioid epidemic. The COVID-19 pandemic has only made the problem worse.
Today, fentanyl is often found in combination with other opioids and prescription drugs and accounts for the majority of overdose deaths in West Virginia. Drug control leaders are still finding ways to tackle the rise in overdoses since its peak in 2020.
Overall, opioid overdoses fell from 675 to 1,136 from 2019 to the end of 2020. Dr. Matthew Christiansen, director of the Office of Drug Control Policy, said that although death data is incomplete for 2021 and 2022, he expects similar numbers.
“It doesn’t necessarily mean that there are more people who are addicted. It just means that the supply of drugs to people who are already addicted is more deadly,” he said.
Christiansen explained that the pandemic had a lot to do with the increase in opioid deaths, as the supply shifted more from heroin to fentanyl. He said that’s partly because the closures have forced the cartels to find easier ways to smuggle the border.
Fentanyl can be smuggled in small packages with multiple doses per package due to its potency. It’s also synthetic, which means it doesn’t require the cultivation of poppies like heroin, and it can only be made in a lab.
“There really is no limit to the amount of fentanyl these cartels and criminals produce,” he said. “They can really ramp up production relatively quickly in a warehouse instead of having to grow fields of plants and poppies in the Middle East or Asia and then purify them and ship them to the United States. It’s a much more direct threat.
Dangers of poly-substances
Poly-substance overdoses involving fentanyl and other opioids also saw an increase in 2020. Christiansen said the drugs are becoming deadlier because the more borders the drug crosses, the more supply is cut off with other substances and becomes unpredictable.
“People who have been addicted to opioids, illicit opioids for a long time, get an idea of how much they can use, get caught off guard, and die from this very potent poison that’s spilling out into the streets,” he said. .
Fentanyl, in particular, is mixed with other opioids and has even been found in marijuana and fake prescription pills, without users realizing it. Now, Christiansen said, fentanyl is responsible for more than 75% of all overdose deaths in West Virginia.
Users who don’t know fentanyl is in their supply take the same amount of this drug as any other opioid, but according to the Centers for Disease Control and Prevention, fentanyl is up to 50 times stronger than heroin and 50 to 100 times stronger than morphine.
An analysis last year by the Drug Enforcement Administration found that drug trafficking organizations typically distribute fentanyl by the kilogram when possible.
“Probably the majority of the overdoses we see in this area are poly-substances,” said Jan Rader, director of the Mayor’s Council on Public Health and Drug Control Policy in Huntington.
“Someone has a substance use disorder – whatever their drug, whatever drug they’re looking for, they take what’s available on the street, and often it’s a mix.”
Not only are users more likely to overdose due to the increased potency of fentanyl in their mix, but an overdose of a poly-substance may require more effort to recover from.
“It seems like the majority of the overdoses I’ve witnessed here recently, it seems like it takes more naloxone to work,” Rader said.
The CDC has reported that more than one dose of naloxone may be needed in overdoses involving stronger opioids like fentanyl. In a poly-substance, where opioids are mixed with other drugs, such as benzodiazepines, naloxone will only work to recover the user from an opioid overdose, but expert medical care will still be needed to recover a user of other drugs.
In 2020, the West Virginia Office of Drug Control Policy recorded 244 deaths from overdoses of benzodiazepines combined with any opioid in the state. According to the National Institute on Drug Abuse, polysubstance overdose deaths related to benzodiazepines accounted for 16% of overdose deaths nationwide that year.
Both types of drugs work to put the user to sleep and suppress breathing, which could lead to death in an overdose. The CDC recommends clinicians avoid co-prescribing these drugs, but the mixture, “benzo dope”, was discovered last year on the streets of Canada, according to experts in British Columbia.
“I have yet to hear of widespread distribution of benzo dope in West Virginia; however, it’s something we definitely have on the radar and something we need to be prepared for,” Christiansen said.
Control the broadcast
Morgan Switzer, assistant general counsel for the state Department of Homeland Security, said the state saw a spike in fentanyl-related overdose deaths from 2017 to 2020. She said the West Virginia Fusion Center found a link this spike to a 550% increase in fentanyl seized at the Mexican border and destined for shipment to West Virginia.
Switzer said fentanyl is not made in West Virginia or the United States, meaning it must come from across the border or overseas. She said the distribution of fentanyl is not specific to West Virginia, but the accessibility of freeways makes it easier to travel through the state’s beggars.
In response to this, Governor Jim Justice signed into law Senate Bill 536, also known as the “fentanyl bill,” in April of this year. This increases penalties for fentanyl distributors in West Virginia and those caught transporting fentanyl into the state.
It also made it a crime to implicate anyone under the age of 18 in the distribution of any controlled substance.
“We have all worked very hard to make sure that the people who bring this type of drug and sell it here are punished,” Switzer said. “We have made it a priority to try to keep West Virginia as safe as possible by increasing penalties and bails, and we look forward to seeing the results of this new legislation.”
Christiansen said the West Virginia Office of Drug Control Policy tries to ensure that it not only addresses opioid use disorders, but all addictions as well. He said they have rolled out addiction interventions and expanded drug treatment programs and certified recovery beds to treat all addictions holistically.
“We see this as a holistic effort across the state to make sure we don’t just specify it to one drug, because we know that often people will migrate from one drug to another,” Christiansen said.
“We have to be very nimble and think on our feet and make sure we’re addressing the root cause of addiction, which is often unresolved trauma, unresolved mental health issues, and that we’re not just targeting the substance, because that’s really just the tip of the iceberg.
He said he has seen the efforts of the Office of Drug Control Policy bear fruit since April 2021. He said the numbers were still high, but there had been a decrease in overdose deaths since the peak of the pandemic compared to other states, which have only plateaued. at some of their pandemic peaks.
“Across the state of West Virginia, we’ve dramatically increased access to services and truly been able to empower more people and help more people achieve long-term recovery than ever before,” did he declare. “There are more people living today in recovery, in long-term recovery, from addiction than we have ever seen.
“There is always hope.”
For 24/7 access to recovery support specialists, treatment referrals and other addiction recovery resources, call or text 844-HELP4WV.