The U.S. had never seen a pandemic like that of the coronavirus - the global spread of a potentially fatal virus that became the worst ever U.S. public health emergency, affecting any and every citizen, with hundreds of thousands dead, a toll that’s still rising and will continue to do so.
The U.S opioid epidemic was here long before the coronavirus pandemic - again, a national public health emergency never seen before, affecting a wide and diverse range of the country’s demographics, from the old to the young, and from the rich to the poor, and an emergency that was pushed to the back of the line when it came to the continuing expenditure needed to defeat it.
Now, the fentanyl crisis (and that’s exactly what it is) is driving back many, if not all of the gains made against the opioid epidemic in recent years.
Did you know that in 2019, before the coronavirus hit our shores, the U.S. actually saw record numbers of drug-related deaths, driven by the spread of fentanyl into more areas of the country, and into virtually every other illicit drug available on your local, downtown street corner?
For our beleaguered U.S. healthcare response, battered by the ongoing pandemic, the fentanyl crisis is a whole new ball game - one without rules.
“This is a new era. We haven't seen anything like this since heroin first hit the streets more than 100 years ago.”
- Bryce Pardo, associate policy researcher, RAND Corporation, and lead author of “The Future of Fentanyl and Other Synthetic Opioids”
Fentanyl, a synthetic opioid, an illicit, laboratory-made substance, and quite deadly on its own, can now be found in virtually every type of other illicit drug you can imagine, from meth to heroin, and from cocaine to ecstacy; furthermore, it is often pressed into pills that look just like a standard medical prescription, written out by your friendly family doctor.In a situation such as this, even if there were rules there to be followed, illegal fentanyl would undoubtedly break them.
Fentanyl: Painkiller, Anesthetic & Certainly Not New
Fentanyl has been used for decades as both a painkiller and anesthetic. However, surgeons quickly learned to monitor their patients closely after administering the drug because of the way it rapidly stiffened the muscles that control breathing.
Today, fentanyl is actually a mail-order product, marketed on the open internet, and shipped directly to consumers and dealers, with no international drug cartels required. In this form, it comes from both Mexico and poorly regulated labs in China. As an indication of how easy it is to “traffic” the product, delivery is normally guaranteed.
The Fentanyl “Virus”: Growing & Spreading Exponentially in Arizona
Researchers from the RAND Corporation found several Chinese firms still willing to ship a kilogram of nearly pure fentanyl to the U.S. for as little as $2,000, a very cheap purchase when you consider that an illicit shipment of heroin with a similar potency would cost at least 50 times that much.
It has, therefore, been of little surprise that U.S. drug dealers, here in Arizona and elsewhere, quickly realized they could cut a bag of heroin with cheap fentanyl, and then pocket the difference. However, fentanyl is not just cheap - it's 30-50 times more powerful than heroin.
In other words, the difference between a euphoric high and a lethal dose is around a few grains of salt.
The massive growth and spread of fentanyl among recreational drug users, searching for that ultimate euphoric high, right up to hardened, street-wise drug addicts, simply looking to just score their usul hit or two of the day, has never been witnessed in the U.S. before.
The scale of its growth within the industry of drug manufacture and trafficking means big, big business for the Mexican drug cartels, the primary provider of illicit fentanyl in the U.S. If it was a recorded piece of music, and not a potentially lethal substance, it’s sales would already have gone platinum, many, many times over.
“It's more useful to think of the fentanyl crisis as a mass poisoning than as a traditional drug epidemic. The margin of error is so narrow - one more milligram, and that could put you in the grave.”
- Bryce Pardo
To provide a basic idea of how dangerous and how expansive the fentanyl crisis is, the following statistics make for harrowing reading:
The Original Source
The Unsuspecting Addict
The Tragic Result
Please, No Repetition of Recent Mistakes
It’s a time for a healthy dose of candid honesty, and the right time to acknowledge that the recent past has become a litany of U.S. public health policy mistakes.
Look back 50 years, and you’ll find President Nixon’s declaration of a “War on Drugs” - a mistake that has slowly taken half a century to put right. During those 50 years, the U.S. has witnessed a number of drug epidemics - heroin in the 1960s and early 70s, cocaine in the 1980s, and opioids since the 1990s. And now there’s one more for the list, and one far more lethal - fentanyl.
In December, 2020, the final report from the congressionally-mandated Western Hemisphere Drug Policy Commission was published, and it calls for a much greater investment in substance addiction treatment and prevention, stating that it is impossible to control the supply of dangerous, potentially lethal drugs without reducing the actual demand for them - it further states that it is impossible to curb demand for these drugs without also limiting their supply, and, thus, their availability.
Confronting the fentanyl crisis, however, is going to take more than disrupting supply and getting people into treatment. New, innovative, and likely controversial, policy changes - such as supervised drug-consumption sites and providing free fentanyl test strips to drug addicts - will need to be a critical part of the U.S. public health response.
There are other mistakes that should never be repeated, too. For example, the pandemic took attention away from the opioid epidemic, and, on a practical level, it removed the latter’s funding, too. There was the sense that it was either one or the other - we were fiscally unable to deal with both public health emergencies. It will be vital that this “ethos” changes, and rapidly.
Additionally, addiction and other health experts predicted a sharp rise in depression, anxiety and stress among communities, particularly for those who already had a mental health or behavioral disorder, or a substance use disorder, as normal access channels to their treatment were being severely disrupted. This, they believed, could lead to a rise in drug overdoses, self-harm and suicide.
They were not proved wrong.Therefore, these channels, from drug rehabs to community clinics. and even including AA meetings, need to be policy-secured for all drug addicts seeking or continuing their addiction recovery treatment.