The increased number of overdose deaths from opiates is due in part to the ubiquity of fentanyl. Many drug manufacturers choose to use fentanyl as a way to strengthen other opiates, but because of the extreme potency of fentanyl, this often leads to immediate overdose upon use. Fentanyl is a synthetic opiate about 80 times more powerful than morphine. Even very small amounts are capable of immediately inducing overdose. Much of the danger comes from the inability of illegal drug manufacturers to measure how much fentanyl they are using. According to a 2016 Stat News article, “while dealers try to include fentanyl to improve potency, their measuring equipment usually isn’t fine-tuned enough to ensure they stay below the levels that could cause users to overdose. Plus, the fentanyl sold on the street is almost always made in a clandestine lab; it is less pure than the pharmaceutical version and thus its effect on the body can be more unpredictable.” The drug binds to the opioid receptors in the brain the same way as drugs like morphine and heroin, but does so much more rapidly. The result is often an immediate overdose from respiratory depression. Dr. Lewis Nelson, medical toxicologist at New York University’s School of Medicine, explained in a 2016 Forbes article, “This difference in fentanyl’s potency is critical–it takes very little to have the same effect as other opioids. The reason so many are dying is because the dose is relatively uncontrolled with street fentanyl, and small excesses can lead to overdose.” The CDC recognizes that most of the fentanyl present in heroin and other opiates comes from illegally manufactured sources, making the margin of error much greater. They explain, “Recent state reports have indicated that increases in synthetic opioid-involved deaths have been associated with the number of drug products obtained by law enforcement testing positive for fentanyl but not fentanyl prescribing rates. These reports indicate that increases in synthetic opioid-involved deaths are being driven by increases in fentanyl-involved overdose deaths, which are likely due to illicitly-manufactured fentanyl.” These illegal sources, as well as the drug dealers, are not capable of dosing fentanyl in a way that makes it less likely to cause immediate overdose. Death rates from synthetic opioids like fentanyl have skyrocketed all across the country in recent years, and nobody using drugs like heroin is safe from the possibility of buying a drug containing a lethal dose of fentanyl.
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