An epidemic has been declared in the United States, and unlike the images that may crowd into the minds of many when they hear the word epidemic, this isn’t a matter of contagious disease. Rather, the Opiate Epidemic was named a state of emergency by the highest levels of Government in 2017 due to the immense levels of opiate abuse and deaths. While all 50 states have been gravely affected by this crisis, New Hampshire is number 1 for Fentanyl related deaths.
What is Fentanyl?
Fentanyl is a very, very powerful opioid analgesic – but what does that mean?
Analgesic is a term that means that the opioids within the drug Fentanyl attach and react with opiate receptors in the brain.
So basically, Fentanyl is a synthetic opiate painkiller prescribed for severe and acute conditions that interacts with receptors in the brain to treat pain. Unfortunately, as with all opiate and opioids, a side effect of this chemical interaction is an intense feeling of euphoria that occurs because the brain becomes flooded with Dopamine.
Dopamine and Serotonin are the two chemicals in the brain most responsible for happiness, joy, and feelings of wellbeing. What that means is that the use of opiates and opioids sends signals to your brain that you are extremely happy – otherwise known as a high.
Fentanyl and the Link to Heroin
While Fentanyl is abused, it is much less common than the abuse of Heroin and other prescription painkillers. So, what is the link between those dying of Fentanyl related overdoses, and those who abuse Heroin?
The answer is cost-effective business, as strange as that may sound. Heroin is created by using Opium, which is derived from Poppy plants. The United States does not produce the Poppy plant, and as a result, Heroin in the United States is almost always imported.
This fact, combined with the fact that poppies are a finite resource, makes producing Heroin more expensive than producing Fentanyl. By contrast, Fentanyl is synthesized in a lab, and is much cheaper to produce even though it is at least 50 times more potent than Heroin.
For this reason, it is more cost effective for dealers to cut- meaning mix- Fentanyl into poor quality Heroin than it is for them to buy and sell high quality Heroin. It is estimated that 40 percent of all Heroin sold in the United States contains Fentanyl or other synthetic opioids.
The Danger of Fentanyl Laced Heroin
It shouldn’t surprise anyone to learn that street dealers are not scientist. You would be hard pressed to find many dealers that could accurately tell you the appropriate dose of Fentanyl for the person they are selling to based on medically pertinent factors such as height, weight and gender.
Herein lies the danger in mixing Fentanyl into Heroin.
As discussed, Fentanyl is 50 times more potent than Heroin, and Heroin can kill a fully-grown adult all on its own. It doesn’t take much Fentanyl to cause a fatal overdose, and unfortunately those who are mixing these drugs are not informed on just what that amount is. As a result, Heroin is sold to addicts every day containing fatal doses of Fentanyl.
Once the dose has been used, there is almost nothing that can reverse the deadly effects. Even the overdose reversal drug Narcan can be ineffective, as it may take multiple doses of Narcan to reverse a Fentanyl overdose, versus the one dose that would be effective in a typical Heroin withdrawal.
What Makes New Hampshire Unique Regarding Fentanyl?
New Hampshire is highly affected by Fentanyl because of one unique distinction – more users in New Hampshire actively seek out Fentanyl. Add that to the fact that most Heroin is also laced with Fentanyl, and you have a serious and dangerous problem. According to a study supported by the National Institute on Drug Abuse, between 2010 and 2015, Fentanyl related deaths in New Hampshire increase by an astronomical 1,629 percent.
The state fire department has even traced active users back to dealers and found that those who seek out the drug are purposefully looking for dealers who are known to sell Fentanyl laced Heroin – even when those users know that people have died from drugs purchased through the exact same dealer.
Additionally, the state has a very high rate of prescribing prescription opioids. The state has found that most current users of Fentanyl were initially introduced to painkiller through prescriptions.
What is New Hampshire doing to Combat the Problem?
One major step was a CDC regulation for prescription narcotic painkillers, it’s aimed at preventing potential users from being introduced to the drugs. T
he regulation was introduced in 2016, and studies are currently being conducted to measure the efficacy of this line of prevention. Unfortunately, at the state level, spending on drug abuse prevention and treatment is the second lowest in the Nation.
Addicted individuals may have difficulty finding information on treatment options or obtaining Narcan needed to save the lives of those in an active state of overdose. However, some locals have taken notice, and begun to act on their own. T
he Manchester Fire Station began a program in 2016 called Safe Station, in order to provide information on New Hampshire Methadone Treatment options, inpatient drug treatment options, and education of prevention. The program also works with local Mental Health agencies. Members of New Hampshire’s state Government are looking at expanding the states spending on treatment and prevention for drug abuse, and recently began to allow Needle Exchange programs to offer clean supplies to users to lower rates of blood born disease.
These efforts are just the beginning of what will need to be done in order to address the severity of the issue taking place in New Hampshire, but many hope that it is the beginning of the end for the mass death toll within the state. Additionally, other rural states in the Nation may benefit from learning from New Hampshire and taking note of how they are setting up their infrastructure to implement in their own states.