Just when you thought the opioid overdose epidemic couldn’t get any worse, it has. It spread. Now, more people are dying of fentanyl laced methamphetamine and cocaine.
Deaths in Philadelphia involving cocaine and methamphetamine are increasing in combination with fentanyl. According to a study by the Philadelphia Department of Public Health From 2016 to 2017, the number of cocaine deaths involving fentanyl increased by more than 130%, and the number of methamphetamine deaths involving fentanyl increased by more than 200%. It has spread to other states.
Fentanyl is a prescription opioid painkiller. It’s primary use is as an adjunct to anethsia. It is a narcotic painkiller that is up to 50 times more potent than heroin and up to 100 times stronger than morphine. It is used to treat severe pain such as in patients who have terminal cancer. A euphoric high or death can occur if a person takes too much of it. Many overdose deaths are caused by unknowingly ingesting this drug with what they think is heroin.
Methamphetamine is referred to as “meth.” It is a stimulant. Meth is often confused with Methadone. Say it out loud, “Meth is not the same as Methadone” and commit it to memory. Meth is an illicit substance of abuse. Methadone is a helpful medication to treat opioid addiction.
Meth can cause hallucinations and violent behavior and take a toll on medical health. Meth surged in the 2000’s because it was easy to produce in labs set up in homes or abandoned buildings. Congress cracked down on the sale of Sudafed, used in cooking meth, by requiring a prescription. Much of the meth comes from Mexico now, rather than being produced locally. It is popular, plentiful and more lethal than ever. Although it is harder to overdose on meth than opioids, meth related overdose deaths are increasing. Both meth and heroin can cause heart failure.
Cocaine is a stimulant known as a party drug. Fentanyl-laced cocaine can be a deadly drug mixture. The DEA reports 7 percent of cocaine seized in New England in 2017 included fentanyl, which is a 4 percent increase from 2016. And in Connecticut, the number of fatal overdoses involving cocaine and fentanyl together has increased 420 percent in the past three years. Law enforcement officials speculate that dealers are adding fentanyl to cocaine because it is more cost-effective for them, and it makes the drug more addictive.
The gold standard of opioid dependence treatment is Methadone, Buprenorphine (a.k.a. Suboxone), and Naltrexone (a.k.a. Vivitrol). The properties of these medications are threefold. First, Methadone and Suboxone stop withdrawal symptoms. Second, when on a therapeutic dose, these medications block euphoria. Third, they reduce cravings.
There is no equivalent medication for meth or cocaine. Non-opioid substances are primarily psychological in nature, whereas opiates are biologically and psychologically addictive. Therefore, opiate addicts can undergo severe and intense withdrawal symptoms when the opioids are ceased. People in late stage opioid addiction are no longer getting high. They are simply trying to avoid withdrawal symptoms. They may turn to meth or cocaine to get through the sickness.
While we’ve been watching one epidemic, another has sprouted. Rather than say that we have an opioid epidemic, we should now admit we have a polysubstance problem.
What can we do? This is a complicated and multifaceted problem. But one thing that can help is Naltrexone (a.k.a. Narcan) that reverses an opioid overdose. It is effective to combat fentanyl that is mixed with other substances. Naloxone is available from many pharmacies now. Treatment providers should be ready for this new, potent, and deadly wave of addiction. If you or someone you know takes these substances, be careful.