In March of 2021, three New York professionals died of a Fentanyl overdose. Three different lives, three separate locations, all unbeknownst to each other; the three victims had received Cocaine laced with Fentanyl from the same text-order drug delivery service.

On a Wednesday in late winter, 26-year-old Julia Ghahramani, 40-year-old Ross Mtangi, and 38-year-old Amanda Scher texted their dealer, Billy Ortega, asking for Cocaine. The 35-year-old stay at home dad operated a delivery service and upon receiving the orders, sent out courier Kaylen Rainey to distribute the drugs.

Dealer Sends Assuaging Texts, Pleads Not Guilty

Communicating via text with the customers, incriminating messages reveal that Ortega knew the batch he was selling was deadly, or at least highly dangerous. Records show a text thread between Ortega (sometimes using the moniker “Jason Melissa”) and Scher the day she bought the drugs:

“Hey try not to do too much because it’s really strong”

“Hey boss lady you heard”

“Lol”

These messages came after Scher had told him that this batch was “Def better” than her previous order earlier in the week. By the time she was found dead on her couch by her dog walker the next day, Scher had several missed Facetime calls from Ortega as well as a text sent that morning to “give [him] a call back” to “ask [her] something real fast.”

The timestamps are fuzzy regarding the correspondences between Ortega and his three customers, but prosecutors allege that roughly six hours after Rainey had delivered the drugs to Ghahramani, Ortega tried to reach her, too. Like Scher, Ghahramani and Mtangi were both found already dead the next morning.

Both Ortega and Rainey are pleading not guilty to causing the three deaths.

Cocaine Prevalence Among New York Elites, Now Cut With Fentanyl

Thanks to its Stimulant nature and euphoric effects, Cocaine gained popularity as a party drug in New York in the 1980s. With a bustling night life full of busy-bodied professionals and a nonstop mentality, it’s not necessarily surprising that this powdered substance is so widely used. According to the Wall Street Journal, the rate of Cocaine usage in New York is higher than the national average of 2%.

What’s worse and considerably more concerning is the increasing prevalence of illicit Fentanyl found in a variety of street drugs, particularly those like Heroin, Cocaine, and sometimes even counterfeit Adderall. Fentanyl, when pharmaceutically rendered and medically prescribed, can alleviate intense pain following surgical procedures and even provide relief for cancer patients. When bought in the drug market illicitly, though, the drug is highly dangerous and incredibly lethal. A synthetic Opioid, Fentanyl is 50-100 times stronger than Morphine and deadly in a dose of around 2 milligrams, roughly the same amount as several grains of sand.

Recent data from the New York Department of Health shows that nearly half of all overdose deaths involve Fentanyl, often the victims none the wiser that their drug contained any traces of the deadly substance. Sassan Ghahramani, 26-year-old Julia’s father said of his daughter’s devastating overdose, “Julia was a driven professional with everything to live for. Never in a billion years would she have touched anything with Fentanyl. This is like putting bullets in people’s brains.”

Fentanyl Overdose Fatalities Steadily Climbing

Because the illicit, street-derived Fentanyl is relatively low cost and easy for cartels and dealers to procure, it is being cut into more and more substances either accidentally, as an experiment, or a way to lower the cost of more expensive drugs like Cocaine and Heroin.

In New York alone, of the 980 Cocaine-related deaths in 2020, 81% involved Fentanyl. Drug usage and overall fatalities have increased over the last few years of the COVID-19 pandemic and subsequent shutdowns and isolation. According to the Centers for Disease Control and Prevention (CDC), there were 107,622 reported fatal overdoses throughout the United States in 2021, an increase of 15% from the 93,655 deaths the previous year. While still stifling, this 15% increase is only half of what it was from 2019 to 2020’s 30% rise. Of those 107,622 deaths, 71,238 of them involved the presence of a synthetic Opioid—largely, Fentanyl.

Accidental Overdose Can Happen To Anyone

Ross Mtangi was a Wall Street executive who regularly ran five miles through Manhattan, Harvard-educated, and an expecting father. Julia Ghahramani virtually graduated from Columbia Law School in 2020 and was working as a first-year lawyer, days away from a family holiday trip. Amanda Scher was a dedicated social servant, splitting her time between hospital work and virtual counseling, and a doting mother to an elderly rescue dog.

These unsuspecting, recreational users became victims in a matter of moments; their bright futures permanently snuffed. None of them fit the bill of “addict,” their story added to the list of dozens like it, another heartbreaking glimpse into the danger and devastation of the drug trade.

Get Help For Fentanyl And Illicit Drug Use

If you or someone you love is struggling with illicit drug use, there are resources available. Reach out and contact a treatment provider today to learn more and discuss treatment and recovery options. Don’t wait until it’s too late; life is too precious and moves too fast.

The post Fentanyl Overdose Kills Three New Yorkers appeared first on Addiction Center.

A new type of animal tranquilizer called Xylazine is appearing more frequently in drug supplies across the country and is thought to be responsible for thousands of overdoses in states like Pennsylvania, New York, Delaware, and New Jersey. Also known by the street name, “Tranq,” Xylazine poses a major threat to public health, as not only can the drug be lethal, but it can also cause necrosis (death of bodily tissue) which can lead to loss of fingers, toes, and even limbs in severe cases.

Xylazine belongs to a class of drugs known as sedatives and is sold under the brand names Rompun®, Sedazine®, and AnaSed®. Currently, it is approved by the US Food and Drug Administration (FDA) for veterinary medicine only, where it is used as a sedative, analgesic, and muscle relaxant for horses and cattle, similar to tranquilizers like Ketamine.

The Dangers Of Tranq

Officials say drug suppliers are lacing the Fentanyl and Heroin supply with Xylazine because it is cheap and easy to get. This means that many users may be using the drug unknowingly. Because Xylazine isn’t an Opioid, it can’t be detected by Fentanyl testing strips, nor can its effects be negated using Naloxone, a medication that reverses the effects of drug overdoses. The drug has been said to be so powerful that it can “knock out” users for about 6 to 8 hours, far longer than most Opioids.

Shawn Westfahl, an overdose prevention coordinator for Prevention Point, Philadelphia’s only needle exchange, says the combination of Xylazine and Fentanyl can put a person to sleep for hours, making it harder to determine whether someone is experiencing an overdose.

Along with its extremely addictive nature, Xylazine poses serious risks for users. Since the drug is often mixed with Opioids like Fentanyl or Heroin, it can not only be ingested unknowingly, but it can also be extremely deadly.

Jamill Taylor, a member of Philadelphia’s narcotics unit, says that “[Xylazine] is basically eating them alive. It causes them to rot from the inside out.” Taylor is referring to perhaps the most alarming symptom of Xylazine use: necrosis. In many cases, the use of Xylazine use can cause skin cells to die, leading to loss of fingers, toes, and even limbs in some cases. Health officials in Philadelphia report that a woman who had been admitted to the hospital for Xylazine needed both an arm and leg amputation due to “severe necrosis.”

Symptoms of Xylazine Use

According to officials with the US Drug Enforcement Agency, reports of non-fatal Xylazine cases ranged from concentrations of 30 to 4,600 mL. In non-fatal cases, some of the most reported symptoms include:

• Blurred vision
• Disorientation
• Drowsiness
• Staggering
• Coma
• Miosis (constriction of the pupils)
• Hyperglycemia (high blood sugar)

Reports of fatal overdoses involving Xylazine were identified as those with a drug concentration up to 16,000 mL. According to the DEA, it is extremely difficult to ascertain exactly where the threshold of lethal and non-lethal doses of Xylazine is due to the wide range of reported doses.

When used frequently, in high concentrations, or alongside other substances like Fentanyl, Xylazine can have serious, life-threatening symptoms. These include:

• Respiratory depression
• Bradycardia (slowed heart rate)
• Skin lesions
• Frequent, persistent skin infections
• Necrosis
• Overdose

Furthermore, the DEA has urged extreme caution surrounding Xylazine use, as normal overdose-prevention medications, like Narcan, will not work on someone heavily sedated on Xylazine. Given the high prevalence of Opioids like Fentanyl that are commonly mixed with Xylazine, health officials still say Narcan should be administered should someone display overdose symptoms.

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Where Is Xylazine Coming From?

While it’s unclear where exactly the surge in supply of Xylazine is coming from, what public health officials do know is that Philadelphia has become ground zero for this new, deadly drug.

Health officials in the city claim that an “alarming” amount of the drug has entered the city in the last few years, leading to a spike in cases of Xylazine-related overdoses. Researchers in Pennsylvania estimate that Xylazine is in 91% of the Heroin and Fentanyl supply in Philadelphia, and claim its prevalence is making its way west. Additionally, the Detroit Free Press reports that deaths involving the tranquilizer increased 87% from 2019 to 2020 in the state of Michigan.

Other states that have been plagued by the recent spike in Xylazine include New York, New Jersey, Delaware, and Maryland, all of which have seen a staggering increase in overdoses in the last year. In Maryland alone, which ranks 6th in the country for the rate of fatal overdoses (44.6 per 100,000), Xylazine was involved in nearly 20% of all fatal drug overdoses in 2021.

Treating Xylazine Addiction

While Xylazine in and of itself is not a “new” substance, its use outside of veterinary medicine has skyrocketed in the last few years. Since the drug has not been studied for its effects on humans extensively, along with the fact that much of the Xylazine in circulation is laced with Opioids like Fentanyl, it can be extremely difficult to determine when someone may be experiencing an overdose or severe adverse effects.

Since health officials know very little about the drug, it is not advised for anyone who is using Xylazine to detox alone. Experts suggest undergoing a supervised medical detox at an inpatient rehab facility for the safest possible outcome.

Once detox is completed, treatment may include a variety of methods, including medically assisted treatment (MAT), recreational therapies, group therapies, and other specialized treatment methods geared toward specific Xylazine withdrawal symptoms. Certain psychological counseling modalities have shown to be particularly successful in treating addictions to similar substances like Ketamine. These include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

Get Help Today

Should adverse effects or signs of addiction to Xylazine or other drugs be present, the time to get help is now. Xylazine has no authorized use outside of veterinary medicine, meaning any use of the drug is not only illegal but can have potentially life-threatening side effects.

To start your journey toward recovery, contact a treatment provider to learn more about what treatment options are available to you.

The post Animal Tranquilizer Xylazine Poses Major Threat appeared first on Addiction Center.

The Opioid crisis has been increasingly present in the United States for nearly 2 decades. Since 1999, more than 1 million people have lost their lives to a drug overdose. Year after year, a growing number of those overdoses have involved a Synthetic Opioid known as Fentanyl, which now accounts for nearly 90% of all Opioid-related overdoses and over 65% of all reported drug overdoses.

In the last year alone, drug overdoses have increased by over 15%, from 94,000 in 2020 to over 108,000 in 2021. Of those 108,000, over 80,000 involved Opioids and over 70,000 of those involving Opioids included Fentanyl.

With no clear signs of slowing down, America’s Fentanyl crisis is at an all-time high. Cities across the country, many of which have historically had low numbers of Opioid-related deaths, are now seeing alarming rates of overdoses. Entire states are being affected as well, with many rural states like West Virginia and Kentucky leading the nation in overdose death rates (81.4 and 49.2 per 100,000 respectively).

Fentanyl-Related Overdoses Continue To Rise In 2022

Drug overdoses have been steadily increasing for over 20 years. Since 2014, however, the number of overdoses has exploded largely due to Fentanyl. Fentanyl is a synthetic Opioid that is 50 to 100 times stronger than Morphine.

“These past three years we have seen an increase of contamination of other illicit drugs with Fentanyl, be it Cocaine, be Methamphetamine, and more recently, illicit prescription drugs,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse. This has put a bigger population of drug users at risk of overdoses, she adds. “In many instances, these may be people that take just one pill, and they get that contaminated pill and they can die.”

What is even more concerning to many experts is the potential of overdoses among younger adults, adolescents, and even children. In 2020 alone, there were 6,129 Opioid overdoses among people under the age of 24, with the overwhelming majority involving Fentanyl.

Overdoses in this age group have become so common, in fact, that for the first time they are on they are rise. A recent study found that for the first time in over a decade, the number of teens who died from overdoses rose in 2020. Experts believe that Opioid overdoses among younger individuals, especially those involving Fentanyl, are more common because the drug is often “cut” or mixed into counterfeit prescription drugs like MDMA which are popular among younger people.

Reports of “candy-colored” or “rainbow” Fentanyl have surfaced in multiple states, which appear to be marketed toward a younger, more impressionable audience. Officials at Arizona’s Nogales Port of Entry reportedly seized over 15,000 rainbow-colored Fentanyl pills, following 250,000 similar multi-colored pills that were seized at the same port just 24 hours earlier. Similar reports of colorful Fentanyl pills have been reported in Oregon, California, and Washington, D.C.

Where Is Fentanyl Coming From?

In recent years, the amount of Fentanyl-contaminated drugs entering the country has skyrocketed. Most of the Fentanyl that enters the country is made in clandestine or illegal laboratories, oftentimes under the guise of brand-name medications like Adderall and Xanax. This means that some people may consume Fentanyl without their knowledge.

According to the United States Drug Enforcement Agency (DEA), as of 2019, China remains the primary source of Fentanyl and Fentanyl-related substances trafficked through international mail and express consignment operations environment, as well as the main source for all Fentanyl-related substances trafficked into the United States. Other major countries of origin include Mexico and India, with even smaller amounts arriving from Canada’s black market.

From October 2021 to June 2022, the U.S. Customs and Border Protection (CBP) has reportedly seized a total of nearly 11,000 pounds of Fentanyl from U.S. borders.

While recent polls show that most Americans believe the majority of Fentanyl is smuggled into the country by migrants, the reality is that these claims are extremely false and misleading. While it is true that many cartels will use migrants as a distraction, the overwhelming majority come through official ports of entry such as cargo ships or trucks.

“The probability [migrants] are going to carry some kind of illicit narcotic is probably close to zero,” says Victor Manjarrez, a retired CBP agent of over 20 years and director for the Center for Law and Human Behavior at the University of Texas, El Paso.

“When you look at the chaos and clutter that occurs at a port of entry, just with the legitimate traffic – you know, trucks and personal vehicles – and so if you’re looking at a couple of pounds of Fentanyl hidden in that chaos – you know, if you’re the bad guy, you kind of like your odds,” he continued.

What’s Being Done To Combat The Fentanyl Crisis?

The Fentanyl crisis has progressed to such an extreme degree that immediate, meaningful action is needed.

“It’s absolutely devastating and heartbreaking that we continue to remain in this position,” says Sheila Vakharia, deputy director of research and academic engagement at the Drug Policy Alliance, an addiction policy advocacy group. “We are over 20 years in this overdose crisis and there’s no sign of any kind of slowing down of deaths. If anything, things have only seemed to have gotten more dire.”

Since 2007, the United States has been working with Mexico in a program known as the Merida Initiative. The program has provided Mexico with more than $3 billion in security and counternarcotics aid, both for police and judicial reforms. While the Merida Initiative has led to the capture of some top cartel leaders, including Joaquin “El Chapo” Guzman, Mexican President Andres Manuel Lopez Obrador has staunchly criticized the agreement.

In 2021, both Mexico and the U.S. announced a new agreement to improve “health and security cooperation.” In a similar partnership, the U.S. had been working with Columbia starting in 2000, where it provided the Columbian government with over $10 billion in aid up until 2016 when the agreement ended.

It’s not just international efforts that have been made to combat the Fentanyl crisis. In April, the Biden administration announced plans to address the unprecedented number of Fentanyl overdoses across the country. The plans included increasing access to harm reduction methods like Naloxone, a powerful medication that reverses overdoses. However, experts agree that this is simply not enough to solve the ongoing Fentanyl crisis. Currently, there are only 2 above-board, legal harm reduction sites in the entire country, both of which are in New York City.

While the need for more legal, safe harm reduction sites continues to grow and gain support across the country, legislation continues to fall short. On Monday, California Governor Gavin Newsom vetoed a bill that would have allowed cities to open supervised drug injection sites as a part of a pilot program to help decrease fatal overdoses.

It’s important to note, however, that while harm reduction has been proven to reduce fatal overdoses and in some instances steer individuals toward quitting, it is not a substitution for treatment. With that said, the two can work well together when implemented correctly.

Getting Help Before It’s Too Late

Getting help for an addiction to Opioids or other illicit drugs can seem like an impossible, constant uphill battle. Along with abundantly underfunded harm reduction programs, the stigma that surrounds drug addiction can be enough to keep those who need help from seeking it out.

As the Fentanyl crisis continues to rage forward, experts warn that an increasing number of illicit drugs will be contaminated with Fentanyl, which often goes unnoticed by those who consume them. If you or someone you know is struggling with a substance use disorder, the time to get help is now. To get help today, contact a treatment provider who can help you start your journey toward recovery.

The post America’s Fentanyl Crisis Is Getting Worse appeared first on Addiction Center.

Public health officials in Chicago are urging would-be Lollapalooza-goers to test their drugs for Fentanyl, citing concerns of potential overdoses during the four-day music festival. The festival, which was held over the weekend, saw nearly 400,000 people flood the city’s Grant Park, many of which were believed to be partaking in illicit drug use.

“There’s going to be people walking around with backpacks at Lollapalooza, that are going to be selling pills that are going to be laced with Fentanyl. There’s not a doubt in my mind,” said a spokesperson for the Chicago Drug Enforcement Agency (DEA) in the days leading up to the festival.

In the official warning put out by the Chicago Department of Public Health (CDPH), officials warned of the potential dangers of Fentanyl, and urged all Lollapalooza attendees to “Test your drugs before you use, carry Narcan, and don’t use alone.”

CDPH said Fentanyl is found in Cocaine, Ecstasy (MDMA) and other drugs – not just Heroin. The department also informed attendees that Narcan and Fentanyl test strips can be picked up at Chicago public libraries “in easy-to-access Narcan dispenser kits,” similar to other harm reduction sites found in other major cities across the country.

Previous Concerns About Fentanyl At Music Festivals

The warnings by CDPH are not the first to be made by the city, nor are they first to be made regarding a music festival. In the last year, Chicago alone has seen over 1,300 Fentanyl-related overdoses. Fentanyl now accounts for nearly 70% of all Opioid-related deaths in the United States, with a growing number of overdoses occurring at events such as raves or music festivals.

While not a surprise to many, music festivals such as Lollapalooza have become hotspots for party drugs like MDMA (Ecstasy), Cocaine, and many other recreational substances. These drugs, combined with extended periods outdoors in the heat, lack of proper hydration, and the drug culture surrounding music festivals can all spell disaster for those partaking in illicit drug activity.

Unfortunately, deadly overdoses involving Fentanyl at music festivals are becoming more and more common. Since 2006, there have been 26 confirmed cases of overdoses from Fentanyl-tainted Ecstasy alone at music festivals and other rave-like events. In fact, just two weeks ago at a music festival in Washington state called Wiggle in the Wetlands, a 21-year-old woman was found dead after consuming Ecstasy that had been laced with Fentanyl.

It’s not just regular drug users that are falling victim to overdoses at music festivals. In 2018, 16-year-old Evan Kitzmiller died at Lollapalooza after a fatal overdose involving Ecstasy. Andrew Kitzmiller, Evan’s father, remains adamant that Evan was not a drug user, and that it was likely Lollapalooza was his first time using.

Music festivals create unique opportunities, and risks, for illicit drug use. Most major festivals, like Lollapalooza, Bonnaroo, and Coachella, draw massive crowds, sometimes exceeding half a million attendees. This makes it easy to slip backpacks filled with drugs past security, which is oftentimes lacking to begin with.

These types of festivals are also typically held in the height of summer, with many in locations that can exceed 100 degrees in the daytime. This, combined with alcohol and drug use, can cause severe dehydration, which can increase the risk for a drug overdose.

Fentanyl Can Be Found In Many Drugs Used At Festivals, Not Just Heroin

Fentanyl is commonly associated with drugs like Heroin or Methamphetamines, as it is commonly used to lace or “cut” the substance to make it more potent or addictive. However, many people may be unaware that Fentanyl can also be found in numerous other drugs, including the two most commonly used at music festivals: Ecstasy and Cocaine, according to a 2018 survey on illicit drug use at music festivals.

Fentanyl is a synthetic Opioid that is 50-100 times stronger than Morphine. The drug is typically used to treat patients after surgery but has become rampant in recreational drugs where it is often used to “cut” or lace other substances. This can oftentimes be unknown to drug users, which can lead to devastating consequences for unsuspecting music festival attendees.

Illicit drugs like Ecstasy and Cocaine don’t come with an ingredient list, and it’s nearly impossible to tell if they have been laced with Fentanyl unless you test them with Fentanyl test strips. Even in small amounts, Fentanyl can be extremely deadly, making any level of illicit drug use potentially dangerous. When compared with other illicit drugs, such as Cocaine, which can be lethal in doses around 1.2 grams, Fentanyl can be lethal in as little as 2 milligrams.

Since October of last year, Chicago DEA has seized over 80,000 pills containing Fentanyl. What makes these pills especially dangerous, according to DEA officials, is that they are nearly identical to the real thing.

“I’ve done this job for 20 years,” said one DEA official. “I can’t distinguish between a fake Fentanyl pill or a pill containing Fentanyl and one that doesn’t.”

While the answer to staying safe from Fentanyl at music festivals is to avoid illicit drug use altogether, health officials say that should attendees decide to use, they should do so safely. Narcan, also known as Naloxone, is a drug used to help reverse the symptoms of an overdose and save lives.

“Having your own naloxone could save someone else’s life. Or if you carry it around and let your friends and other loved ones know where it is, because you can’t use it on yourself,” said Dr. Maria Rahmandar, who often treats patients during Lollapalooza at Lurie Children’s Hospital. “If you decide to use something, I would encourage you to not use alone and to use with people who are sober.”

Even Occasional Drug Use At Music Festivals Can Lead To Addiction

It’s important to note that there is a difference between occasional drug use and drug addiction. Using illicit drugs once, or occasionally, is known as drug misuse. Because no level of drug use is safe, drug misuse still carries significant risk, especially considering the increased warnings surrounding Fentanyl at music festivals.

Where drug misuse crosses over to drug addiction is when it is accompanied by compulsive behaviors such as seeking out drugs, despite adverse consequences. Addiction is considered a brain disorder, because it involves changes to the brain that alter the way it functions. These changes oftentimes involve altering the circuits involved with reward, risk, stress, and self-control. This is why it’s recommended to seek professional help for drug addiction.

If you or someone you know are unable to stop using drugs, they should consider treatment for drug addiction. Treatment for drug addiction usually begins with detox, which should be done at a treatment facility, as drug withdrawals can be especially dangerous. Depending on the substance you are using, detox can take anywhere from 24 hours to two weeks.

Detox is just the first part of treatment. On its own, detox is usually insufficient for a successful recovery. You will need to speak with your doctor or addiction treatment specialist to determine what steps you will need to take once detox is complete. Typically, this will include inpatient or outpatient rehab programs, or a combination of both.

To find a treatment center near you, contact a treatment provider to get more information on addiction treatment.

The post Fentanyl At Music Festivals Raises Concerns appeared first on Addiction Center.

This week, the Centers for Disease Control and Prevention (CDC) presented a set of recommendations for Opioid prescriptions. These new guidelines are the first revisions made to the organization’s 2016 suggestions which stopped many with chronic pain from getting the relief they needed. 

The Opioid Epidemic And The CDC

For over 3 decades, the US has been experiencing a serious public health crisis known as the Opioid epidemic. In the 1990s, pharmaceutical companies, insurers, and pain specialists endorsed Opioid pain relievers as being less addictive and safe to use for common ailments. The marketing of drugs like OxyContin led to an increase in prescriptions being written for issues like backaches and arthritis. 

As a result, US overdose deaths rose drastically. From 1999 to 2017, Opioid-related overdose deaths increased almost sixfold. While local and federal governments attempted to restrict prescriptions, the crisis continued. Those who had already become addicted to Opioids turned to Heroin or Fentanyl when they couldn’t get a prescription. In fact, studies have shown that 80% of people who have used Heroin first used prescription Opioids. 

The CDC released a set of guidelines in 2016 aimed at decreasing the number of Opioids being prescribed. The organization urged physicians to explore other treatment options before turning to Opioids. Other medications and non-drug therapies were recommended as alternatives. If doctors chose to prescribe painkillers for acute pain, the CDC proposed a 3-day limit for prescriptions and that doctors prescribe the lowest possible effective dose. These guidelines also applied to treating chronic pain. Despite being voluntary, doctors and local governments implemented these recommendations. 

An Unintended Consequence

Although these guidelines ultimately contributed to a decrease in Opioid prescriptions being written, they were largely opposed due to their effect on a specific group. Many doctors across the US feared there would be criminal or civil consequences if they did not follow them. Doctors became very hesitant to prescribe Opioids and quickly tapered patients off of their prescriptions. This greatly affected many chronic pain patients who rely on doses higher than the 90 milligram ceiling of Morphine listed in the 2016 guidelines. 

Studies have shown that rapid tapering patients off of Opioids can lead to harmful outcomes. One particular study of 100,00 chronic pain patients found there was 68% increase in overdose deaths for patients experiencing tapering compared to those who were not. For the tapered group, there was also a spike in mental health conditions. Chronic pain patients were also more likely to turn to substances like Heroin and Fentanyl to self-medicate their pain after being tapered off their medications. Suicide can also be an outcome of tapering. It has been reported that up to 30% of Opioid overdoses could be suicides. 

The rigid interpretation of the CDC’s 2016 guidelines also affected those who were struggling with a substance use disorder (SUD). Many doctors developed a one strike policy. This meant that if a patient tested positive for an illicit substance, they were not given further treatment. 

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CDC Proposes New Guidelines

Several organizations spoke out against the original 2016 guidelines. In 2019, the US Food and Drug Administration issued a warning about the dangers that can come from suddenly tapering patients off of Opioids. The American Medical Association recommended that doctors immediately suspend the CDC’s guidelines in 2020. In response, the CDC acknowledged that their suggestions had been misinterpreted and misused. Concerned about the reports of people with chronic pain being denied relief, the CDC began to work on revisions to their 2016 guidelines. This time, their recommendations were drafted with no input from drugmakers. 

The new guidelines, released on Thursday, are aimed at balancing the necessary use of Opioids for severe pain and protecting other patients against harmful risks. The 12 recommendations proposed in the 229 page document changes the “one-size fits all approach” to Opioid prescriptions. Doctors are being urged to look at each patient’s situation and assess the risk and benefits prescribing Opioids. Overall, the CDC still believes that non-Opioid therapies should be attempted before prescribing Opioids for pain. At the same time, they removed the 90 milligram ceiling of morphine for chronic pain patients and the 3 day limit for acute pain. 

While the document warns of addiction, depressed breathing, and effects to mental status, they have noted that they serve a very important medical purpose. Relieving pain from traumatic injuries, such as burns and crushed bones, were listed. In these cases, it is recommended that immediate release pills be used rather than long-acting. The CDC also stated that these guidelines do not apply to those with cancer, sickle cell, and end of life or palliative care. 

The CDC also noted that patients who come in and test positive for illicit substances could have untreated pain or a substance use disorder. The new guidelines recommend that doctors offer treatment, counseling, and careful tapering when necessary. In doing so, they can assist patients in improving their quality of life. 

These recommendations are currently available on the Federal register. For 60 days, the public can make comments on the proposed guidelines. The CDC will then review these comments and will likely release a final issue by the end of the year. 

The post CDC Releases New Opioid Prescription Guidelines appeared first on Addiction Center.

It was sometime in the 2010s when Fentanyl, a synthetic Opioid similar in color and texture to Heroin, made its way to the streets and to deadly consequence. The United States Drug Enforcement Administration (DEA) has confiscated over 15,000 pounds of Fentanyl this year alone; an amount large enough to kill every American. The biggest concern? It’s no longer an issue of Fentanyl-laced Heroin or other common street drugs like Cocaine, Molly (Ecstasy), or Methamphetamine (Meth). Drug traffickers are now using online modalities such as social media to sell pills of Fentanyl identical in resemblance to prescriptions such as OxyContin, Xanax, and Adderall; otherwise “tightly-controlled” substances.

This means, essentially, that everyone with a smartphone (roughly 85% of the American population) and a connection to the internet has access to the networks in which these bootleg pills are being sold. Federal authorities believe the rise in Fentanyl-laced drugs is due largely to the fact that the substance is easy to transport and difficult to track. “You can fake out your parents, your friends, your partner, law enforcement,” says Joseph Palamar, associate professor and drug epidemiologist at New York University. Unlike Heroin, which is cultivated from the opium-poppy plant, Fentanyl is derived from strictly chemicals and is 50 times more powerful than Heroin. The vast majority of these counterfeit pills have been brought, bought, or smuggled into the country from Mexico where drug cartels are purchasing the necessary ingredients from China.

Mexican Sinaloa Cartel Catering To “US Need” Of Fentanyl

In late October of this year, Mexican authorities intercepted the Sinaloa Cartel, one of the largest and most dangerous drug organizations in the Western Hemisphere, discovering a record-breaking amount of Fentanyl. In this one raid, police found approximately 260 pounds of the substance, estimated to be worth roughly $50 million US dollars.

Former commissioner of Mexico’s Federal Police, Manelich Castilla Craviotto told Business Insider, “If Mexican authorities seized more than 100 kilograms, it means criminals are producing at least several tons.” Fentanyl is both easier to produce than Cocaine or Heroin and is 20 times more profitable because it is easier to smuggle and the user requires only a minuscule dosage to become addicted; cooks are even trained to mix and create Fentanyl “according to US need”— a chilling remark. Craviotto also said, “Today Mexico does not have a policy or campaign to point out the traffickers and the producers. The present administration’s vision is very limited when compared to how things are done in the US,” a fact that makes the drug trade even more dangerous.

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DEA Releases Public Safety Alert

According to the Centers for Disease Control and Prevention (CDC), more than 100,000 people died from overdose between April of 2020 and April of 2021; an estimated 75,000 of those deaths were due to an Opioid overdose—largely, from Fentanyl. For the first time in 6 years, the DEA has issued a public safety alert on the dangers of fake pills after confiscating more than 9.5 million bootleg pills – an increase of nearly 430% since 2019. Of every fake pill the agency encountered, roughly 40% have contained at least 2 milligrams of Fentanyl: an amount comparable to a few grains of course sand and enough to cause a fatal overdose.

As recently as Thursday, December 16^th, the DEA discovered more than 570 new cases stemming from a single law enforcement surge, linking 39 fatal overdoses. “Social media is the perfect drug trafficking tool,” Anne Milgram, DEA Administrator said in a press conference on that same day. She spoke of cases of young teens found dead after taking what looked like prescribed Oxycodone or other legitimately procured medications purchased online, usually through social media. Drug cartels choose these mediums, Milgram says, for several reasons including the vast accessibility; “[they’re] easy to use, drug traffickers can hide their identities, they can lie about what they are selling, and most importantly, the sites permit the sale of these fake counterfeit pills every day to go unchecked.”

The other issue is that the network of criminal drug activity is completely misrepresenting what it is they are marketing and selling to people. Whether it is deliberate deception on the part of the drug cartels is not clear. “People think that they are buying real Xanax pills, real Adderall pills, real Oxycodone using online platforms that they trust…in reality, they’re getting deadly Fentanyl and pills that look just like the real thing,” Milgram said in the same conference. Hopefully awareness, vigilance, and tightened precautions can lead to a safer, more prosperous future.

The post The Deadly Link Between Social Media And Fentanyl Pills appeared first on Addiction Center.

Researchers at the University of British Columbia have developed an artificial intelligence (AI) tool for analyzing synthetic drugs. Up until now, psychoactive “designer drugs” have been difficult to identify with standard drug tests. This new AI tool not only easily detects synthetic substances but also can predict new chemical structures. 

This advancement in AI, called DarkNPS, could help to develop more accurate drug screening tests with faster results. While current tests can take weeks, or even months, this tool could deliver results in just a few hours. 

What Are Synthetic Drugs?

Synthetic drugs are constructed in labs with the intention of imitating the effects of other drugs that may be illegal or hard to obtain. These substances are created by altering the original drug’s chemical structure. In doing so, synthetic drugs circumvent existing drug laws and safety standards. Although often marketed as being harmless “legal alternatives,” lack of regulations make the use of these substances extremely dangerous. 

Currently, the 2 most common types of synthetic drugs in the US are Cannabinoids and Cathinones. Synthetic Cannabinoids, like K2 and spice, emulate the effects of THC which is the main psychoactive compound in Marijuana. Manufactured Cathinones, like bath salts, mimic Stimulants such as Cocaine, Methamphetamines, and LSD. The effects of Opioids, Benzodiazepines, and Phenethylamines have also been replicated. Using these popular substances can have negative health effects such as anxiety, elevated blood pressure, hallucinations, seizures, chest pain, extreme paranoia, and violent behavior. 

The first US report of synthetic drugs occurred in 2008 when a shipment of spice was seized in Dayton, Ohio. To further avoid safety standards, synthetic substances are typically smuggled into the US after being manufactured in another country. Packaging usually reads “not safe for human consumption” or is mislabeled intentionally. 

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AI Detection Tool

Michael Skinnider, an MD/PhD student at the University of British Columbia worked to develop the new AI tool for synthetic drug detection. To achieve this, Skinnider and his colleagues collected over 1,700 known synthetic drugs from around the world. Tandem mass spectrometry, or Tandem MS, was used to examine the chemical structure of these substances. This technique breaks down ions of the substance into smaller fragments. In doing so, the AI tool was able to find patterns between the chemical structures of these collected drugs. With this information, the AI tool was able to predict 8.9 million potential synthetic drugs. 

After training this tool, the team of researchers at UBC tested the AI technology with 194 new synthetic drugs. The DarkNPS tool was able to recognize 174 of the tested substances by searching for the most common chemical structure patterns. This 89% accuracy rate supports the idea that DarkNPS can be used to anticipate and identify future synthetic drugs. 

Previously, the possibilities for new synthetic drugs were seemingly endless with an unknown amount of different chemical structures. With the ability to predict future structures, this tool could be helpful in narrowing down the search for harmful synthetic drugs. Additionally, DarkNPS could shorten the length of investigations. 

The Impact Of Synthetic Drugs

In addition to bypassing drug laws, synthetic drugs are cheaper to manufacture than other substances. Because they are created chemically, the supply chain needed to make and distribute synthetic drugs is reduced which can lead to more profits. The potency of synthetic substances also contributes to their appeal to manufacturers who can sell smaller amounts with the same effects. These substances are also frequently mixed with other more expensive drugs to lower production costs. 

The mixing of synthetic substances is one of the main reasons that using them is so dangerous. This is especially true for Fentanyl which is a synthetic Opioid and one of the leading causes of overdose deaths in the US. Originally created to treat cancer related pain, Fentanyl is 80 to 100 times stronger than Morphine. This synthetic Opioid is frequently used to cut Heroin, unbeknownst to users. Because Fentanyl is almost impossible to detect, the amount present is very unpredictable.  

When individuals unknowingly consume a synthetic substance, there is a high chance for addiction, health issues, and overdose. Just last week, it was reported that US overdose deaths reached over 100,000 in the past year. This record-breaking number indicated an increase in synthetic Opioid overdose deaths as well. 

The AI tool created by UBC could be useful in preventing future overdose deaths from synthetic drugs. According to the study’s authors, several authorities from around the world have expressed interest in utilizing DarkNPS. 

The post AI Tool Can Now Easily Identify Synthetic Drugs appeared first on Addiction Center.

On Wednesday, the Centers for Disease Control and Prevention (CDC) released data showing that overdose deaths have hit a record-breaking high: more than 100,000 fatalities due to drug overdoses, many of them caused by Fentanyl, occurred in the 12-month span that concluded in April of this year.

CNN contextualized the scope of the statistic in its reporting; an article published by the outlet reveals that deaths increased “28.5% from the same period a year earlier…nearly doubling over the past five years.”

Almost 2 in every 3 deaths are due to Synthetic Opioids, and within that class Fentanyl is the most deadly.

There’s speculation that the pandemic has facilitated the spread of drugs like Fentanyl, and that potent and synthesizable substances are appealing to drug traffickers who must contend with lockdown measures and may only have so much physical storage space with which to move their product.

Experts tend to agree that the long-term solution to the overdose crisis involves making addiction treatment, like the kind offered by inpatient and outpatient rehab, available to more Americans. In the meantime, however, state governments and law enforcement agencies are taking steps to act against Fentanyl — and a new model law released by the current administration may lead to more access to lifesaving medications that can help prevent further tragedy.

The Fight Against Fentanyl Ramps Up

The same day that the CDC released the new data, Pennsylvania Department of Drug and Alcohol Programs Secretary Jen Smith stressed the importance of carrying Naloxone (also called Narcan), a medication that can save lives by undoing the effect Opioids have in the brain and reversing an overdose.

Secretary Smith stated, “You never know when you may come across an individual suffering from an overdose. There are numerous ways [to] access life-saving naloxone…we’re here today to encourage that people take advantage of those resources.”

Pennsylvania has County and Regional Centralized Coordinating Entities (CCEs) that work with first responders to distribute Naloxone. Many states may have similar programs; in all 50 states, Naloxone is available with no prescription and may be obtained at a local pharmacy.

The medication is safe to use and relatively easy to administer, does not generally cause any side effects, and doesn’t get the user high.

At the same time that everyday Americans are being asked to step up and learn how to use Naloxone to save lives, law enforcement agencies are coming down hard on Fentanyl suppliers.

A day before the CDC released their data, the Los Angeles Police Department (LAPD) declared that it would begin more thoroughly and systematically pursuing Fentanyl dealers, especially when 1 dealer or group of dealers is seen to be responsible for multiple instance of the drug being distributed.

Assistant Chief Bea Girmala said that it was important to not merely address the currently unfolding crisis but also ask “What does the supply chain look like…can we link it to any particular dealer or an establishment where maybe people had frequented prior to the overdose?”

The LAPD said it would work with the DEA to dismantle and bring justice to Fentanyl suppliers; many law enforcement agencies across the country are doing the same.

New Model Law Could Provide Solution

On Wednesday, the White House Office of National Drug Control Policy gave states a legal template that might be used to increase access to Naloxone across the nation. As Bloomberg Law reported, “The model law would promote educational initiatives on the benefits of drugs like Naloxone, create a pilot program for bystanders to access the drug, and grant legal protections for people who administer it.”

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It could be beneficial to open up access to Naloxone in more places around the country; though it is legal without a prescription in all states, laws are very different across different jurisdictions. Furthermore, in many states, individuals who administer Naloxone could potentially be criminally charged for their behavior. Legal shields that would prevent something like that from happening could go a long way toward saving lives that might otherwise be lost to Fentanyl or drugs like it.

According to the White House, the administration is committed to increasing “access to evidence-based prevention, treatment, harm reduction, and recovery support services…In addition to these actions, the President’s FY22 budget request calls for a $41.0 billion investment for national drug program agencies.”

The post Overdose Deaths Exceed 100K, Fentanyl To Blame appeared first on Addiction Center.

Xavier Becerra, the Secretary of Health and Human Services (HHS), has indicated that the war on drugs may be in the midst of a shift (and so too the Biden administration’s drug policy); late last month, Becerra told NPR that as far as harm reduction strategies concerned with mitigating damage from drug abuse go, “We are willing to go places where our opinions and our tendencies have not allowed us to go [before].”

Becerra’s willingness may be the result of desperate times calling for desperate measures; according to the Centers for Disease Control and Prevention (CDC), there were 96,779 overdose deaths during the 12-month period ending in March of 2021. Addiction, often a disease of despair, was provided an opportunity to flourish during the pandemic given the multitude of layoffs and abundance of time spent at home; reporting on the subject, the Associated Press shared that, “pandemic restrictions isolated those with drug addictions and made treatment harder to get.” Furthermore, the proliferation of Synthetic Opioids — along with the legacy of deceptive marketing practices by drug companies, which often masked the addictive and dangerous nature of Opioids — has put the country in a position where new approaches may be well-warranted.

The aforementioned harm reduction strategies include, according to NPR, “clean needle exchange programs designed to slow the spread of diseases such as HIV/AIDS and hepatitis among drug users” as well as “fentanyl test strips to help active drug users identify contaminated street drugs.” In Becerra’s own words, “We are literally trying to give users a lifeline.”

Perhaps most controversially, in his remarks Becerra seemed to open the door to so-called “safe consumption sites.” These are locations where illicit drugs can be taken in a way that is regulated and supervised. Safe consumption sites have been operating in Europe for roughly 30 years; they are largely verboten in the US, despite evidence that they can effectively reach marginalized populations and facilitate health and recovery.

Earlier this year, Rhode Island became the first state to pass legislation to allow safe consumption sites. According to Vice News, at the kind of sites now legal in Rhode Island, “people can use drugs, with oversight from medical professionals trained to administer medicines like naloxone…users can also meet with case workers to connect them with services like housing and job training.” The description of the site sounds in line with Biden administration drug policy aims as stated by the American Rescue Plan Act passed earlier this year, which earmarked millions to “support community based overdose prevention programs, syringe service programs, and other harm reduction services.”

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Pushback To Biden Admin Policies And Recommendations

Though Becerra seemed to signal a willingness to give safe consumption sites a shot in more places than Rhode Island, telling NPR that “We’re not going to say ‘but you can’t do these other type of supervised consumption programs that you think work or that evidence shows work,’” HHS immediately distanced itself from the sentiment; an agency spokesperson said in a later statement that, “HHS does not have a position on supervised consumption sites,” elaborating that, “The issue is a matter of ongoing litigation. The Secretary was simply stressing that HHS supports various forms of harm reduction for people who use drugs.”

The Biden administration has faced friction in the face of its drug policies from without as well as from within; a coalition of groups including Human Rights Watch, the American Civil Liberties Union, and the National Council on Alcoholism and Drug Dependence recently addressed a joint letter to President Biden, congressional leadership, and administration officials including Becerra.

The letter accuses the Biden administration and its drug policies of “[leaning] on law enforcement, not evidence-based public health solutions, to solve the overdose epidemic,” going on to say that “it is time to center a public health approach rooted in expanding access to harm reduction and treatment instead of the same ineffective approach of arrest and incarceration.”

Making direct reference to the Biden administration’s recent drug policy recommendations to Congress, which called for “fentanyl-related substances” to be forever designated Schedule I under the Controlled Substances Act, the advocacy and watchdog groups declared that “there is simply no evidence that classwide scheduling or increased enforcement works to reduce illicit drug supply or rates of overdose and addiction.”

Stigma Persists As Supreme Court Defers

Data concerning how well scheduling a substance works to stop abuse of that substance is mixed. Scheduling a substance certainly might help contribute to the already-present stigma that surrounds addiction — potentially portraying drug users as dangerous or immoral people. President Biden has previously pushed back against the characterization of drug users in this manner, and has called for policies that prioritize rehabilitation over punishment.

Most Americans believe that the taboo around drug use and addiction is alive and well. According to a survey conducted earlier this year by Fors Marsh Group, more than two-thirds of Americans think that people who receive treatment for substance use disorders are generally regarded poorly as a result.

Furthermore, 7 in 10 Americans in recovery indicated they didn’t believe they would be hired if they talked about struggling with addiction or substance abuse in a job interview; 93% of respondents, meanwhile, “said it’s important for employers to support substance use recovery programs for their employees.”

The American public seems to want recovery-related resources made available to individuals affected by addiction. The Biden administration’s drug policies may have the same goal; only time will tell if they will end up being a closer match to Becerra’s harm-reduction rhetoric or to the punitive, law-and-order image painted by advocacy and watchdog groups.

For now, it doesn’t appear that recovery-related resources — at least in the form of safe consumption sites — will get any help from the Supreme Court. The Supreme Court of the United States chose not to complete a case review that might have allowed a supervised injection site which could work to prevent overdoses to operate. Therefore, the ruling of a lower court will stand; the nonprofit’s operators will continue to look for a way around the so-called “crack house statute” that has been used to shutter and prevent safe consumption sites for decades — a statute that, ironically, in its enforcement against these sites may itself be leading to more activity inside of actual crack houses.

The post Biden Admin Signals Shift To Harm Reduction appeared first on Addiction Center.