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.

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.

As the world reels from the 6.13 million lives lost directly to COVID-19, new research reveals the extent that the pandemic’s toll has reached, and it goes well beyond the disease itself. In the pandemic’s first year, from 2019 to 2020, the number of Americans who died from alcohol-related causes increased by 25%, as most forms of normalcy, routine, treatment access, and coping skills were either disrupted or eradicated during this time. 

The pandemic has drastically disrupted work, home, and social life, and among these changes were America’s relationship with alcohol. The 25% increase in alcohol-related deaths was represented among all age groups, starting with age 16, ethnicities, genders, and races, but young adults ages 25 to 44 experienced the most significant increase. In fact, for adults younger than 65 years old, alcohol-related deaths outnumbered COVID-19 deaths, 74,408 to 74,075. Additionally, the study, conducted by researchers with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), found that the rate of alcohol-related deaths, including deaths from liver disease and accidents, outpaced the increase of death from all causes.

Changes In Alcohol Consumption During The Pandemic

To offset widespread fear, frustration, and social isolation rampant during the pandemic, many turned to alcohol to self-soothe. In the first month of the stay-at-home orders in March of 2020, national alcohol sales rose 54%, and some states even allowed restaurants and similar on-premises retailers to sell carry-out alcohol beverages. As more individuals found themselves stuck at home with amplified stressors, minimal coping strategies, and increased alcohol availability, the frequency of alcohol consumption increased by 14% compared to the previous year, according to a study by the Journal of the American Medical Association (JAMA). Increased alcohol consumption was a developing trend predating the pandemic, as were mental health struggles, but the conditions of the pandemic made individuals more susceptible to substance abuse. 

However, the pandemic particularly impacted women and parents with young children regarding alcohol consumption. Women have disproportionately taken on the responsibility of child care, home management, and children’s education since the pandemic, so it reasons that women have increased their use of alcohol disproportionately. What may have started as an additional glass of wine with dinner turned into a 41% increase in the number of days women are drinking heavily or consuming 4 or more drinks within a short time. Those without children faced their own struggles as many experienced increased rates of isolation and loneliness, which are factors related to increased alcohol consumption. 

Drug Overdoses Rise Alongside Alcohol-Related Deaths

In conjunction with rising alcohol-related deaths, the number of Opioid overdoses involving alcohol increased by 40.8% in 2020, and there was a 59.2% increase in overdoses involving alcohol and synthetic Opioids like Fentanyl. While rates of Opioid overdoses have been on the incline in recent years, the pandemic only exacerbated these trends due to several factors, including increased isolation, stress, and a lack of treatment and support resources due to lockdown stipulations. 

Additionally, drug overdose deaths reached a record high during the pandemic’s first year, with over 100,000 Americans dying from overdoses within 12 months. This increase, much like the increase in alcohol-related deaths, can be linked to the loss of access to treatment, increased mental health issues, and the availability of potentially lethal substances. The rise in overdose deaths was primarily due to the widespread use of Fentanyl, but stimulants like Methamphetamine, Cocaine, and natural and semi-synthetic Opioids, such as prescription pain medication, also factored into increased rates. 

Loss Of Access To Treatment

Not only were individuals unable to connect with loved ones during quarantine, those who were in recovery from a substance use disorder (SUD) suddenly found themselves without multiple resources as treatment facilities closed temporarily. Those who may have already been struggling with sobriety could not attend in-person support group meetings like Alcoholics Anonymous or receive addiction treatment medicine from clinics. Treatment facilities across the US shut their doors in compliance with COVID-19 safety regulations, and health care providers struggled to tend to the onslaught of coronavirus patients, potentially deterring individuals from pursuing treatment for substance abuse. This rapid severance of treatment left many individuals experiencing a SUD reeling and struggling to find support.

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This disruption of recovery treatment could lead individuals to resort back to old coping mechanisms, including using substances. “Stress is the primary factor in relapse, and there is no question there was a big increase in self-reported stress, and big increases in anxiety and depression,” said Aaron White, the senior scientific adviser at the NIAAA. These increased levels of stress, uncertainty, and anxiety that the pandemic has instilled in people only increases the risk of relapse in those struggling with substance abuse. 

Entering the third March of the pandemic, it is still unclear if alcohol-related deaths will decrease as the pandemic wanes. As COVID-19 restrictions continue to lax, many can physically access treatment centers, attend support group meetings, and connect with loved ones, so researchers are hopeful to see a reduction in alcohol-related deaths. 

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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. 

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Over the past few years, Marijuana has become legalized for recreational use in certain states across the US. A new study has found that nationally, and specifically in legalized states, the rate of children getting sick after accidentally consuming Marijuana edibles has been significantly increasing. 

What Are Marijuana Edibles?

Edibles are food or drinks that contain chemical compounds that are found in cannabis. When consumed, these compounds, also known as cannabinoids, have effects on the mind and body. While cannabinoids, like cannabidiol (CBD), are non-intoxicating, tetrahydrocannabinol (THC) produces euphoric or high feelings. 

These products typically look very similar to normal foods, such as chocolate, cookies, lollipops, or fruit gummies. Some are designed to look like recognizable candy brands. Because these products can be easily mistaken for common treats, some states have instituted laws that dictate how they should be labeled and packaged. 

Growing Rates Of Children Consuming Marijuana Edibles

Accidental edible consumption has been climbing in legalized states and on a national level. Five years after Marijuana retail sales began in Washington state, the first state to legalize recreational Marijuana, the number of these incidents essentially tripled. In the US, there were 187 instances of child exposure to Marijuana edibles in 2016. This number rose to over 3,000 by 2020. 

New data is showing that children ages 3-5 are at the highest risk for accidental Marijuana edible consumption. Children in this age group may be affected at higher rates because they tend to be more curious and have less supervision during this stage. Additionally, edibles are responsible for half of the Marijuana accidents for children 9 and under. These incidents are more common in states where the substance has become legal for recreational use. 

What Is Being Done To Prevent These Accidents?

Currently, there are 19 states where Marijuana can be used recreationally. These states include: Alaska, Arizona, California, Colorado, Connecticut, Washington, D.C., Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, New York, Oregon, Vermont, Virginia, and Washington. In these states, Marijuana edibles can be purchased from retail stores. Additionally, some states allow residents to grow limited amounts of the substance for their own personal use.

Colorado began requiring a universal symbol on edibles in 2016. This diamond shape marking with the letters “THC” must be found on the product itself, not just the packaging. This requirement was made in addition to other childproof packaging, such as difficult to open zippers and lids. Despite being intended to prevent children from consuming edibles, rates have continued to increase. 

The Risks Involved For Children

While the numbers of accidental ingestion by children are increasing, no overdose deaths have been recorded as a result. Despite this, 15% of children experienced moderate symptoms of Marijuana use. Major symptoms were present in 1.4% of these cases. The symptoms that occur and their severity will depend on how much the child has ingested and in what form. Moderate symptoms include: 

• Drowsiness
• Agitation 
• Confusion
• Increased heart rate 
• Trouble breathing 
• Coordination issues 
• Red eyes 

Severe symptoms include: 

• Seizures 
• Neurological impairment 
• Intense breathing issues 

Edibles are often packaged with more than one adult serving. Because they look just like any other candy or snack, children are at risk for consuming more than the recommended dose for adults. Elizabeth Perry, a Maryland mother, spoke to D.C.’s NBC station last year about her toddler’s overdose on Marijuana edibles. Oliver consumed 15 gummies which was 75 mg of THC, or 7 times the serving size. 

Some states have passed laws regarding the maximum amount of THC that can be in a serving size. In Oregon, 5mg per serving is the maximum, while in Colorado, it is 10 mg per serving. 

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What To Do If Your Child Has Consumed Edibles

If you suspect that your child has accidentally taken Marijuana edibles, it’s important to remain calm. Next, get as much information as you can. This includes identifying what type of edible, how much has been ingested, and the warnings included on the label. To determine how much your child has consumed, you may have to recall how much was in the packaging before they got into it. 

It may seem as if your child has no symptoms. This might be due to the fact that effects of edibles take longer for the body to absorb. While it could take up to 90 minutes for effects to kick in, they also can last longer (up to 24 hours) than other forms of Marijuana. For these reasons, you should make sure to call poison control even if your child is showing no signs of use. 

If your child is showing symptoms, such as sleepiness, slowed breathing, or seizures, call 911 and seek help immediately. 

How To Prevent Accidental Child Marijuana Consumption

The best way to prevent your child from unintentionally taking Marijuana edibles is to keep them in a very secure location. They should be treated as if they are a toxic substance or prescription medication. This may mean finding a spot where they can be locked up and out of reach. It is also important to not take Marijuana edibles in front of your children as it’s possible they will follow your actions should they find the edibles. Finally, friends and family members can also be a cause of exposure. For this reason, you should be sure to speak with others about where they keep their edibles, especially if your child spends time in their home frequently. 

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New York City officials have proposed a new initiative that will feature the installation of “public health vending machines.” These vending machines will dispense free toiletries, safe sex kits, and harm reduction supplies, such as overdose reversal medications and sterile syringes.

What Is Harm Reduction?

Harm reduction programs are aimed at reducing overdose deaths and other adverse outcomes that can come from drug use. While most policies are focused on abstinence, harm reduction works to give agency to those who are struggling with a substance use disorder (SUD). This is done through a spectrum of approaches such as managed and safer use.

Because each program differs based on the community’s needs, there is no set definition for harm reduction. States in the US who take this approach typically provide medications to reverse overdose, resources on treatment, and needle exchange. The National Harm Reduction Coalition lists 8 principles that are essential for harm reduction programs. These principles include:

1. Accepts that licit and illicit drug use is part of our world and chooses to not ignore or condemn harmful effects. 
2. Recognizes that substance use is a complex situation and that some methods are safer than others. 
3. Uses the quality of individual and community life as the program’s criteria. 
4. Services and resources are provided without judgement or coercion. 
5. Program is created by routinely giving a voice to those who use substances or have a history of substance uses. 
6. Those who use substances are the primary agents in reducing harm. 
7. Acknowledges that social inequalities, like poverty, class, racism, past trauma, and discrimination can affect an individual’s vulnerability for substance use. 
8. Does not minimize or ignore the harms and dangers that are associated with substance use. 

New York City’s Vending Machine Plan

It has been reported that every 4 hours, a person in New York City dies of a drug overdose. Like the rest of the US, New York City has seen an increase in overdose related deaths over the past few years. In 2020, 2,062 overdose deaths were recorded for the city which is 500 more than the prior year.

This $730,000 pilot program is geared towards curbing overdoses by making harm reduction supplies easily accessible. In order to reach the areas that have been especially affected by overdose deaths, 10 public health vending machines will be placed in all 5 boroughs of the city. Central Harlem, Union Square, Far Rockaway, Stapleton, and East New York have been identified as top priority neighborhoods. 

While residents of New York state currently have access to clean syringes at pharmacies throughout the state, these vending machines may be a more appealing option. By eliminating face-to-face interactions and being available 24/7, harm reduction vending machines can get supplies to the people who need them most, where they need them, and on their schedule.

Needle Exchange Programs And Naloxone

Exchanging needles and providing Naloxone will be the main focus of New York’s harm reduction vending machines. 

The Centers for Disease Control and Prevention (CDC) defines syringe services programs (SSP) as community based programs that provide access to sterile needles and syringes, facilitate safe disposal of used syringes, and link people to treatment programs. Studies have shown that those who participate in SSPs are 5 times more likely to enter treatment than those who do not. It has also been proven that these programs can be successful in preventing the spread of HIV, Hepatitis C, and other skin and other high risk infections.

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Naloxone is a medication that can reverse Opioid overdose by attaching to Opioid receptors to block the substance’s effects. This can be achieved through a nasal spray form of Naloxone or by injecting it into muscle. Being able to recognize an Opioid overdose is important when it comes to using Naloxone. Signs of of Opioid overdose include:

• Unconsciousness 
• Small pupils 
• Shallow breathing 
• Vomiting 
• Inability to speak 
• Faint heartbeat 
• Pale skin 
• Purple fingernails or lips 

Once Naloxone has been administered, it will only reverse effects for 30 to 90 minutes. For this reason, it is essential that emergency services be contacted immediately along with the use of Naloxone. 

Las Vegas’s Harm Reduction Vending Machines

Nevada was the first state to install vending machines similar to the ones included in New York’s plan. The state, which began using these vending machines in 2017, saw significant success within the first year, especially in the Las Vegas area. From 2017 to 2018, approximately 23,540 clean syringes were distributed. 1/4th of the transactions were for HIV and Hepatitis C tests and 5% of clients asked for referrals for treatment programs. Additionally, nearly half of those who used the vending machines requested Naloxone.

The 3 vending machines placed in southern Nevada have been deemed a success. Their harm reduction services have been able to keep people safe by providing supplies to otherwise hard to reach groups of people. These populations can receive the supplies they need in a discreet manner which has helped to lower the stigma that is associated with getting help for a SUD. 

Biden’s Push Towards Harm Reduction

The Biden Administration is the first to openly support harm reduction policies. While not everyone is in support of this approach, the need for reducing the harms caused by drug use is more important than ever. In 2021, the US reported its highest number of overdose deaths in a 12 month period at over 100,000. 

On December 8th, 2021, the Biden Administration announced that they will be making efforts to work towards implementing more harm reduction programs. To do so, they will be supplying over $30 million in grants. These grants will be used for harm reduction services such as syringe exchanges and Naloxone. 

Critics of harm reduction believe that these programs do not address the most critical issues of addiction. Additionally, it is often thought that needle exchange programs will create more litter in the area. Studies have found that this claim is not true. 

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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.

The ruling of a 2019 Opioid case against Johnson & Johnson was overturned by the Oklahoma Supreme Court on Tuesday. The original case was the first of its kind to go to trial and found that the pharmaceutical company played a major role in the state’s Opioid overdose deaths. In a 5 to 1 outcome, the Supreme Court determined that the original $465 million verdict incorrectly applied the state’s public nuisance law. 

Just last week, a California state judge determined that J&J and 3 other drug companies are not responsible for the state’s Opioid crisis. Like the Oklahoma ruling, the California case did not believe a public nuisance was provable in this situation. Currently, there are about 3,000 lawsuits with similar public nuisance claims against drug manufacturers, distributors, and pharmacies. 

What Are Opioids?

Opioids are a class of drugs that are derived from the poppy plant. These substances can relieve feelings of pain by affecting receptors in the brain and body. While Opioids like Heroin and Fentanyl are illicit in the US, some Opioids, such as Oxycodone and Hydrocodone, can be obtained legally through prescriptions. These substances, even when prescribed by a medical professional, have a high potential for misuse and addiction which can lead to fatal outcomes. Individuals who become addicted to Opioids after using a prescription may turn to more dangerous but easier to obtain substances, like Heroin, as an alternative. 

Since 1999, there have been over 760,000 Opioid related deaths in the US. In 2019 alone, 70,630 people in the US died as a result of an Opioid overdose. Oklahoma specifically experienced the loss of more than 4,600 citizens to Opioid overdose deaths from 2007 to 2017. Nationwide and locally, fatalities due to Opioids are considered to be a major public health, social, and economic crisis. 

Johnson & Johnson’s Involvement In The Opioid Crisis

The Opioid crisis, also known as the Opioid epidemic, began in 1995 when the US Food and Drug Administration (FDA) approved a pain medication developed by Purdue Pharma. This substance, called OxyContin, was marketed as being effective in controlling  pain while having a low potential for abuse due to its controlled release formula. Pharmaceutical companies began pushing sales of OxyContin to distributors which led to an increase in Opioid prescriptions in the US. Rapidly, the substance started to be misused by people all over the country. By 2003, 2.8 million people were using OxyContin for non-medical use. 

In the 2019 Oklahoma Johnson & Johnson case, the state provided evidence of the company’s contributions to the Opioid epidemic. This evidence argued that the drug manufacturer targeted high prescribing doctors, women, and veterans and misrepresented OxyContin as being safe to use for every day pain. Additionally, it was presented that J&J created a mutant strain of poppy which allowed them to manufacture Opioids, as well as supply about 60% of the active ingredients for Opioids made in the US. Because Johnson & Johnson was supplying ingredients to other companies, the state claimed that for 15 years the company campaigned the sale of Opioids, even those manufactured by other companies. 

Based on this evidence, Oklahoma declared that Johnson & Johnson’s actions fall under the state’s public nuisance law which was instituted in 1910. A public nuisance is defined as conduct that interferes with the rights of the public. Oklahoma’s law specifically says, “A public nuisance is one which affects an entire community or neighborhood, or any considerable number of persons, although the extent of the annoyance or damage inflicted upon the individuals may be unequal.” 

Oklahoma Supreme Court’s Decision

The Supreme Court’s reversal, as stated in the opinion written by Justice R. Winchester, determined that the 2019 ruling took the public nuisance law too far by extending it to manufacturing, marketing, and prescription Opioid sales. Winchester went on to say that Johnson & Johnson, and companies in general, cannot be liable for how their products are used by patients after they have been sold. They found this to be especially true as there are multiple levels of distribution. Manufacturers sell to distributors and wholesalers who then supply to pharmacies, hospitals, and doctors. It is at this point that Johnson & Johnson’s products are prescribed to patients. 

The lawful use of Opioids for treating pain, such as cancer related pain, was also cited as being a reason the public nuisance verdict was overturned. Additionally, Johnson & Johnson stopped marketing Opioids in 2015 and completely stopped selling them after a 2021 New York lawsuit. This case resulted in a $230 million settlement and the agreement to end nationwide sale of Opioids. Despite this settlement, the company does not admit liability or wrongdoing. 

Although the 2019 case was overturned, the Supreme court does not want to minimize the suffering that Opioids have caused many Oklahoma citizens. Johnson & Johnson also acknowledges the tragedy caused by the misuse of Opioids in the past 2+ decades but agrees with the court’s decision. The company has said that they support the overturning of what they called a misguided and unprecedented attempt to expand public nuisance laws. 

“We recognize the Opioid crisis is a tremendously complex public health issue, and we have deep sympathy for everyone affected. The company’s actions relating to the marketing and promotion of these important pain medications were appropriate and responsible,” Johnson & Johnson said in response to the ruling and on their involvement with Opioid epidemic. 

Because public nuisance laws are different depending on the state, it is not known whether this overturned case and the California ruling will inform the many similar cases against drug manufacturers. Earlier this year, Johnson & Johnson, along with 2 other companies, agreed to pay a $26 billion settlement. Currently, 42 states, 4 territories, and Washington D.C. have signed to this agreement. It is possible that the overturning of the 2019 Oklahoma verdict could convince states that are on the fence into signing on to this settlement. 

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