On April 21, 2016, Prince Rogers Nelson joined the all-too-long list of famous names who’ve fallen victim to pharmaceutical abuse.
You may know the drug responsible for Prince’s untimely demise was the painkiller fentanyl. What might surprise you is that fentanyl, an opioid, is exponentially more powerful than heroin, and at the heart of a recent substance abuse epidemic in the United States and Canada.
If you were around for the heroin epidemic of the 1970s, you saw how powerful the grip of opioid addiction can be. More recently, OxyContin and oxycodone have ushered in a new era of opioid abuse, claiming nearly 20,000 lives in 2014 alone. But drug makers have tweaked the chemical formula, and now the pills are losing favor with users.
Fentanyl, however, is available full-fat—and a dose the size of three grains of sugar can kill you.
Originally synthesized in 60’s by Janssen Pharmaceuticals, the powerful opioid was first used as an operating room anesthetic. These days, it can be prescribed to cancer patients in the form of a pill, patch or lollipop.
But while these prescription variants occasionally fall into the wrong hands, it’s Mexican drug cartels that have made fentanyl a killer. How, you ask? fentanyl laced heroin. According to those in the business, “almost no one” even bothers to sell pure heroin anymore. If you’re a heroin user not expecting the altered product, your life is in danger.
The fentanyl-heroin mixture has earned the nickname “El Diablito” or “The little devil” because of its frightening killing power. It has become the choice product of El Chapo’s Sinaloa cartel, who began pushing it after Purdue Pharma made OxyContin harder to tamper with in 2010. Around the same time, fentanyl pills made to resemble OxyContin hit the streets.
The cartels get raw ingredients for fentanyl from China, cook up El Diablito, and then smuggle it across the border into the United States. The result has been a dramatic increase in overdose deaths in places like New Hampshire, California, and even Alberta, Canada.
North America’s New Nightmare
In 2015, New Hampshire attributed nearly 300 casualties, two thirds of all overdose deaths, to fentanyl overdose. In British Columbia, the drug is associated with one of every three opioid-related deaths.
Part of the drug’s fatal effect involves the inability of abusers to determine how strong it is. If you’re a heroin user seeking a fix, you’re as likely to purchase nearly pure fentanyl as you are mildly cut heroin, and without proper instruction the two look nearly identical. The drug takes effect so quickly that many users are found with needles still protruding from their arm.
Just a week before his death, Prince was treated with the drug Naloxone, which is used to reverse the effects of opioid overdose. In communities like Sacramento, California, which has seen bouts of over a dozen overdose victims in 48 hours, doctors report that recent victims require larger doses of Naloxone to save, because the street dope they’re getting contains higher levels of fentanyl.
A Problem of Awareness
But keeping people safe from such a deadly drug can’t start in the emergency room. In an uncommon change of roles, the US government has made Naloxone available for opioid users for some time now, but Canada has only recently changed its policy to allow the purchase of at-home kits that can save lives in the case of an overdose.
The fentanyl epidemic will continue as long as the drug is available on the streets. The search for “El Chapo”, leader of the Sinaloa cartel widely associated with El Diablito, has already made him one of the world’s most wanted men, but his is not the only operation putting lives in danger. Even if El Chapo’s cartel were shut down, Mexico would continue to export the deadly coctail.
During their 2016 presidential campaigns, both Jeb Bush and Hillary Clinton visited New Hampshire. Both Clinton and Bush reported being caught by surprise at the number and intensity of questions about what was being done to quell the state’s increasing drug problems.
Many feel the only way to stem the outbreak of deaths is better security at the border, but it should be noted that before drug cartels ever sold fentanyl for a profit, drug companies invented it. Do we really need a drug 50 times more potent than heroin?
You have to wonder if pharmaceutical companies give any discretion to the potential for misuse when they invent these powerful drugs, because they sure don’t show any signs of stopping.
Corinne Keating is a health and wellness blogger. She can usually be found doing research at a local coffee shop or hiking the nearest trail. Find her on her blog, Why So Well, or on Twitter @corikeating.