The opioid epidemic has spread across the United States, and it’s only gotten worse in recent years. In the past few years, opioid overdose deaths have spiked, partly due to an increase in fentanyl, a potent synthetic opioid.
The epidemic has affected California, along with the rest of the country. However, California has seen lower overdose deaths because of fentanyl that other states with smaller populations. There are many reasons why this might be the case, but one factor might be access to fentanyl testing kits.
Learn more about fentanyl, fentanyl testing, and how it could save more lives.
What is Fentanyl?
Fentanyl is a potent synthetic opioid that’s used in medical settings and on the street as a recreational drug. As a medication, fentanyl is useful in situations where quick pain relief is needed. Fentanyl is often used in epidurals. Because labor can be unpredictable, a fast-acting opioid can prevent going through intense labor pains while patients wait for the drug to kick in.
Fentanyl also comes in a transmucosal lozenge called fentanyl citrate. It is sold under the brand name Actiq. This form of the drug is taken via a lollipop, and it’s primarily used in military settings. In controlled settings, fentanyl can be a helpful medication, but on the street it’s deadly. Even more deadly than heroin and other prescription opioids.
Fentanyl is so powerful that it can be active in doses much smaller than a single milligram. That makes it difficult for untrained, clandestine pharmacists to measure out the proper doses. In fact, the drug can be active with as little as 5 micrograms. A single grain of sand is twice as heavy. It doesn’t take much for fentanyl to become deadly.
It takes about 30 milligrams of heroin to be fatal to the average person, and it only takes 3 milligrams of fentanyl to cause a fatal overdose in the average adult. According to the U.S. Centers for Disease Control and Prevention, the drug can be as much as 100 times more powerful than morphine.
This powerful opioid is used to increase the perceived value of other drugs like heroin and even cocaine. Heroin is often adulterated as it makes its way from the places its made to the average user. Adding inert substances can stretch profits, but it creates a weaker supply. Fentanyl is cheap to make and easy to transport. Because it’s so potent, profitable amounts can be shipped in small packages, like smartphone boxes.
Like heroin and other opioids, fentanyl is addictive. It can quickly lead to a severe substance use disorder if it doesn’t cause a fatal overdose first. Fentanyl works in the brain by mimicking your own naturally occurring opiates called endorphins. Endorphins are designed to regulate the pain response in your nervous system by binding to opioid receptors and blocking pain signals at the site of pain, in the spine, and in the brain.
Fentanyl does this to a much greater degree. It can stop the pain and slow down your nervous system in a way that produces a euphoric high. However, it can also slow down your nervous system to the point of slowing your breathing and your heart rate. In most cases of deadly opioid overdose, slowed or stopped breathing leads to oxygen deprivation, brain damage, and death.
Why do People Use Fentanyl?
Opioid addictions are notoriously difficult to overcome, and they often progress until you get the help you need. Even then it’s a tough road, though addiction is a treatable disease. People who start out abusing prescription opioids like Percocet often progress to illicit options like heroin.
According to the National Institute on Drug Abuse, abusing prescription opioids is a major risk factor for heroin use. Nearly 80 percent of people who use heroin report starting with prescription opioid abuse.
Heroin use can lead to the intentional or unintentional use of illicit fentanyl. Some users who have been struggling with heroin addiction for a long time may have a high tolerance to opioids. Because fentanyl is potent and cheap, some may seek it out intentionally to get more for their money. However, many people use fentanyl before they realize what they’re taking. Fentanyl is mixed into heroin to make it seem purer or to give it a powerful boost.
But this can be deadly. A person may get used to heroin at its typical purity, and they may adjust their dose to compensate for weaker heroin. If they encounter heroin that’s been mixed with fentanyl and take their normal dose, they may be taking an extremely potent dose of heroin. In many cases, fentanyl overdoses are cases where the user didn’t even know they were taking fentanyl.
The Opioid Crisis in California
The opioid crisis has spread across the United States and has affected most areas to some degree. According to the California Department of Public Health, there were 2,311 opioid overdose deaths in the state in 2018. Around 743 of those were related to fentanyl.
These are significant numbers, but they are relatively low, considering California’s population and the degree that the opioid crisis has affected the East Coast.
There are multiple reasons why fentanyl hasn’t impacted California at the same level that it’s affected places like Ohio, New Jersey, and Massachusetts.
One is that higher volumes of fentanyl are arriving by ship in eastern ports and spreading west.
However, it could also be related to how certain California cities respond to fentanyl outbreaks.
For instance, The Washington Post reported that San Francisco responded to a 2015 spike in fentanyl by emphasizing harm reduction strategies like the distribution of naloxone, the drug that can reverse an opioid overdose.
They also provided drug testing strips as a part of their outreach programs.
Fentanyl Test Strips
Fentanyl test strips are thin strips of paper that are coated in chemicals that react in a certain way when exposed to fentanyl. The strips can be used in any setting a person might using heroin or fentanyl. Test strips are placed inside liquid containing the drug. Depending on the specific test kit, a marking, typically a red line, will appear based on the content. Two red lines appear when the test is negative, and one red line appears when the drug contains fentanyl.
Access to these test strips may increase awareness about what is actually in the heroin supply in a given area. For people who want to avoid fentanyl, the tests can let them know when their drugs may contain the deadly substance. For people seeking fentanyl, it can cause them to be more careful about the dose they are taking.
Test strips are a form of harm reduction. They don’t solve the problem of addiction, but they might help addicted people avoid life-threatening consequences. Still, effectively addressing addiction means getting the help you need to treat the disease.