Fentanyl and Opioid Addiction – Understanding the Epidemic

Overview of the Current Opioid Epidemic

The number of drug related deaths has increased by almost 30% from 2019 to 2020 and has quintupled since 1999.  Nearly 75% of the 91,799 drug overdose deaths in 2020 were opioid related.

From 2019 to 2020:

• Opioid related deaths increased by 38%
• Prescription opioid related deaths increased by 17%
• Heroin related deaths decreased by 7%
• Synthetic opioid related deaths increased by 56% (not including methadone)

From 1999 to 2020, more than 564,000 people died from an opioid related overdose. This includes both prescription and illicit forms of the drugs. 

This rise in opioid overdose deaths can be outlined in three distinct waves:

1. The first wave began in the 1990s with an increase in the prescribing of opioids. 
2. The second wave started in 2010 with massive increases in overdose deaths involving heroin.
3. The third wave began in 2013 with a spike in overdose deaths involving synthetic opioids, particularly illicitly manufactured fentanyl. 

Many opioid related deaths can be attributed to the use of other drugs in combination. 

What is Fentanyl? 

Fentanyl is an extremely powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent.

It is a prescription drug and is also made and used illegally. Like morphine, it is typically used to treat severe pain, especially after surgeries. It is also used for chronic pain when patients are tolerant to other opioids. 

In its prescription form, fentanyl is known by such names as Actiq, Duragesic and Sublimaze.

Fentanyl is being found in other drugs so people are using the drug unknowingly. For example, cocaine can be cut with fentanyl as it is cheaper. This is leading to an increase in the number of overdoses and deaths. 

History of Fentanyl

Fentanyl is one of the deadliest opioids in the world. Sadly, it’s popularity has been on the rise as the opioid epidemic continues to claim lives throughout the US. Oftentimes people are unaware that the substance they’re consuming is spiked with fentanyl.

Many people are curious about how fentanyl became so widespread since it’s such a deadly drug. 

Fentanyl was developed in 1959 by Janssen Pharmaceutica. Back then it was primarily used as an anesthetic and pain reliever for medical purposes.

During the 1960s, it started being used as an IV anesthetic called Sublimaze.

In mid-1990s the fentanyl patch was introduced for the treatment of chronic pain. Soon after, other forms like lollipops and lozenges became available. 

Where Does Fentanyl Come From?

Most illicit fentanyl in the United States is coming from China, either directly or via Mexico. 

China’s pharmaceutical industry has a lack of regulations making it easier for them to manufacture and distribute drugs and chemicals that are illegal in other countries.

They are exporting various fentanyl products, including raw powder and counterfeit prescription drugs that are laced with fentanyl.

At a glance:

• 8 pounds of fentanyl was seized by border agents in 2014
• In 2015 this number rose to 200 pounds
• In 2022 a staggering 10,000 pounds of fentanyl powder and over 50 million fentanyl pills were confiscated

In recent years China has shown interest in preventing illegal fentanyl manufacturing and distribution but despite these efforts, fentanyl continues to find its way into the US. 

How Does Fentanyl Affect the Brain?

Like other opioid drugs, fentanyl works by binding to the brain’s opioid receptors, which control pain and emotions. 

After prolonged use, tolerance develops so one must consume more of the substance to get high. It also makes it harder to feel pleasure from anything other than the drug. When people become addicted, drug seeking takes over their lives.

Fentanyl’s effects include:

• extreme happiness
• drowsiness
• nausea
• confusion
• constipation
• sedation
• problems breathing
• unconsciousness

Causes of Opioid Addiction

Opioids are highly addictive due to the fact that they activate the powerful reward centers in the brain. They trigger the release of endorphins, which are the brain’s feel-good neurotransmitters.

These endorphins alleviate pain and increase feelings of pleasure, creating a powerful (but temporary) sense of wellbeing. When the dose wears off there is a strong urge to use again, hence how addiction begins.

• Anyone who takes opioids, whether prescribed or illegal, is at risk of developing an addiction
• One’s genetic makeup can contribute to the risk of becoming and addict (one’s family history)
• The amount used and length of time someone uses the drug will have an impact on addiction

When you take opioids over time, your body’s natural production of endorphins is slowed down. The same dose will no longer produce the same good feelings. This is called tolerance and leads to an increase in the amount one consumes. 

Because doctors are aware of the risks of addiction, it can be quite difficult to get your doctor to increase your dose or renew your prescription. At this point many people resort to seeking the drug illegally and their lives are changed drastically. 

Risk Factors

Opioids become more addictive when they are consumed using methods different from what was prescribed, such as crushing a pill to powder form so it can be snorted or injected.

This increases the risk of overdose as the pill may be extended release and can lead to taking too much at once.

Taking more than your prescribed dose increases one’s risk of addiction.

Risk factors of opioid misuse and addiction:

• poverty
• unemployment
• personal history of substance abuse
• family history of substance abuse
• age
• gender
• history of criminal activity 
• contact with high-risk people or environments
• mental health issues
• risk-taking or thrill-seeking behavior

Women have a unique set of risk factors for addiction. Interestingly, women have higher rates of chronic pain than men. Women are more likely to be prescribed opioids, to be given a higher dose and to use the drugs for longer periods of time.

It has been suggested that women have biological tendencies to become more dependent on prescription opioids than their male counterparts. 

Get Help for Fentanyl and Opioid Use Disorder

If you’re taking opioids and you’ve developed tolerance, you should seek professional help right away. There are various treatment options which Luxe Recovery would be happy to discuss with you. Please reach out today.