Heroin use began to surge about a decade ago, creeping into just about every nook and cranny of society. Then around 2014 there was a sudden surge in overdose deaths, initially attributed to heroin. Eventually, it became known that this spike in overdoses was due to the effects of fentanyl-laced heroin. Fentanyl is a synthetic opioid that is 50-100 times more potent than morphine, and which is usually used by physicians to help manage pain in terminal cancer patients. Fentanyl and its analogs, or clones, are being manufactured illicitly in China and Mexico, then widely distributed on the streets of our country in the form of as fentanyl-laced heroin.
In 2016 alone, more than 19,000 opioid-related deaths were attributed primarily to fentanyl, according to statistics provided by the National Institute on Drug Abuse, showing a six-fold increase since 2010. The Centers for Disease Control (CDC) reported that overdose deaths caused by fentanyl doubled in a six-month period between the end of 2016 and the summer of 2017. According to the CDC, “The number of deaths involving heroin in combination with synthetic narcotics has been increasing steadily since 2014 and shows that the increase in deaths involving heroin is driven by the use of fentanyl.”
The CDC had issued a health advisory in 2015 regarding the dangers of fentanyl, but this was upgraded to an alert in early 2018 as deaths continued to mount. The alert included information that the powerful drug was showing up in heroin, methamphetamine, ketamine, benzodiazepines, cocaine, and counterfeit opioid pills on the street, and encouraged wide availability of the opioid antidote, naloxone, to help reverse the effects of the drug in individuals still alive. While a heroin overdose can be overturned with 1 mg of naloxone, for the individual who has overdosed on fentanyl laced heroin, a dosage of 8-10 mg of naloxone is needed, although most individuals will not survive.
Why is Fentanyl So Deadly?
Fentanyl is a powerful narcotic analgesic manufactured under such brand names as Duragesic, Abstral, Fentora, Actiq, and Subsys, and is used by physicians to control pain in patients with serious or terminal illness. The fentanyl compound is easy to be replicated and reproduced in a lab, being widely distributed as street drugs or through online websites.
The drug is so potent that it is measured in micrograms, not milligrams. Law enforcement and first responders fear having any contact with the substance, as just a few granules can produce fatal respiratory effects. Many of the overdose deaths occurring in recent years occurred in individuals who were unaware that they were ingesting fentanyl.
Fentanyl is a synthetic opioid that was first introduced in the 1960s for use as an anesthesia during surgeries. Later, fentanyl was approved for its analgesic properties for use as a prescription pain medication. Although fentanyl is in the news in recent years, it is not new. News reports from 1991 were informing the public of a spate of fentanyl laced heroin overdose deaths in Pennsylvania. Later, in 2005-2006, this deadly mixture was at the center of another outbreak of overdose deaths in various regions.
Deaths occur because the fentanyl, an opioid agonist, impacts the opioid receptors in the brain associated with controlling the respiratory system. A high dose of fentanyl can reduce the breathing rate dramatically, possibly causing breathing to stop altogether, leading to death.
The Danger of Heroin and Fentanyl Together
In many cases, it is the opioid epidemic of this past decade that has led to a significant increase in heroin addiction. This happens when the opioids become increasingly difficult to obtain, or if the cost of the prescription opioids becomes prohibitive. To avoid withdrawals, some will switch to heroin as a cheap, easily procured substitute for the opioid.
Since most heroin addicts obtain the drug from dealers on the street, they may be unaware that the heroin they purchased is cut with fentanyl—or may even be pure fentanyl. In most cases it is impossible to detect the presence of fentanyl, especially when it is cut into counterfeit opioids or cocaine, as these are also white substances. However, because heroin has a yellowish tint, if a large amount of fentanyl has been cut into the heroin it might be detected. Understanding the dangers of heroin and fentanyl can help raise awareness through the education of our youth from as early as adolescence.
Symptoms of Fentanyl Overdose
Because fentanyl impacts the central nervous system like any other opiate, the respiratory system is significantly affected. The drug is so potent that a tiny amount carries the risk of a drug overdose. The effects of fentanyl-laced heroin can lead to an overdose, which is a serious medical emergency that allows very little time for successful intervention. Signs of fentanyl overdose include:
- Extreme grogginess, sleepiness, or fatigue
- Difficulty breathing, slowed respiratory function
- Contracted pupils
- Inability to walk, loss of coordination
- Cognitive impairment
A fentanyl-related overdose is a medical emergency. Death can occur rapidly, so if these symptoms are present it is necessary to obtain immediate medical help. Most first responders now carry naloxone to help reverse the effects of opiate overdoses.
Getting Help For Heroin Addiction
Individuals who are addicted to heroin or opioids must seek professional help to be able to get off these highly addictive drugs so they can avoid the accidental effects of fentanyl-laced heroin. Overcoming an opiate addiction requires specialized treatment. Without a formal addiction treatment program, the individual will not succeed long-term.
Opioid addiction recovery is possible but it is dependent on the individual completing a treatment program that uses evidence-based, or proven, treatment methods, medication-assisted treatment (MAT), as well as complementary therapies and aftercare services.
Those who decide to get treatment for a heroin addiction will progress through four steps in recovery:
- Intake. When the individual approaches treatment they will first be involved in an assessment and intake process. After the clinician has considered all the information, including the length of history of heroin abuse, the daily dosing, the general health status of the individual, and whether there is a coexisting mental wellness disorder present, they will design an individualized treatment plan. This tailored approach is important, as each person will have unique recovery needs.
- Detox and Withdrawal. Detoxification is the first necessary step in getting free of a heroin or opioid addiction. Without clearing the body of the drug and stabilizing, the individual would be unable to fully participate in treatment with a clear mind. The detox and withdrawal process is difficult and highly unpleasant, and not to be undertaken on one’s own. People who attempt to go it alone are not able to endure the withdrawals and will swiftly relapse back to drug use.
A medically monitored detox will provide continuous oversight while providing medical interventions that help ease the withdrawal symptoms. Psychological support is also provided, helping the client emotionally throughout the detoxification process. Medications, such as buprenorphine, methadone, or naltrexone, can be initiated once the drug has been eliminated from the system, and can help reduce the intensity of withdrawal symptoms and also reduce cravings. This medication-assisted treatment (MAT) can help the individual become stable in recovery by reducing the risk of relapse. MAT requires the individual to continue engaging in outpatient therapy following rehab, and the medications are strictly monitored to help prevent abuse.
- Active Treatment. Active treatment begins immediately following detox and involves a variety of treatment elements. Rehabs programs include individual psychotherapy, group therapy, recovery group meetings, family therapy, addiction education, relapse prevention planning, and medication management. Together these interventions can help the individual change habitual addiction-associated patterns and behaviors, while also addressing underlying factors that may be contributing to the drug abuse. In addition, the individual is coached to establish healthy lifestyle habits, such as diet and exercise, and taught relaxation techniques to help manage stress.
- Aftercare Therapy. Once the treatment program has been completed, it is essential to continue to participate regular outpatient counseling, both individual therapy and support groups. Attending a weekly or twice weekly therapy session can help clients over the rough spots during the first year of recovery when they are the most vulnerable to relapse. Sober living is another good aftercare option, providing a living environment that is drug and alcohol-free and where the client can learn healthy new daily routines and habits, and practice recovery skills before heading back to their regular life. Additionally, engaging in a 12-step or similar recovery group can provide an additional layer of peer support and accountability.
Although overcoming heroin dependence requires time, patience, and perseverance, it is something that can be done. A heroin addiction cannot be wished away, it must be muscled away through sheer will and a steely commitment to embrace a clean and sober lifestyle.
Ken Seeley Communities Provides Treatment for Heroin Addiction
Ken Seeley Communities is an integrated addiction recovery program in beautiful Palm Springs, California. Through an immersive approach to recovery, the expert team at Ken Seeley Communities will guide individuals through each step of the process—intake, medical detox, treatment, and aftercare. Ken Seeley is a renowned interventionist who provides these professional services for families to help persuade someone to enter treatment. In addition to the evidence-based treatment approach, the emphasis on nutrition and fitness helps reinforce recovery efforts. Embrace sobriety with the support of this comprehensive and highly effective program. For more information about the program, or about the effects of fentanyl-laced heroin, please contact Ken Seeley Communities today at (877) 744-0502.