The Different Types of Fentanyl Terrorizing Georgia

People are finally shining a light on the severity of the drug problem in Georgia. To shed some insight on the subject: in 2014, drug overdoses took more lives in the state than car accidents. Worst yet, the primary type of addiction found in Georgia opioids—which are synthetically produced drugs based off alkaloids that come from the poppy seed. There’s a whole arsenal of arguments to be made as to why the opioid problem spiraled rapidly out of hand (everything from over-prescription, bootleg replication, etc.) but the finality of the matter is that it has.

Problem is, many opioid addicts turn to heroin if they can’t get their fix, or if their fix has become too difficult or expensive for them to acquire. Reason being? Heroin is an opiate, and the euphoria and pain relief it induces is quite similar to the same ‘release’ users obtain from opioids. Now let’s paint a picture. There’s a group of addicts searching the streets for opioids, and they’re doing it because either their doctor caught onto their addiction, or the actual medication is now too expensive. Enter the new and cool drug dealer that’s selling knockoff Percocet, which originates from an opioid called Oxycodone. He raves about his pills and says they’re even stronger than the FDA approved regulated version.

Credit: CNN

Addicts flock to this new drug dealer because not only is he selling the opioids they covet, but he’s also giving them a price that won’t burn a hole in their wallet. Satisfied, they buy their Percocet, which albeit having a few variations—appear quite similar to the real deal. They go home or walk about or find that place where they love to get high and take their just-bought opioids. These veteran addicts, or novice addicts, or simply recreational users have a semblance of how their tolerance interacts with Percocet. Perhaps they know how much to take because they were once prescribed it, or they Google what doctors generally prescribe as a healthy dose, and then they proceed to use the drug.

While addiction is the source of the problem, and the tragedy lies in these users taking to the streets for their fix, at least the slight positive (in fact there’s none) in the situation is that it’s actually quite difficult to overdose on Percocet in comparison to other opiates and opioids. But the picture I’m painting is not a happy one, and what these people don’t know is that their Percocet is in fact not Percocet.

Having been imported from a shabby and black market lab in China, smuggled through Mexico, across the border, and then across the US, Fentanyl made its way into the hands of this popular new drug dealer promising a better high. Why? Because it’s cheaper for him to import, easier for him to produce, and he can make more product out of a smaller volume of a substance. Thing is, Fentanyl is 50 times more powerful than Heroin, which is about three times as powerful as Percocet, making it 150x more powerful than what these users are used to taking.

Worst yet, this novice dealer isn’t dexterous in his pressing, and when he produces the pills the concentration of fentanyl is too high. All these users think they’re taking Percocet, and end up overdosing on a drug that is so powerful, often the counteractive substance Naloxone (used to reverse a heroin overdose) does nothing against it. Many of these users die simply from a lack of knowledge, rather than a binge or overuse of the substance at hand (to say the substance they think it is).

I wish I could tell you this story is simply hypothetical, and that it would happen if Fentanyl took to the streets, but it’s a reality. Just a couple months ago, there were a series of overdoses that occurred in southwest Georgia which hospitalized dozens and killed four. Dr. Christopher Hendry, CMO of Navicent Health, reported that ‘we’ve never seen this many overdoses in such a short time.’

Every overdose seemed to stem from the same ‘yellow pills’ that the users bought thinking they were normal 2.5-10mg Percocet. They were tragically wrong. This happens to be only one case where the use of ‘ghost Fentanyl’ sent multiple users into an overdose. The drug has now disrupted street markets across the US and Canada, and the repercussions are startling, while the future (if it grows in presence) is downright terrifying.

What is Fentanyl and how is it affecting Georgia?

Fentanyl is a schedule II opioid that has been around for close to a decade. It’s a drug that’s about 100 times more powerful than morphine, and it was developed for late-stage cancer patients as a pain reliever. Fentanyl is often the drug doctors prescribe as an ‘end-all.’ It’s meant to keep patients a bit more comfortable in their last days, in so to curb their misery.

The drug is also prescribed to patients that have opiate resistance, meaning the normal painkillers don’t work. Just as well—for extremely invasive surgeries, it can be prescribed for the patient to take directly after, to mitigate the severity of the first wave of pain that ensues in the healing process. It can be taken orally, used as a nasal or oral spray, or a transdermal patch. The latter is what’s most terrifying, as this drug can be absorbed via skin-to-skin contact, and it takes about the size of three grains of salt to kill you. If that sounds a bit much, know that in May of 2017 two first responders in Hartford County, Maryland, responded to a heroin overdose and one ended up overdosing himself by accidentally touching loose grains of fentanyl.

This very feat is exactly what makes the problem in Georgia so dangerous; the sheer power of Fentanyl as a substance. Worst yet, as stated before, it’s being mixed into counterfeit opioids without the user’s knowledge. But save for opioids it’s being used a booster for the effects of heroin (meaning it’s mixed in—which creates a much more powerful product and a higher likelihood of overdose), into certain other street drugs, and now in some places, we’re even seeing it in cocaine. The idea of Fentanyl being used to cut cocaine is an entirely different conversation in itself, given the popular nature of the drug, and a number of recreational users that do it globally.

But the problem with Georgia is that their primary addiction is to opioids. And opioids are most often taken orally, meaning they ‘fully dose’ themselves in one sitting. Whereas cocaine, there’s a possibility the user could use a fraction of their entire amount, and realize there’s something off about the substance. It’s rare that an opioid addict will bite, or test a piece of their pill to dictate whether or not it’s the real deal.

Credit: VICE

This is noted in the rising statistic of fentanyl related deaths in Georgia. In 2011, deaths from overdose related to—or solely from—fentanyl were in the 75~ range, with a few cases that were difficult to determine the cause. In 2012, a tad less than that number. In 2013, even less.

But what’s remarkable is the jump from 2013-2014, which is believed to be the year in which China began mass –producing a replication of fentanyl, and exporting it. In 2014 there were 175~ deaths in Georgia related to fentanyl overdose. And in 2015 there were even more, with the number nearing 200. While the statistics for 2016 have yet to be verified, when put into consideration that of the 900 opioid overdoses in 2015—in Georgia—over 20% of them had to do with fentanyl (a number that doubled in the space of year), the problem shows its true colors.

What’re the rumors of the new lethal forms of fentanyl found in Georgia?

It shouldn’t be a shocker that the state which happens to be leading the opioid addiction is also the stomping grounds for new forms of fentanyl. While fentanyl, when synthetically created in FDA regulated labs and sold by pharmaceutical companies, is extremely potent and stronger than any other opiate or opioid on the market, there are actually bootleg forms of the drug that are stronger.

They’re going by a series of different names like ‘White Snow,’ ‘China Girl’ (this comes from where it’s originating), ‘Apache,’ ‘Dance Fever,’ and ‘Murder-8,’ with that last name being indicative of the drug’s true nature. What’s happening is these untrained and irresponsible dealers are selling fentanyl or cutting it into other drugs without a thorough understanding of potency.

Georgia is seeing a rise of the drug in varying proportions. In some cases, it’s a dismal amount sprinkled into a batch of heroin that—while enhancing the drug—won’t necessarily be the cause of an overdose. But in others—like that of the Percocet—the drugs being sold are nearly 100% composed of fentanyl, which makes them less like drugs and a whole lot more similar to poison. Two of these fentanyl related substances are called acrylfentanyl and tetrahydrofuran fentanyl, and both are resistant to naloxone, the drug used to counteract heroin and opioid overdose.

There are people rallying to address the issue, and a popular belief is that these dealers should be arrested and held accountable to the degree of murder, due to the nature of what they’re introducing to the streets.

What are the consequences?

Quite obviously, people are dying. When addiction comes into question, death is always the worst evil in play. And now that it’s about ten times easier to overdose when using fentanyl—we’re seeing a lot more deaths related to it. There are about 120 deaths from overdose per day in North America. The fear is that number will rise dramatically—seeing as opioids are either the addiction or one of the gateways for heroin—if fentanyl becomes more popular than it already is. And as research shows and sources say, due to its ‘punch,’ how little volume it takes to feel it, and its inexpensiveness, dealers are going to keep importing it and integrating it into preexisting drugs.

But aside from the death toll, in 2013 the problem was estimated to have already caused the state $78 million dollars. This is money set aside specifically for healthcare that is intended to be spread across the entire spectrum of the field, and since 2007 the price of opioid use (for the state) has increased by 80%. Yeah. The problem is certainly worsening.

However, Congress has passed several key pieces of legislation that are aimed specifically at substance use disorders. One of them was called CARA, which used a six-pillar system to try and solve the opioid and heroin problem. It’s a rather recent program, having launched a year ago, but its aim is to expand everything from education and prevention efforts, the abundance of naloxone, resources to treat addiction, disposal sites for obsolete prescription medication to keep them away from dealers and users, and then to launch multiple different programs all related to opioid and heroin addiction (everything from treatment centers to research platforms).

While there haven’t been any huge successes the platform is still relatively new and needs time to develop. There are other organizations like The Georgia Prevention Project that are making strides towards tackling the opioid and heroin problem in Georgia. While the overall war on opioid addiction is certainly the bigger problem, the battle against fentanyl, if lost, could scale the war to a size we don’t want to imagine.

The fact that there are several new types of fentanyl on the streets that are being cut into varying drugs, differ in potency and killing people at double the rate than they were only a couple years ago is extremely alarming. When taking into consideration the type of personality that usually constitutes a drug dealer, morality is usually out of the question, and in this case, in particular, we can bet that they’ll continue to distribute the substance in search of better profits. However it’s up to us as the people to ensure that at the very least, our peers are educated on the matter and that dialogues are occurring, as this lethal drug that’s quite literally murdering people in Georgia is not isolated to that state, but in fact nationwide. Worst yet, you say fentanyl to someone and 9/10 times they don’t know what you’re talking about. It’s time that changes.

Sources:

Pirani, Fiza. “What is Fentanyl? 10 Things to Know About the Potentially Deadly Drug” AJC. 28 Jan. 2019. 11 Mar. 2019. https://www.ajc.com/news/health-med-fit-science/what-fentanyl-things-know-about-the-potentially-deadly-drug/qOcUSQkagnlhaUnwHchJ4I/

“New Lethal Forms of Fentanyl Confirmed in Georgia.” USA Today. 28 June 2017. 11 Mar. 2019. https://eu.usatoday.com/story/news/nation-now/2017/06/28/new-lethal-forms-fentanyl-confirmed-georgia/434854001/

“Opioid Use in GA.” District 4 Public Health. 11 Mar. 2019. https://www.district4health.org/opioid-use-in-ga/