Exclusive: Dangers, Prevalence Of Unintentional Fentanyl Poisoning By Way Of Other Drugs (Xanax, MDMA) – National Fentanyl Prevention and Awareness Day By Facing Fentanyl

Times Square Takeover for National Fentanyl Prevention and Awareness Day

Editor’s note: Readers may remember our story from last weekend on the Opioid Funding Staten Island is now slated to receive. 

The following questions were posed to the Facing Fentanyl Organization, and answers were provided by the doctor credited below the last answers.  

Is fentanyl poisoning generally from laced heroin or other drugs?

Illicit fentanyl poisoning is almost universally other drugs these days. We are seeing heroin infrequently these days but see illicit fentanyl in almost all other illicit drugs. One of the biggest of these are counterfeit pills that are manufactured to look identical to the pharmaceutical originals. These counterfeit pills are not just look-alike opioids like Percocet or oxycontin, but also other types of drugs like Xanax (benzodiazepine), Ecstasy (MDMA), or Adderall (Stimulant). This is one of the reasons we call these poisonings; because these people are not looking to use an opioid, but rather other drugs, yet they are unknowingly ingesting illicit fentanyl and often dying as a result. Illicit fentanyl is also frequently cut into powdered drugs like cocaine and methamphetamine making their use extremely dangerous as well.

Can a person tell if a drug has been laced with fentanyl?

No. You can’t see it, smell it, or taste it. The use of fentanyl test strips, when used properly can help, but also is not a foolproof method of detecting illicit fentanyl. This is because tiny amounts of potent illicit fentanyl can be hard to detect with just a small sampling of the illicit drug being tested with fentanyl test strips. That said, it’s better than not testing if you intend on using illicit drugs.

What are the solutions proposed by your organization to the fentanyl issue?

1) Raising national awareness about illicit fentanyl contaminating the entire illicit drug supply. This message should be everywhere; on TV, on billboards, on the radio. We are doing a pathetic job of getting this message out fast enough or widely enough.

2) Everyone should carry naloxone and have it in their homes. It should also be readily available in schools and public places. It should be in bars, clubs, concert venues, and all places people go to party. Over 40% of opioid overdoses happen with a bystander present and something like 80% happen in someone’s home.

3) There also needs to be much more awareness around what the evidence-based treatment options are for people with opioid use disorder (OUD). We have extremely effective medications for OUD like buprenorphine and more recently extended-release buprenorphine. These medications dramatically reduce cravings for opioids, lower relapse rates, and, most importantly, reduce death from overdose and poisoning. Yet less than 20% of people with OUD are on any of the 3 FDA-approved forms of medications to treat moderate and severe OUD, which is widely regarded as a life-threatening disease.

What makes fentanyl deadly, and are there statistics related to this?

Illicit fentanyl is so deadly due to its potency and speed of onset. It is, on average, 100x more potent than morphine and 50x more potent than heroin. It’s highly lipophilic (fat-loving) and passes from the bloodstream into the brain very quickly. Once in the brain, it binds to opioid mu receptors resulting in profound sedation and respiratory depression or apnea. This is how people die–they stop breathing and within minutes are dying of oxygen deprivation to the brain, heart, and other vital organs. A fentanyl overdose happens within minutes and it’s also more difficult to reverse with standard doses of naloxone, like Narcan, because it’s so potent. Doses of naloxone that would predictably antagonize and displace heroin from the opioid mu receptors in the brain often are insufficient for an overdose caused by illicit fentanyl. This is the rationale for more potent naloxone formulations like Kloxxado, which have been developed and received FDA approval in recent years. Illicit fentanyl is involved in about 80% of all overdoses/poisonings where an opioid is involved.

What exactly is fentanyl and how did it become so prevalent in the drug supply?

The main reason is money. Illicit fentanyl and other synthetic opioids are primarily manufactured by the drug cartels in Mexico. Unlike heroin, which requires poppy plants to be grown then harvested and processed, illicit fentanyl can be manufactured with precursor chemicals 24 hrs. a day 7 days a week with minimal equipment. Therefore, they can make virtually unlimited amounts of illicit fentanyl, and it’s very cheap to make. Also, because it’s so potent, smaller amounts are easier to smuggle into the US drug supply. This is also one of the reasons they are mixing into so many other drugs. They are trying to convert non-opioid-using illicit drug users into people hooked on fentanyl. Many of these people have no tolerance to opioids and end up dying from inadvertent fentanyl ingestion.

Do people intentionally purchase fentanyl by itself or is it always in another drug?

Both. People who have OUD will purchase and use illicit fentanyl intentionally. Many others are unintentionally using illicit fentanyl as I described above. They intend on using some other illicit drug, often non-opioids, but the drug has been contaminated with illicit fentanyl or is pure illicit fentanyl made to look like some other pill.

What can you tell other parents who are concerned about drug use by their children?

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They should first go online and educate themselves as to the dangers of using any illicit drug. There are a multitude of government websites with good information about illicit fentanyl in the drug supply. Some examples can be found at SAMHSA, ASAM, CDC, DEA (one pill can kill) and state government authorities.

DEA–One Pill Can Kill has great stats. 70% of seized pills are counterfeit and have enough illicit fentanyl to kill the average person. Enough pills and powdered fentanyl were seized in 2023 to make 390 million lethal doses–more than the entire US population by a wide margin; and that’s only what was seized.

https://www.dea.gov/onepill

Then parents should have an open conversation with their kids about the risks and give them the information in a matter-of-fact discussion about the risks of illicit drug use and contamination with illicit fentanyl. Avoid scare tactics if possible as studies show they do not work. There are websites with good information on how to talk with your kids. Encourage kids to carry intranasal naloxone (drugs like Narcan or Kloxxado) because they never know when they will be the one witnessing an overdose at a party, concert, or wherever. Acting quickly with intranasal naloxone can make all the difference between someone living or dying. Waiting for EMS and watching helplessly vs. being the person to take action can make a big difference in their lives too. Also, using naloxone on someone not experiencing an opioid overdose will not hurt them. It only works on opioids to reverse the respiratory depression from an overdose.  [Note: Contagious, reviewed here, gives a good psychological analysis as to why the “Just Say No” anti-drug campaign of the 1980s was counterproductive]

[From the Editor: How can Staten Islanders get a free Naloxone kit? 

There is a helpful link to NYC pharmacies that provide a free “Emergency Overdose Rescue Kit“.  Anyone can get a kit, and no identification or insurance is required. There are two locations on Staten Island that provide these kits, and every Staten Islander who goes to parties or knows someone who does should get one.]

Kloxxado. Image Credit – Facing Fentanyl

About

Dr. Deyhimy is an addiction medicine specialist and anesthesiologist with more than 20 years of experience who is dedicated to helping those suffering from substance use disorder and preventing overdose deaths from opioids. He is the founder and medical director of MYMATCLINIC [mymatclinic.com], specializing in treating and prescribing medications for opioid use disorder (MOUD).⁸ He is also the Chief Medical Advisor for Project Opioid [projectopioid.org] and, more recently, End Overdose [endoverdose.net]—organizations dedicated to preventing opioid overdose deaths through education, training, and distribution of overdose reversal resources. He is the medical director of The Solace Foundation of Orange County [solacefoundationofoc.org], the first non-profit naloxone distribution program in Orange County with more than 2200 documented opioid overdose reversals. He also serves as a medical advisor for healthcare companies with therapies to treat opioid use disorder and prevent overdose death, including Hikma Pharmaceuticals [hikma.com].⁸ A firm believer in medical research and evidence-based substance use disorder treatments, he has helped thousands of patients improve their lives with medical treatments, education and behavioral change. He can also speak to the danger and lethality posed by recreational drugs laced with fentanyl and offer real-world advice to parents who are anxious about their kids’ safety.

Kloxxado. Image Credit – Facing Fentanyl

On Wednesday, August 21, not-for-profit organization Facing Fentanyl, took over Times Square for the third annual National Fentanyl Prevention and Awareness Day (see media alert below).

At 12pm sharp billboard was in Times Square for 20 minutes. See images on their FB page

Facing Fentanyl distributed naloxone from 12-2 and spoke to attendees to create awareness on the dangers of fentanyl

In addition to the billboard, there will be a custom big rig in Times Square that informs the public about the dangers of illegal fentanyl use, see image below

Facing Fentanyl’s founder Andrea Thomas, who lost her daughter, Ashley Romero, and her team will be joined with parents who lost a family member to fentanyl poisoning, in Times Square from 12-2pm in Duffy Square. This includes:

• James Carroll, Facing Fentanyl Advisory Board Member and former Director of the White House Office of National Drug Control Policy (also known as Drug Czar)
• Michael Fiore, Outreach Coordinator, Facing Fentanyl (in recovery himself)
• Jaime Puerta, Co-chair, Facing Fentanyl and President of V.O.I.D., “Victims Of Illicit Drugs (lost son to accidental fentanyl poisoning)

Times Square Takeover for National Fentanyl Prevention and Awareness Day: Wednesday, August 21

Facing Fentanyl, a not-for-profit awareness group composed of families who lost loved ones to illicit fentanyl, is commemorating the third annual National Fentanyl Prevention and Awareness Day on August 21, 2024, with a Times Square takeover to raise awareness and share education about the crisis.

As the devastating illicit fentanyl crisis continues to grip our nation, this day serves as a crucial reminder of the importance of education, prevention, and collective action to combat the growing public health crisis illicit fentanyl has posed.

• According to the CDC, there were over 105,000 overdose deaths in the 12-month period ending in February 2024.
• Furthermore, a study published this spring found that more than 115 million pills containing illicit fentanyl were seized by law enforcement last year, compared to over 71 million in 2022.
  • The study stated that the number of pills seized last year was 2,300 times greater than the roughly 50,000 seized in 2017.

Facing Fentanyl shared information and distributed 8 milligram naloxone, the life-saving medication that can reverse an opioid overdose.

Billboard at the event. Image Credit – Facing Fentanyl

Billboard at the event. Image Credit – Facing Fentanyl

Billboard at the event. Image Credit – Facing Fentanyl

Billboard at the event. Image Credit – Facing Fentanyl

About

Voices for Awareness was founded in 2018 after Andrea Thomas lost her daughter, Ashley Romero, to a counterfeit pill containing fentanyl. In just three years, the event has grown significantly, gaining unanimous support from the United States Senate, CDC, federal law enforcement agencies, grassroots organizations, and many other stakeholders. This day is now observed by families nationwide. The primary mission is for everyone to come together to find solutions, create education and awareness of the dangers of illicit fentanyl, and remember those lost to fentanyl poisoning.

Banner Image: Billboard. Image Credit – Facing Fentanyl