It’s as though the opioid crisis wasn’t bad enough, but it seems there is another potentially fatal opioid hitting the street. Emergency room doctors could see a large number of patients they believe in having overdosed on heroin, only to find out about this newer and deadly designer drug called acetyl fentanyl. We have reached the third wave of the opioid crisis in the United States, and unfortunately, this may be the most deadly of them all.
The opioid crisis has come in three distinct phases. It began in the 1990s when pharmaceutical representatives urged doctors to distribute their product at a much more significant rate. They assured doctors that patients could not easily get addicted to opioids, and physicians responded by prescribing at a much more generous rate. Drugs like OxyContin were prescribed for simple ailments that an over-the-counter drug, like Tylenol, could be used to treat. Unfortunately, it had a snowball reaction.
Once medical professionals and government officials saw a spike in overdose deaths, they began issuing stricter policies with regard to opioid prescribing. It led to those already addicted to opioids directly to heroin to get their fix. With prescription drugs harder to obtain and more expensive than heroin, it made perfect sense. Unfortunately, those trapped in the disease of addiction will do anything to fight off the sickness, and drug-seeking behavior comes with the territory.
The second wave of the opioid epidemic saw an explosion of heroin. Unfortunately, the past few years have seen us enter into the third wave. The final stage in this epidemic may be the deadliest yet. While prescription drug overdoses have dropped significantly, we see a rise in fentanyl overdose deaths. It is safe to say that fentanyl may be the most deadly drug in modern history. It has hit our street like a tornado claiming lives in its path. It seems as though much cannot be done to curb this.
Acetyl fentanyl is the newest analog of the drug created in clandestine laboratories. Let’s take a more in-depth look into acetyl fentanyl.
More than 399,000 thousand people have died from overdoses involving any opioid from 1999 to 2017. Acetyl fentanyl is a new potent opioid in a long line of fentanyl analogs. The drug possesses no medicinal uses, and there have been several reported deaths as a result.
It is similar to the Schedule II opioid fentanyl. The drug does not show up in illicit drug screens and can remain undetected in some cases. It falls into a class of synthetic opioids known as phenylpiperidine. It contains phenylacetamide, whereas fentanyl does not.
All opioid drugs fall under the umbrella of central nervous system (CNS) depressants, and cause their users to experience anxiolytic feelings, euphoria, and sleepiness. Fentanyl is considered 50 times stronger than heroin, and 100 times stronger than morphine. The drug is designed to attach to naturally occurring opioid receptors in our body and relieve us of pain. Opioids are much stronger than our endorphins and are designed to create similar effects in our brains.
The U.S. Centers for Disease Control and Prevention (CDC) has a division known as the Health Alert Network, and they have received a steady increase in fatalities associated with acetyl fentanyl since 2012. Some reports estimate that there have been 700 overdose deaths due to acetyl fentanyl from 2013 to 2014. The report shows that the number may be much higher since some states are reporting more significant numbers.
Ohio reported 514 fentanyl overdoses in 2014, and Maryland another 185. Unfortunately, acetyl fentanyl is not tested for by medical examiners. The National Forensic Laboratory Information System also highlights an increase in the number of drug seizures for the drug from 618 in 2012 to 4,585 in 2014. Those who do use drugs should consider purchasing a fentanyl test kit to determine if their drugs are tainted.
Opioids are notorious for tolerance and dependence, which makes acetyl fentanyl no different. Repeated use of the substance can lead to tolerance, with escalating doses required to achieve your desired effect. The drug can also serve as a substitute for heroin or other opioids in those dependent on opiate drugs. Individuals may believe they are using heroin, when, in fact, they are using acetyl fentanyl. They may become inadvertently tolerant or dependent on the more potent drug. A return to heroin may no longer provide the expected effects.
Withdrawal has not been described with acetyl fentanyl, but given its affinity for opioid receptors, a typical opioid withdrawal pattern can be expected. Some of these symptoms include sweating, anxiety, nausea, vomiting, shivering, diarrhea, and piloerection. Those who become dependent on potent drugs like fentanyl may have a challenging time stopping the substance alone. If you do plan on stopping opioid use, we highly recommend that you check yourself into treatment to navigate around the potential risks and pain.
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Avedschmidt, S., Schmidt, C., Isenschmid, D., Kesha, K., Moons, D., & Gupta, A. (2019, January). Acetyl Fentanyl: Trends and Concentrations in Metro Detroit. from https://www.ncbi.nlm.nih.gov/pubmed/29940698
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