Fentanyl and Other Killer Drugs: Addressing Global Opioid Crisis.

“Opioids reach every part of society: blue Collar, white collar, everybody. It’s nonstop. It’s every day. And it doesn’t seem like it’s getting any better.” Walter Bender-a Deputy Sheriff in Montgomery County, Ohio

In 2017, opioid use increased in Africa, Asia, Europe, and two-thirds of the 585,000 drug related deaths, were as a result of opioid use, according to the United Nations office on Drugs and Crime 2017 report.

It was noted in the report that, North America’s overdose mortality rates due to fentanyl account for most of the drug related death around the globe.  For instance, Nigeria, has been plagued with opioid crisis with no concrete strategy in place. Unlike in North America, where fentanyl seems to be the most widely used, in Nigeria, the bigger concern is tramadol which is considered to be widely available although it’s not the first choice of drug in Nigeria. Marijuana is the most widely use drug in Nigeria, according to the report. Another published report by the United Nations office on Drugs and Crime on drug use in Nigeria indicated that around 14.3 million people aged 15-64 years in Nigeria had used a psychoactive substance in the past year for non-medical purposes. It is worth stating that the majority of high risk drug users were regular users of opioids in Nigeria according to the report.

The National Institute on Drug Use described opioids as a class of “drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and many others. Regular use, even as prescribed by a doctor can lead to dependence and, when misused, opioid pain relievers can lead to addiction, overdose incidents, and deaths.”

 It is worth noting that the drug naloxone can be used to reverse an opioid overdose when given right away. Fortunately, according to the National Institute of Drug Abuse (NIDA) effective medications exist to treat opioid use disorders including methadone, buprenorphine, and naltrexone. Talk to your physician!

As the fentanyl and tramadol crisis ravage through cities across North America and other parts of the world, it seems that some of the strategies put in place to tackle the crisis are deemed controversial.

One of the controversial strategies include opening of supervised drug/ injection use sites. The arguments against this is that; the sites will encourage more addicts to abuse substances while the arguments for this strategy insist that this approach saves life and does not increase drug usage because it allows trained specialist to monitor and respond accordingly in case of overdose.

Additionally, there is a debate whether non-medical community workers should carry Naloxone (antidote) to treat people in emergency situations. The opposition insists that administration of Naloxone by non-medical workers can result in improper usage of the drug. Thankfully, some places have legalized the sale of naloxone without prescription (over the counter), other places require prescription, and some places only allow health workers to carry the antidote.

While all sides of argument have valid points but with the increase in death rates and frankly with no end in sight in terms of controlling the manufacturing and distribution of the synthetic drug, isn’t it worth exploring all options and utilizing all proposed strategies to deal with this tragedy?

There is no doubt, this is a global epidemic, so, we need to identify those with substance abuse disorders and help them in overcoming the disorder. Further, concrete and effective strategies are needed to combat this issue head on! Leaders need to stop pointing fingers and allocate needed funds to fight this crisis at local, state, and global stage.

Addiction is a disease and the problem is real! How did we get here and where do we go from here?

If you or someone you know struggles with addiction, please seek help.

Facts & Statistics on Opioids

•Globally, there is an estimated minimum of 190,900 premature deaths caused by drugs (range: 115,900 to 230,100).

•Opioids account for the majority of drug-related deaths and in most cases such deaths are avoidable.

•Opioids responsible for two-thirds of global drug deaths in 2017

•North America continues to experience the highest drug-related mortality rate in the world, accounting for 1-in-4 drug-related deaths globally. (Source: United Nations office on Drugs and Crime)

Possible Signs of Opioid Addiction

•Mixing with different groups of people or changing friends

•Spending time alone and avoiding time with family and friends

•Losing interest in activities

•Not bathing, changing clothes or brushing their teeth

•Being very tired and sad

•Eating more or less than usual

•Being overly energetic, talking fast and saying things that don’t make sense

•Being nervous or cranky

•Quickly changing moods

•Sleeping at odd hours (Source: American Society of Anesthesiologist)

Symptoms of an Opioid Overdose

•Slow, shallow breathing

•Extreme sleepiness

•Inability to talk

•Blue skin color and dark-colored lips

•Snoring or gurgling sounds   (Source: American Society of Anesthesiologists)

Responding to an Opioid Overdose?

If you think someone may be experiencing an opioid overdose, take the following actions immediately:

1. Lightly tap, shake and shout at the person to get a response. If you do not get a response, rub your knuckles on the person’s breastbone.

2. If the individual responds, keep the person awake.

3. If you have naloxone, a medication that can rapidly reverse the effects of an overdose, administer it according to the instructions on the package (in addition, seek medical help right away) (Source: American Society of Anesthesiologists)