Opiate Dependence Treatment: An Opiate That’s Stronger Than Heroin

In the last two years, the number of overdoses from opiate addiction, including heroin and painkillers, have dramatically increased. The number of addictions to opiates are quickly spreading throughout the United States. In fact, the number of accidental opioid-involved overdose deaths in 2011 was nearly triple the number of deaths in 2000, according to the New York City Department of Health and Mental Hygiene.

The Dangers of Opiates

However, physicians and other medical experts are realizing that the many drug overdoses taking place in hospital emergency rooms are not due to painkillers, but instead to Acetyl Fentanyl, an opiate that is mixed into street drugs and marketed as heroin.

The danger is that users themselves don’t even realize what they’re buying. It’s being sold as heroin but then later when those users are in the emergency room, the typical emergency drug treatment for opiates doesn’t work. As John Stogner, Ph.D. of the Department of Criminal Justice and Criminology at the University of North Carolina pointed out, “A patient may report heroin use and have symptoms consistent with heroin overdose, but an emergency physician may find that the standard [treatment] doesn’t work. Larger or additional doses are necessary when acetyl fentanyl is responsible. It’s never good to lose time between overdose and treatment.”

Typically, opiate dependence treatment includes a variety of forms, including methadone, suboxone, and naltrexone. And when a patient is in the middle of an overdose, the emergency drug naloxone is used. Naloxone blocks the opiate effects, allowing a person to breathe again long enough to live. However, as mentioned above, Naloxone is not working for those who have unknowingly taken acetyl fentanyl instead.

Acetyl fentanyl is a stronger form of heroin and requires a stronger dose of Naloxone in order to save a life. It is 5 to 15 times stronger than heroin. Users typically use it intravenously as a direct substitute for heroin or painkillers. However, those who use it may suffer severe consequences because of its potency. The drug is legal when packaged and labeled “not for human consumption”. However, because of the severe risks that come with using the drug, it is technically legal.

Reasons for the Drug Epidemic

Because of the overwhelming amount of overdoses and opiate-related deaths, experts in opiate dependence treatment and prevention are exploring reasons for the drug epidemic. For instance, a recent study published in the International Journal of Drug Policy indicates that there is a strong need for more education among adults who are abusing painkillers and/or heroin.

Surveys were provided to individuals participating in opiate dependence treatment and assessed their knowledge on what would induce an overdose experience. Surveys were in-depth and semi-structured interviews, exploring their knowledge of opioid safety practices and overdose prevention  services available to them. The researchers also measured participants’ knowledge of naloxone, a specific opioid receptor antagonist used to reverse an opioid overdose.

The study revealed that most participants were not aware of overdose dangers and how to respond to a potential overdose. Many participants were not aware of the use of naloxone as a means for prevention nor how to access the preventative drug. Furthermore, many participants were not aware of any opiate dependence treatment opportunities in their neighborhood.

The research study specifically interviewed the high risk group of young adults. The surveys further explored their knowledge of what to do when in the presence of a friend who is overdosing. Most responded with primitive suggestions such as slapping someone or placing them in a cold shower as a means to revive an individual who is overdosing on opioids. It was clear that television shows and movies were a large influence on this population who frequently referred to the movie Pulp Fiction, which includes an unrealistic overdose reversal scene.

Prevention Through Education

It’s clear that those addicted to opiates require education – not only on ways to prevent an overdose, but also on the danger of acetyl fentanyl innocuously mixed into their drug purchase.  Clearly providing some of this education can happen through the use of television, radio, and perhaps at opiate dependence treatment where family members might also be exposed to the education.