Fentanyl overdose. Few words strike more fear in the hearts of parents.
That’s because fentanyl is all over the news and in our social media feeds for all the wrong reasons. It seems like not a week goes by that we don’t hear of someone – often a teenager – accidentally overdosing on fentanyl. Sometimes, if they are lucky, they survive. Tragically, many who overdose lose their lives.
Fentanyl is an incredibly potent opioid: it is 50 times as strong as heroin and more than 100 times stronger than morphine. Opioids, including fentanyl, are responsible for more than 150 overdose deaths every day in the United States. According to the Texas Health and Human Services Commission, fentanyl alone kills an average of five Texans each day. It takes very little fentanyl to deliver a fatal dose.
The prevalence of fentanyl is a crisis in our midst that all families must navigate.
Privia Medical Group North Texas physicians want all parents to have the facts about fentanyl and how you can best protect your child from the clear and present danger this drug poses.
What is Fentanyl?
Fentanyl is a powerful, synthetic (man-made) opioid. There are two types of fentanyl: pharmaceutical and illegally manufactured. To understand the current fentanyl crisis, it’s helpful to know how opioids came to be and what they are used for.
Opioids are a class of powerful drugs used to relieve pain. They are sometimes prescribed to treat moderate to severe pain resulting from an injury, surgery or cancer. Some common prescription opioids include oxycodone, hydrocodone, morphine and methadone. Not all opioids are prescription drugs, however. For example, heroin – an illegal drug – is also considered an opioid.
Sometimes, opioids have a useful role to play in pain management. For patients battling cancer, an opioid may be necessary to make the pain tolerable. In the wake of a severe injury or surgery that is causing acute pain, an opioid prescription for a limited amount of time may be the most appropriate treatment.
In recent years, opioids have sometimes been prescribed to treat chronic pain, such as osteoarthritis or back pain. This has, in part, contributed to the rise in some people becoming addicted to opioids.
Because they are highly addictive, opioids are dangerous to take for an extended length of time. When people take opioids on a long-term basis, resistance to the drug may develop. This resistance can lead to the urge to take even more of the opioid to feel a meaningful effect, creating a dangerous cycle that may lead to an overdose.
For many years, we saw an increase in overdoses resulting from the overuse of prescription opioids, such as oxycodone. This is still a concern, but increased awareness of the highly addictive nature of these opioids has resulted in more stringent oversight of their use.
“At Privia Medical Group North Texas, our physicians carefully evaluate all options for treating pain and will only prescribe an opioid if we believe it is the most effective way to treat the patient and the risk of a harmful side effect is acceptably low,” explains Dr. Scott Berlin, a pain management specialist serving patients in Fort Worth, Arlington and Cleburne. “Opioids are never the first option we start with, and if we do prescribe an opioid, we will discuss the pros and cons thoroughly with the patient first.”
The Current Fentanyl Crisis
In contrast to the opioid epidemic of the past several years, the current fentanyl crisis is different in a couple of important ways. With opioids, the problem generally started when people were prescribed an opioid for pain and became addicted to it over time. The more people took, the more powerful the addiction became and the risk of an accidental overdose increased.
Today, when we hear about a fentanyl overdose, there is virtually never any type of prescribed medication involved. Further, many people who overdose were not seeking to take fentanyl at all – more often than not, they were intending to take another drug and they were unaware that drug was actually fentanyl.
“This is what makes fentanyl so insidious and dangerous,” explains Dr. Michael Phillips, a pain management specialist with offices in Fort Worth, Arlington and Cleburne. “Someone may believe they are taking a completely unrelated drug and unknowingly take fentanyl. When you also factor in that it only takes a very small amount of fentanyl to cause an overdose, it’s easy to see how this product is so dangerous.”
Further complicating matters is that fentanyl has no taste and no smell. Without a lab test, it is virtually impossible to determine if a substance contains fentanyl. Test strips that check for fentanyl are currently not legal in the state of Texas, as they are classified as drug paraphernalia.
Lesson #1: Don’t Do Drugs
Illegal fentanyl can be produced in different forms, including liquid and powder. Powdered fentanyl can easily be mixed with other illegal drugs, such as heroin, cocaine and methamphetamines. An unsuspecting drug user may then overdose on fentanyl without ever realizing they were taking it.
The “don’t do drugs” talks parents have had with their children for the last few decades take on an even greater importance in the 2020s. Taking any type of illicit drug is obviously not good for anyone, especially a child. But there was also a belief that a mistake like one-time drug use, while bad, was usually not a life-ending one. Now, with fentanyl so widespread, one poor decision may become a fatal mistake.
“As parents, we know how important it is to frequently talk with our kids about the dangers of drugs and alcohol,” says Dr. Roy Clarke, a pediatrician in Dallas. “The fentanyl crisis makes these conversations even more urgent – our kids have to understand that as little as one dose of a drug laced with fentanyl is enough to kill them.”
Lesson #2: One Pill Kills
To make matters even more complicated, it’s not just illicit drugs like heroin and cocaine that can be laced with fentanyl. Illegal fentanyl may be passed off as seemingly “legal” medication.
Social media and other online sites have made it easy for dealers to sell supposedly legitimate medications that are easy for young people to access. They may show up in a middle school or high school and be marketed as anxiety medication, an ADHD pill or other “legitimate” drug. Of course, no one should ever take a medicine that was not prescribed to them – but it’s especially important that kids understand just how dangerous one of these seemingly innocuous pills may be.
Here is one tragic example: a couple of years ago, a college student in Austin took what he believed to be a sleep-aid pill to cope with insomnia. The pill, acquired through an online dealer, was actually fentanyl. The unsuspecting student was killed immediately.
“It is so important that we teach our kids to never, ever take a pill that has not been prescribed to them and that did not come from a pharmacy,” says Dr. Michelle Kravitz, a Dallas pediatrician. “If you or a trusted family member didn’t pick it up personally from the pharmacy, you simply cannot trust that the pill is legitimate and safe. Don’t take a chance – it’s not worth it.”
Overdose? Act Fast!
With fentanyl so prevalent – and other opioids still posing a risk – it is important that everyone be able to recognize the signs of an overdose and know what to do.
Common signs of an overdose include:
- Losing consciousness
- Cold or clammy skin
- Choking and gurgling
- Labored breathing or no breathing at all
- Pupils are unusually small
- Body goes limp
- Skin discolored, especially in lips and nails
If you suspect someone of having an overdose:
- Call 911 immediately
- If you have naloxone (see below) nearby, administer it immediately
- Do your best to keep the person awake
- Lay them on their side to prevent choking, in the event they vomit
- If the person stops breathing, administer CPR
- Stay with the overdose victim until the paramedics arrive
Naloxone is a medication that can quickly reverse the effects of an overdose and save the person’s life. Also known as NARCAN, it is available in pharmacies without a prescription and many paramedics and law enforcement officers carry it with them. If you have a family member or close friend who has a history of drug use, it is a good idea to keep naloxone on hand and nearby in case they suffer an accidental opioid overdose.
Naloxone usually comes in the form of a nasal spray, but it can also be an injection. While this drug is effective at rapidly reversing the effects of an overdose, it does so only temporarily. That’s why it’s important to get an overdose victim to a hospital as quickly as possible.
Talk to Your Kids
“Talk to your kids early and often about the dangers of drugs – both the illegal ones our parents warned us about, as well as the supposedly legitimate ones that are sold illegally,” says Dr. Samuel Davis, a pediatrician in Saginaw. “Remember, ‘one pill kills’ isn’t just a slogan, it’s a scary truth. Make your kids promise to never take any medication that you or they didn’t get directly from a pharmacy. It’s just too dangerous to take a chance, even once.”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The U.S. Centers for Disease Control and Prevention
National Institute on Drug Abuse
Texas Health and Human Services Commission
Substance Abuse and Mental Health Services Administration
