We see this every week. A patient enters our office to begin treatment, saying that they’re getting “legit” pills on the street: either opioids or benzodiazepines. They are sure that their dealer is “straight up” and the product is what the dealer is saying it is. However, when we run a Urine Drug Screen, we usually find that there is none of the drugs they thought they were getting like benzo or oxy. But there is Fentanyl.
Your Street Drugs May Be Cut with Fentanyl
It is often quite alarming for our patients when they recognize how different the substance they were taking is from what they thought it was. It also drives home how much greater the overdose risk was.
Most people have heard some version of the origin story for the Opioid Epidemic in America. One contributor in the late 1990s was the arrival of Oxycontin®, backed by an aggressive and effective campaign to convince physicians that it was a safer, longer-acting, or “non-addictive” opiate medication. After it became clear this was not the case, the manufacturer released a new formulation that made it harder to melt or crush and, over the long term, prescribers became better educated about the risks of opioids and dramatically changed their prescribing patterns.
Unfortunately, much damage had already been done. Millions of people had become physically dependent on opiates and could not easily stop, since doing so would throw them into horrible withdrawal symptoms also known as being “dopesick.” For a lot of people, this began a protracted and tragic chapter involving opiate addiction. After access to prescription opioids dried up or became too expensive, people traded down into heroin as a cheaper option. Over time, cartels then began to adulterate other drugs, including heroin, with Fentanyl in order to make them more powerful and attractive.
Why Fentanyl is So Prevalent in Street Drugs?
Fentanyl is a powerful synthetic opioid which can be manufactured at lower cost than heroin — no massive fields of poppies have to be cultivated or guarded. In large measure, it has crowded out heroin on the streets since it is so inexpensive. It can be “pressed” into pills that people buy while thinking that they are getting prescription medicines like oxy or benzos. Sometimes, it has reportedly been detected in batches of marijuana.
Fentanyl is a short-acting medication that was formulated to treat severe pain under the guidance of skilled medical clinicians. Because of its high potency — 50 to 100 times greater than morphine — it can be easy to overdose on. That’s the main reason that the opioid death rate has shot up in recent years. Source.
Overdose Risk of Fentanyl
Because it gives such a fast, powerful rush, people’s brains can quickly become dependent on it. They can start feeling the effects of withdrawal very soon, driving them to take more at frequent intervals to keep withdrawals at bay. Unfortunately, every time someone uses Fentanyl, there is a material risk of overdose since the margin of error is so low.
Fentanyl binds really tightly to the brain’s opioid receptors, making a “cold turkey” detox much more difficult.
A Safe, Comfortable Fentanyl Detox is Possible
In spite of this, the Coleman Method has maintained a completion rate of around 98% on our outpatient opiate detox process. The Coleman Method, which has been constantly refined over the past 20 years, is as safe and effective with Fentanyl as it has proven to be with other opiates and the success rate remains solid because of the relative comfort and shorter duration of the experience, as well as the nonjudgmental support from our medical staff and case management team.
Crucially, the physicians in the Coleman Network for Addiction Medicine also start patients on long-acting naltrexone in the final step of the detox. Naltrexone is a non-addictive opiate-blocking medication that reduces cravings and can block the highs from opioids. It is a useful tool for people at the beginning of their recovery journey. If you have any questions, please schedule a callback with one of our Care Advocates. We are here to help.
Dr. Deborah Reich