Spread of synthetic fentanyl fuels public health crisis for officials

by Michael Heygood

The spread of painkillers containing the opioid drug fentanyl has risen sharply in recent years, leading to an epidemic of overdoses and deaths caused by this powerful narcotic. According to the Centers for Disease Control and Prevention, fatal overdoses involving fentanyl products rose by 80% between 2013 and 2014, a period during which fentanyl seizures by law enforcement officials rose by a staggering 426%.

Fentanyl is an extremely powerful synthetic opioid painkiller that is about 80-100 times more powerful than morphine. The drug can be prescribed in several formulations, including as a pain patch (Duragesic), a sublingual spray (Subsys), or as a lollipop (Actiq). Because even a small quantity of fentanyl can lead to a fatal overdoses, the drug is only approved by the FDA for patients with severe, chronic pain who are already opioid tolerant, such as cancer patients.

The current fentanyl crisis has its roots in the 1990s, when doctors began prescribing opioid medications in higher quantities in an effort to more aggressively treat and manage pain. Although well-intentioned, this increase in the number of opioid prescriptions in the U.S. coincided with a sharp rise in cases of dependency, addiction, and overdoses caused by opioid medications.

The increase in the number of Americans taking opioid medications has also helped fuel the current fentanyl crisis. According to a study published in the journal Substance Abuse and Rehabilitation, 40% of abusers used opioid painkillers before graduating to fentanyl.

Health and Law Enforcement Officials Face Synthetic Opioid Crisis

Newer fentanyl analogues also pose a serious danger to patients who abuse opioid drugs. Sufentanil is about eight times more potent than fentanyl, which carfentanil is about 100 times stronger than fentanyl and 10,000 times more powerful than morphine.

In addition to fentanyl products that are legally prescribed in the U.S., medical and law enforcement officials are also dealing with an influx of black market fentanyl that is illegally shipped to the U.S. from China or Mexico. Because fentanyl is cheaper than heroin, the drug is often mixed with street drugs to increase their potency, putting users at risk of a fatal overdose due to the high potency of fentanyl.

Part of the current fentanyl crisis is also being caused by the extreme potency of the drug. Fentanyl is so strong that some patients may overdose on the drug even when it is taken in the prescribed dose. The DEA has begun training law enforcement officials to self-administer the opioid reversal drugs in case they are accidentally exposed to fentanyl in the field. Fentanyl is so powerful that even exposure to an amount equivalent to a few grains of sand is enough to kill a 250-pound man. In cases where the protective lining on a fentanyl pain patch breaks, patients can be killed if their skin comes into direct contact with the fentanyl gel contained inside the patch.

Because of the extreme potency of fentanyl, opioid reversal drugs such as Naloxone are less effective at reviving overdose victims than they are with less potent opioids such as OxyContin or heroin. Fentanyl overdose victims may need up to two times as much Naloxone in order to recover from an overdose. If emergency responders do not know what drug the victim took, they may not administer enough medication to reverse the overdose.

Science has struggled to keep up with the surge in fentanyl overdoses. Because synthetic opioids evolve so rapidly, it is hard for testing labs to keep pace, making it difficult to know when patients should be treated with a higher dose of Naloxone. And if a lab hasn’t previously encountered fentanyl or similar drugs, the drug’s unique “fingerprint” won’t be in its database, making testing during medical emergencies, toxicology tests, or forensic reports impossible.

The increased availability of fentanyl products combined with the extreme potency of the drug has helped fuel a surge in overdose deaths in recent years. Between 2014 and 2015, 15 U.S. states saw deaths caused by a fentanyl overdose rise by more than 50%. Most of these states were on the east coast, including Florida, Virginia, Illinois, New Jersey, Pennsylvania, Massachusetts, and Ohio.

Improvements in testing for fentanyl has helped understand the drug’s role in this rise in overdose deaths. After Ohio began testing for fentanyl, the state’s opioid overdose deaths rose to a record 3,025, with most of those being caused by fentanyl.

Although health officials have struggled to keep pace with the alarming spread of fentanyl in the U.S., the federal government began taking steps in 2016 to help curb the nation’s epidemic of opioid abuse and addiction. In September 2016, the FDA issued a warning about the risk of a combined drug overdose for patients who are prescribed opioids together with other central nervous system depressant drugs, such as anti-anxiety medications. In October, the DEA announced that it would lower its 2017 quota for the production of opioid medications in the U.S. in an effort to reduce the availability of these medications.

Hurt By Fentanyl or Opioid Painkillers? You Have Legal Rights.

Many patients have died from fentanyl overdoses because the drug was improperly prescribed for them. If one of your loved ones has died from a fentanyl-related overdose, you may be eligible to file a wrongful death lawsuit against the doctor who prescribed it. The first step in taking legal actions is to speak with an experienced fentanyl attorney who can advise you regarding your legal rights and guide you through the first steps of filing a case.

The law firm of Heygood, Orr & Pearson has handled hundreds of wrongful death cases involving the fentanyl pain patch. These lawsuits include claims against doctors, hospitals, or medical staff who improperly administered fentanyl products to their patients. Some of these cases include instances where fentanyl was inappropriately administered in combinations with other medications that depress a patient’s central nervous system (e.g., other opioids, muscle relaxers, benzodiazepines, etc.).

For more information about filing a lawsuit involving fentanyl or another opioid painkiller, contact the lawyers at Heygood, Orr & Pearson for a free legal consultation to find out if you qualify. You can reach us by calling toll-free at 1-877-446-9001, or by following this link to our free case evaluation form and answering a few brief questions to get started.

by Michael Heygood

Michael Heygood is a licensed attorney and partner at HO&P who focuses on insurance and corporate litigation, and other civil arenas. Michael has been named multiple times to the Super Lawyers List.