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The riskiness of artificial opioids: An emergency room physician clarifies

Deaths from drug overdoses and poisonings rank as the third leading cause of demise in individuals under the age of 20, as reported by the CDC. Synthetic opioids are becoming an increasingly worrying factor in this concerning trend.

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Youthful demise by drug overdose or poisoning - as reported by the CDC - ranks as the third most...
Youthful demise by drug overdose or poisoning - as reported by the CDC - ranks as the third most common cause, with synthetic opioids emerging as a significant factor of worry in this alarming statistic.

The riskiness of artificial opioids: An emergency room physician clarifies

America's Youth and the Synthetic Opioid Crisis

The United States is grappling with an alarming increase in overdose deaths among young people, particularly due to synthetic opioids.

Synthetic opioids like fentanyl and fentanyl analogs have seen a staggering increase of over 20-fold in overdose deaths between 2013 and 2022, according to the US Centers for Disease Control and Prevention (CDC). These substances are now the third leading cause of death among individuals under age 20, surpassed only by firearms and motor vehicle accidents.

Between 2018 and 2022, overdose deaths among U.S. youth ages 15 to 24 rose from 4,652 to 6,723, reports a new study in the journal Pediatrics. Despite a slight decrease between 2021 and 2022, this distressing trend remains.

The largest increase was observed in overdoses involving only synthetic opioids, with these substances being exclusively involved in more fatal overdoses than those involving multiple substances since 2020. Overdose rates were nearly 2.5 times higher among male youth compared to female youth, and more than two times higher among those ages 20 to 24 compared to those ages 15 to 19.

As a concerned parent, one may wonder about the nature of synthetic opioids, their uses, and the dangers they present. Dr. Leana Wen, a renowned CNN wellness expert, is an emergency physician and adjunct associate professor at the George Washington University who has also served as Baltimore's health commissioner and oversaw the city's opioid prevention strategy. Here's what she had to say about synthetic opioids and their effects.

What are synthetic opioids, and what are they used for?

Prescription opioids are medications used to treat severe pain. They are, however, associated with risks, particularly when used in higher-than-prescribed doses or incorrectly, leading to drowsiness, slowed and shallow breathing, and even death. Opioids can be classified by their origins.

Natural opioids, such as morphine and codeine, are derived from the poppy plant. Semisynthetic opioids, like oxycodone and hydrocodone, are made from natural opioids combined with chemical substances. Synthetic opioids, like fentanyl, are manufactured in laboratories.

Fentanyl is the synthetic opioid most implicated in fatal overdoses, according to the National Institute on Drug Abuse. Other synthetic opioids include tramadol and methadone. Methadone is also used as treatment for people with opioid use disorder, but CDC statistics and the new study in Pediatrics do not include methadone in their calculations of fatal overdoses due to synthetic opioids. The majority of synthetic overdose deaths in the U.S. involve fentanyl or fentanyl derivatives.

Are there legitimate medical uses of fentanyl?

Yes, fentanyl is often used in emergency settings to treat acute pain, such as for someone who has just experienced a high-speed car accident and broken their hip. It is also given to patients with chronic pain that isn't relieved by other methods. Some cancer patients with intractable pain use fentanyl patches or fentanyl lozenges.

However, the current trend of youth overdoses is not likely due to fentanyl being diverted from legitimate medical purposes. Instead, illegally produced synthetic fentanyl has become a significant problem.

Synthetic fentanyl is sold illegally as a powder dropped onto blotter paper, put in eyedroppers and nasal sprays, or as pills that resemble other prescription pills. Worryingly, fentanyl is often mixed in with other drugs, such as amphetamines, oxycodone, cocaine, heroin, MDMA (also known as ecstasy), and other "party drugs." Depending on the amount of fentanyl taken, users may overdose and die without realizing the drug contains fentanyl.

What makes fentanyl especially dangerous?

Fentanyl is extremely potent, with its potency estimated to be 50 to 100 times higher than morphine. A small amount can lead to oversedation and death, while users may not know its presence in their drugs or the dangerous nature of fentanyl. There have been numerous cases of high school and college-aged students who have died after being given fentanyl-laced pills.

How are overdoses treated?

The treatment for opioid overdose is naloxone, also known by its brand name Narcan. Available as a nasal spray and an intramuscular injection, naloxone can reverse the effects of an opioid overdose by binding to opioid receptors and displacing opioids, reversing respiratory depression, a primary cause of overdose-related deaths. Naloxone is effective for both fentanyl and other opioid overdoses and can be administered by anyone, so it's essential to have it readily available.

How can people tell if the drugs they are taking contain synthetic opioids?

Given the challenges of identifying fentanyl in illicit substances, the only surefire way for people to know is through using fentanyl test strips. Although these strips help assess the risk of overdose by checking for fentanyl presence in drug samples, it's important to note that just because one pill in the supply doesn't contain fentanyl doesn't mean that others all don't. Additionally, these strips don't test for other contaminants that can also be deadly.

In conclusion, understanding the risks associated with synthetic opioids like fentanyl, taking proactive measures like having naloxone accessible, and educating young people about the dangers of illicit drugs are crucial steps towards protecting our youth.

  1. Synthetic opioids like fentanyl, often associated with medical-conditions such as chronic pain, are now manufactured in laboratories and have become a significant concern in health-and-wellness, particularly amongst the youth, due to their potency and misuse.
  2. The rise in overdose deaths among young people in America, especially between 2013 and 2022, is largely attributed to certain synthetic opioids like fentanyl and fentanyl analogs, which are demonstrating increased usage in fitness-and-exercise and mental-health related contexts.
  3. To improve awareness and promote health-and-wellness, it is essential to understand that the use of nutrition strategies, mental health support, and even CBD, while important for overall wellbeing, should not replace education and precautions about the dangers of synthetic opioids like fentanyl.
  4. Moreover, given the threat posed by illicit substances containing synthetic opioids, utilizing tools such as fentanyl test strips can provide valuable insights, aiding in the detection of synthetic opioids and ultimately promoting health-and-wellness through informed decision-making.

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