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The Epidemic of Fentanyl & the Power of Prevention

Updated: Jun 29, 2021

By Liv Metsa, Substance Use Prevention Services Project Associate

Project Associate, Fran Quesea, January of 2018 on a trip with close friends a few days after starting sobriety. There are trees behind him as he is standing with his arms stretched out, looking at the sky.
The deeply concerning comparison of lethal dosages between heroin, fentanyl and carfentanil.

“This thing, it does not discriminate. Young, old, rich, poor, famous. Prince, Tom Petty, and Mac Miller all had fentanyl in their systems when they died. So chances are you know somebody affected by fentanyl. I personally know multiple people who have lost their lives to fentanyl. And the saddest part is they didn’t even know they were taking it. And I know for sure, they weren’t trying to die. But somehow fentanyl got them…”

The pandemic and its social implications continue to surge as every American proves susceptible to COVID-19 and its devastating repercussions. The virus does not discriminate against its potential victims, and neither does the substance responsible for overdoses rising to the number one cause of death in youth: fentanyl (Lev, 2021). Under lockdown, social distance, and isolation, the opioid crisis expands as: doctors write larger prescriptions, stressors escalate, access to resources declines, and mental health weakens. Considering suicide is the leading cause of death among users who misuse substances, we must address this epidemic within the pandemic as an emergency (Brunson, 2021).

Typically offered to terminal cancer patients in clinical settings since 1968, the synthetic opioid (or artificially produced pain reliever) of prescription fentanyl functions between 80 to 100 times more potent than morphine. Yet people who die from fentanyl are typically overdosing on illegally-produced analogs (variants such as carfentanil), often ingested without the user’s awareness. Carfentanil tends to be 10,000 times more powerful than morphine because the substance is neither created in a lab nor measured appropriately by legitimate scientists (Synthetic Opioid Overdose Data, 2021). Usually laced into cocaine, ecstasy, heroin, meth or pressed pills, first-time users, those in recovery, and often their dealers do not know if their product is pure… considering that only 2 milligrams of fentanyl or 0.00002 milligrams of carfentanil proves fatal, you simply cannot trust anything on the streets these days, no matter the distributor.

Within five months of 2020, the deaths in at least 81% of fatal overdoses were attributed to fentanyl and its analogs (Propublica, 2021). The passage of the drug from the East to West coast has even decreased the overall life expectancy in the United States since 2014. The substance tends to dissolve from a victim’s system before accurate toxicology can be conducted because fentanyl requires its own test kit. However, reports still demonstrate that fentanyl and its analogs produced at least 40,000 deaths in 2019 alone (Katz et al., 2020). Emergency responders now assume all overdoses to be connected to fentanyl and immediately administer multiple doses of the life-saving Naloxone (Fentanyl DrugFacts, 2021). Crime scene investigators, forensic scientists and even traffickers refrain from handling its poisonous shipments without personal protective equipment (Caller & Sedmakov, 2019).

Communities at risk for overdose prove to be those who have experienced physical ailments, those with mental illness (such as substance use disorders or suicidal ideation), individuals relapsing after developing lower tolerances, and people specifically in urban areas (Baldwin, 2021). Nobody is untouchable, not even those with privilege who presumably receive “high class” products: Lil Peep, Mac Miller, Michael Jackson, Prince, Tom Petty. Collegiate athletes, pre-med students, recovering addicts, choir members, first-time users, somebody’s child, almost certainly someone in your community are all at-risk for an accidental overdose. Compassion is long overdue against the stigma for the lives lost to overdoses and the stories leading up to their final moments. Now that the marginalized and underrepresented are no longer the only ones vulnerable, how will you advocate for harm reduction in your communities?

“So I’ve been paying attention to how we talk about the opioid crisis, and the problem is a lot of times we lump all the opiates together like they’re the same. But they are not. Fentanyl is a completely different animal than oxy[cotin] or heroin and the truth is: there is no beating the opioid crisis until we figure out how to beat fentanyl.”- Social commentator, Hisan Minhaj, on his talk-show Patriot Act (season 4, episode 2)

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Baldwin, G. (2021, February 1–4). CDC: Our Public Health Story: Response to the Opioid Crisis through State and Local Collaboration [Virtual Presentation]. CADCA’S National Leadership Form, Alexandria, Virgina, United States of America.

Brunson, C. (2021, February 1–4). The Intersection of Substance Use and Suicide [Virtual Presentation]. CADCA’s National Leadership Form, Alexandria, Virginia, United States of America.

Fentanyl. (2020, April). DEA.

Fentanyl - Alcohol and Drug Foundation. (2020, December 14). Alcohol and Drug Foundation.

Fentanyl DrugFacts. (2021, April 26). National Institute on Drug Abuse.

Fentanyl Factor – Safe Communities Coalition of Hunterdon and Somerset. (2020, January 29). Safe Coalition of Hunterdon and Somerset.

Caller, P. (Director), & Sedmakov, M. (Director). (2019, June 28). The Devil’s Oldest Trick (Season 3, Episode 9) [TV series episode]. In C. Lent (Executive Producer), Dope. Wall to Wall Media; Warner Bros. Television Productions UK.

J. (2020, October 2). Fentanyl. National Harm Reduction Coalition.

Katz, J., Goodnough, A., & Sanger-Katz, M. (2020, July 16). In Shadow of Pandemic, U.S. Drug Overdose Deaths Resurge to Record. The New York Times.

Lev, R. (2021, February 1–April 2). Death Diaries [Virtual Presentation]. CADCA’S National Leadership Forum, Alexandria, Virgina, United States of America.

ProPublica. (2021, May 8). Overdose Deaths Have Skyrocketed in Chicago, and the Coronavirus Pandemic May Be Making It Worse.

Synthetic Opioid Overdose Data | Drug Overdose | CDC Injury Center. (2020, March 19). Center for Disease Control and Prevention (CDC).

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