Potent Fentanyl Fuels Opioid Epidemic
Opioid overdose deaths continue to rise despite heroic efforts to stem the tide. The cause is largely economic, and it’s ripping through society at a catastrophic rate. The latest surge is fueled by the introduction of cheap and potent variants of the synthetic opioid fentanyl. It’s ugly stuff.
I wish the prognosis were better. http://www.cheapjerseys11.com/ But any perusal of autopsy reports from our state medical examiner, documents released by the Drug Enforcement Agency or even the news, tell a grim tale.
For me the light went on when a man in recovery said, «you need to understand the economics of fentanyl.» Now I do. It goes like this. For under $4,000 you can purchase a kilogram of fentanyl from China. There are numerous variants. For the sake of the coming math, we will standardize our kilogram of fentanyl as being 100 times more potent than heroin. So, one milligram of fentanyl equals 100 milligrams of heroin.
If a dealer purchases a kilogram of fentanyl from China for $4,000 that’s 1,000 grams, each of which contain 1,000 milligrams, which equals 1 million doses.
The dealer then buys a pill press for a few thousand dollars, cuts the fentanyl and presses it into shapes that, to a casual eye, look like oxycodone, Roxicodone, Vicodin and even nonopioid controlled substances such as benzodiazepines like alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
These pills wholesale for $5 to $6 each. Or $5 million to $6 million gross, with a net value not far behind that. The final street price, depending on the market and the day, will be between $10 and $20 per pill, so there’s plenty of profit left in the end user sale. Should the dealer skip the pill press and package the fentanyl as heroin, the current price of a bundle (10 bags) is about $35, which means the gross runs around $3.5 million per kilogram of fentanyl.
The opioid trade has always been about huge profits and enslavement to a drug. That was true with the British East India Company in 19th century China. It’s true of pharmaceutical companies, and it’s true of drug dealers. From a twisted perspective, opioids are a perfect product. The customer is a devoted buyer who needs his next fix regardless of the consequence or cost.
With these massive profit margins, the price to the end user can be pushed ever lower. New consumers with limited funds now find fentanyl products cheap and plentiful. What might have once been a high ticket item, has become an entry level option. And while a savvy business person might not want to kill their customers, they know there are many fresh, young faces in the pipeline.
In Connecticut in 2017, the opioid crisis grows worse, despite enhanced education, vigorous law enforcement, policy changes to alter the prescribing behavior of physicians, federal grant dollars, naloxone (Narcan) programs and greater access to treatment.
The reality is that, faced with an irresistible profit margin, we require an iron gut to intervene. Anyone who purchases drugs on the street needs to know that they are likely getting fentanyl.
We need to get higher dose naloxone (Narcan) into the hands of drug users, first responders, family members and anyone else who is likely to encounter an overdose. If you’re the cheap jerseys parent of a teen, you should have it in the house. People who use street drugs need to buddy up and make sure there’s ample Narcan in easy reach. While distasteful to some, supervised drug use settings can save lives.
And finally, although there have been advances in access to treatment for opioid use disorders, this must be pushed further and faster. After an overdose there is only a brief window to get the opioid user into treatment. The person who’s been Narcaned is now in a debilitating withdrawal. If you can’t get them the right level of care (possibly an opioid replacement medication such as methadone or buprenorphine) immediately they will leave the emergency room and find relief or death on the street.