The Rise Of Fentanyl in New Jersey

What Is Fentanyl?

Fentanyl was invented in 1960 to help cancer patients cope with intense post-surgical pain. The drug is regularly prescribed in form of a lollipop or a patch, which slowly releases the dosage through the skin. The patch now has various generic versions, making it the most successful Fentanyl product and has earned a place on the World Health Organization’s List of Essential Medicines.  When Fentanyl was first introduced, it was a huge breakthrough and has been an important part of pain management strategies for decades. When the drug was first created it was the most potent opioid in the world. The designer, a Belgian chemist named Paul Jannsen, tweaked the structure of a molecule similar to morphine so that it could slip quickly past the blood-brain barrier, making it extremely fast-acting. He also made adjustments with its design to make it bind more tightly to the brain’s opioid receptors, which makes it more potent. In surgeries, doctors usually use less of the drug than they would with a drug like morphine. The drug can induce pain relief within one or two minutes. Its effect is short-lived, usually lasting just a few hours or even less. The fast-in and fast-out mechanism give anesthesiologists much better control during an operation.  

In 1963, the drug was introduced across various Western European countries, where it was frequently combined with other medication and used as an intravenous painkiller. However, it didn’t receive approval from the US Food and Drug Administration (FDA) until 1968, with opponents stating its potency made it likely candidate for abuse. Ultimately, it was only approved in combination with another drug, droperidol, with a view to minimizing its abuse potential. It finally became available for use on its own in 1972.

The Dangers of Fentanyl

Ironically, fentanyl was originally created as a safer form of anesthesia than a morphine. But the same qualities that make it ideal for surgery make it addictive and deadly when used illegally and difficult to detect in blood or urine samples. By the 21st century, fentanyl in all its forms had become a widely used drug, providing pain relief to thousands of patients. However, its potency made it extremely vulnerable to misuse both accidently and otherwise. Fentanyl is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin. Just a quarter of a miligram — 0.25 milligrams — can kill you. That amount is equivalent to the size of two grains of salt. The danger of fentanyl isn’t just a threat to anyone who comes into contact with it. The drug can be absorbed through the skin or accidentally inhaled. The Drug Enforcement Administration (DEA) reports that Fentanyl poses a “grave threat” to first responders and law enforcement officers — humans and canines. There have been cases of police dogs assisting in drug raids and immediately showing symptoms of an overdose. Cases of officers overdosing after being exposed to drug substances that later were determined as fentanyl.

The first major wave of illicit fentanyl-laced heroin hit the U.S. around 2005-2006. Now, it has completely invaded the illegal drug market. New Jersey has seen a great rise in overdose deaths relating to fentanyl. According to the CDC, New Jersey experienced a 36 percent jump in drug overdose deaths from November 2016 to November 2017, increasing from 1,886 to 2,556 deaths, the highest percentage in the nation. New Jersey County Prosecutor said in an interview that “Heroin and fentanyl are so plentiful in New Jersey that drug dealers now have ‘free heroin days’ to spur more addiction and draw more customers.”

Fentanyl can be created into several forms. Used in the hospital, it can be injected, put in a patch for absorption into the body or given as a lollipop. Illegal forms include a white powder, a pill or a piece of paper that is placed under the tongue. Non-pharmaceutical fentanyl is created with varying toxicities and is often combined with caffeine, heroin and methamphetamine. Drug dealers often sell fentanyl as fake oxycontin, percocet, xanax or heroin to make the product more addictive and potent. Buyers may not be aware of the laced product they are purchasing and take their regular dosage that can lead to accidental overdose or death from the fentanyl. Naloxone, also known as “Narcan”, is a medication designed to reverse opioid overdose. Naloxone can be used to reverse the effects of Fentanyl. However, because fentanyl is so potent, it may require several doses of it to bring someone out of a fentanyl overdose. This is why it’s so concerning when people don’t know whether their drugs are laced with fentanyl. People around them may not know they need to administer more naloxone to help them out of the overdose.

Fentanyl On The Streets

On the street, fentanyl can have nicknames like:

  • Beans
  • Green apples
  • Apples
  • Shady eighties
  • Eighties
  • Fake oxy
  • Greenies
  • Apace
  • China girl
  • China town
  • China White
  • Dance Fever
  • Goodfellas
  • Great bear
  • HE-Man
  • Poison
  • Tango
  • Cash
  • Jackpot
  • Murder 8

Death rates involving synthetic opioids, which include drugs such as tramadol and fentanyl, triples in New Jersey since 2010:

  • More than 8 people a day die from fentanyl laced heroin in New Jersey.
  • Each year this decade, New Jersey has lost the equivalent of a small town to the opioid crisis.
  • The Centers for Disease and Prevention estimates 2,620 people died of drug overdoses in New Jersey in 2017.
  • Fentanyl was linked to 818 deaths in 2016, nearly doubling the 417 deaths in 2015.

These reports indicate that an increase in synthetic opioid-involved deaths is being driven by increases in fentanyl-involved overdose deaths and the source of fentanyl is more likely to be illicitly manufactured than pharmaceutical. In recent years, forms of fentanyl that are similar in chemical structure have been created, such as acetylfentanyl, furanylfentanyl, and carfentanil. The estimation of potency for these types of drugs are uncertain since the illicitly manufactured products have yet to be evaluated in humans. Carfentanil, the most potent fentanyl analog detected in the U.S., is estimated to be 10,000 times more potent than morphine.

The Fentanyl Pipeline

Hundreds of millions of dollars worth of illegal fentanyl is pouring into the United States through the international mail. Flowing in one direction, this fentanyl pipeline runs through Mexican Cartel drug trafficking routes and is dispersed in the U.S. The pipeline flows in from another direction as well; direct from Chinese laboratories to U.S customers through the mail.  According to Senate investigations, the US Postal Service has been a “virtually guaranteed” way to ship the substance in from China to New Jersey suburban door steps. The drug potency makes it so that it can be concealed in small packets, manilla envelopes and boxes to be sent through the international mail. The Drug Enforcement Administration and the United Nations’ narcotics monitors have identified China as the primary source of most of the fentanyl in U.S street drugs. Since so many of the opioids originate overseas, part of the work requires embassies and foreign authorities to develop agreements and working groups to stop the flow of the drugs. That includes working with the U.S. Departments of State’s Bureau of International Narcotics and Law Enforcement Affairs.

Facing The Issues Head-On

Fentanyl can be cheaply and quickly produced and a little bit goes a long way. Consider what it takes to produce heroin, large plots of secure land to grow opium poppies, labor for farming and refining, along with several months of time. On top of this, you have to deal with weather, pests, and water supply issues. When you move this entire process into a lab it becomes so much more predictable and profitable. With fentanyl, you need about 20 times less product to achieve the same high as heroin. According to the DEA, one kilogram of pure fentanyl from China, costing about $3,300 to $5,000 can be turned into diluted powder and sold on streets at a $300,000 value. The value of the drug only skyrockets as it further aways from the border. With fentanyl being so profitable in the drug market its a fair assumption to say that the drug isn’t going away any time soon. As the death toll rises in opioid related deaths, California launches an experiment to pay for people to test their drugs for fentanyl traces. The California public health department began paying for needle exchanges to distribute the test strips to drug users. The test strips work similar to pregnancy tests, mix a little of the drug with water then dip the strip in for several seconds. Five minutes later, they’ll see the results. One line, there’s fentanyl. Two lines, there’s not.

On January 10th President Donald Trump signed the Interdict Act, a law that will provide U.S. Customs and Border Protection (CBP) with $9million in extra funding to look for fentanyl. On February 1st, China will begin restricting two precursors used to synthesise fentanyl, which American officials hope will stem the flow into the country. The president declared the opioid crisis a public health emergency last year, with the most recent government statistics suggesting that the more than 64,000 fatal overdoses in 2016, outnumber the total number of American deaths in the Vietnam War. Previous federal anti-drug campaigns relied on incarceration to deter drug use but have been widely criticized for disproportionately targeting Black people. In recent years, federal and state officials have shifted their approach towards prevention and treatment.

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