More Americans than ever are succumbing to fentanyl overdoses as the fourth wave of the opioid epidemic sweeps through every community nationwide.
Six years ago, Kim Blake tragically lost her son Sean to an accidental fentanyl overdose in Burlington, Vermont. He was just 27 years old.
“Every time I hear of a loss to substance use, my heart breaks a little more,” Ms. Blake wrote in a blog dedicated to her son in 2021. “Another family shattered. Forever grieving the loss of dreams and celebrations.”
In that year, the United States reached a bleak milestone: drug overdoses claimed over 100,000 lives across the country in a single year for the first time ever.
Of those fatalities, more than 66% were linked to fentanyl, a synthetic opioid 50 times more potent than heroin.
Fentanyl is a pharmaceutical drug used by doctors to treat severe pain, but it is also illicitly manufactured and sold by criminal groups.
Most of the illegal fentanyl entering the US originates from Mexico, using precursor chemicals sourced from China, according to the Drug Enforcement Administration (DEA).
In 2010, fewer than 40,000 deaths occurred due to drug overdoses nationwide, with less than 10% attributed to fentanyl. During that period, fatalities were largely driven by heroin or prescription opioids.
These stark contrasts are highlighted in a recent study by researchers at the University of California, Los Angeles (UCLA), which analyzed US overdose trends from 2010 to 2021 using data compiled by the Centers for Disease Control and Prevention (CDC).
“The rise of illicitly manufactured fentanyl has triggered an overdose crisis in the United States of unprecedented magnitude,” the study’s authors emphasized.
Fentanyl has pervaded virtually every corner of the country, affecting states from Hawaii to Alaska to Rhode Island.
The surge in fentanyl-related deaths first emerged in 2015, according to the data. Since then, the drug has spread nationwide, resulting in sharp increases in mortality rates.
“In 2018, about 80% of fentanyl overdoses occurred east of the Mississippi River,” explained Chelsea Shover, co-author of the study and assistant professor at UCLA’s medical school, in an interview.
However, in 2019, “fentanyl entered the drug supply in the Western US, exposing a previously insulated population to the drug, which led to rising death rates,” Prof. Shover noted.
The study also raises alarms about another alarming trend: fatalities associated with the combined use of fentanyl and other stimulant drugs like cocaine or methamphetamine.
This trend is observed across the US, albeit with variations reflecting regional differences in drug use patterns.
For instance, higher death rates linked to the combination of fentanyl and cocaine were found in northeastern states such as Vermont and Connecticut, where cocaine has traditionally been more prevalent.
Conversely, in other parts of the country from West Virginia to California, deaths were primarily driven by the simultaneous use of methamphetamines and fentanyl.
Ms. Blake, who is also a trained physician, disclosed that her son sporadically used cocaine, although his toxicology report indicated only fentanyl in his system.
She learned that many individuals use fentanyl in combination with other stimulants for prolonged highs.
“It’s no surprise to me that we’re seeing such an increase in stimulant-opioid combinations,” Ms. Blake commented.
When fentanyl first entered the US as part of the illegal drug supply, “many people were hesitant to use it,” Prof. Shover remarked. However, the synthetic opioid became widely accessible due to its lower production costs compared to other drugs.
Moreover, fentanyl is highly addictive, prompting individuals struggling with substance use to seek it out to alleviate painful withdrawal symptoms.
The study identifies states such as Alaska, West Virginia, Rhode Island, Hawaii, and California as having the highest rates of overdose deaths involving fentanyl and another drug.
Historically, these states have had high levels of drug use, Prof. Shover noted, adding that the arrival of fentanyl has intensified the lethality of drug use in these areas.
Although the opioid crisis has been traditionally depicted as a “white problem,” Prof. Shover’s study reveals that African Americans are dying from combined fentanyl and other drug use at higher rates across age groups and geographic boundaries.
This finding resonates with Rasheeda Watts-Pearson, a harm reduction specialist based in Ohio, who has observed a similar trend in her community.
Ms. Watts-Pearson is actively engaged in outreach efforts through A1 Stigma Free, a grassroots organization established to address a significant rise in overdose deaths among African Americans in Cincinnati.
She regularly visits barbershops, bars, and grocery stores to educate people about the lethal consequences of fentanyl.
Her motivation stems from a lack of awareness exacerbated by longstanding healthcare disparities experienced by racial and ethnic minority groups.
Even public awareness campaigns aimed at addressing the opioid crisis often fail to reflect the experiences of Black Americans, she noted.
“I could drive down Avondale right now, and there’s a billboard that says ‘Opioid Crisis,’ but there are two white people on that billboard,” Ms. Watts-Pearson remarked.
A critical blind spot for her community has been the presence of fentanyl-laced street drugs, which has resulted in unsuspecting individuals using this deadly synthetic opioid and developing dependence.
“People are overdosing and dying from cocaine, crack, and pills with traces of fentanyl,” she revealed.
“The black community is now impacted, and not enough attention is being given to it.”
The lethal combination of fentanyl with other drugs has marked what experts describe as the “fourth wave” of the overdose crisis in the US.
Prof. Shover and other experts caution that the treatment options for substance use disorder in the US have not kept pace with the evolving crisis.
“Our treatment system for substance use disorder often focuses on one drug at a time,” Prof. Shover observed. “But in reality, many people who use drugs are using more than one type of drug.”
To honor her son’s memory, Ms. Blake has been vocal about her loss and has supported other families coping with the grief of losing a loved one to an overdose.
“Everyone has a story, and for a parent who has lost a child, that pain is eternal,” she reflected.
During her son’s struggle with substance use disorder, Ms. Blake discovered that treatment options vary widely from state to state, and in many cases, available resources are inadequate.
“Ideally, I think we need to see a situation where people can receive treatment promptly, whenever they need it, and on a long-term basis,” she suggested.
Ms. Blake also proposed the establishment of overdose prevention sites, where individuals could use drugs safely under supervision.
Such sites are widespread in Canada, which is grappling with its own fentanyl crisis, but only two sanctioned sites exist in the US.
Above all, Ms. Blake emphasized the importance of compassion and understanding for individuals grappling with substance use disorders.
“Most of the people I talk to, their children didn’t want to die,” she stressed.
