In 2016, the leading cause of death for people under 50 years old in the US was drug overdose. More than cancer, more than car crashes, and more than gun violence. When most people hear “drug overdose” they usually think of heroin. And it’s true, heroin traditionally is involved in more overdose deaths than other illegal drug. But the face of heroin addiction and the cause of overdose in the US has changed. These days, it’s white middle class suburbanites dying from overdoses, and they are dying from Fentanyl – many of them accidentally.

In 2016, the states with the highest rate of drug overdose deaths were (in order): Maryland, Kentucky, and Delaware. Maryland was also the richest state in the country, per person, in 2015. (Kentucky, on the other hand, was in the bottom five.) The high incomes and secure employment in Maryland doesn’t protect its residents from the scourge of drug addiction. Recent data shows that many heroin addicts started with painkiller pills. They became addicted to pills, and when pills became too difficult or too expensive to get, they found heroin was cheaper and more readily available.

Given the high demand these days for heroin, drug dealers are resorting to new tactics to sell their drugs. After all, drug dealing is ultimately business. (Highly illegal business, that harms the purchaser and their families, but business nonetheless.) One tactic is to “cut” their heroin with substances such as talc and lactic acid that look like heroin, but don’t cost much. This weakens the product though, so it’s common to add in Fentanyl to add a little potency back to the mix. Fentanyl can be up to 100 times more powerful than heroin, so it only takes a tiny bit to make the product seem stronger. The Fentanyl is illegally produced in China or other countries and is incredibly cheap, much cheaper than heroin. In 2016, the DEA reported that hundreds of thousands of non-pharmaceutical, counterfeit Fentanyl pills had entered the US.  Because its unregulated, the Fentanyl varies greatly in potency, so adding it to heroin can be a bit of a haphazard guess.

Quite often, heroin addicts don’t realize they are buying Fentanyl. Most know about the ongoing issue with contaminated heroin, but there isn’t a good way for buyers to know exactly what they are buying. Addicts don’t often prefer Fentanyl because while it is technically stronger, many feel it doesn’t provide quite as much euphoria as heroin and it wears off more quickly. But at the same time, addicts are always looking for a stronger and stronger drug, or hoping they are buying strong heroin, so Fentanyl still sells.

The variation in strength of the heroin/Fentanyl mixes on the street is proving difficult for addicts to anticipate. This leads to more unintentional overdoses. Not only do addicts risk overdose by trying to get as high as possible, but the unpredictability of potency, even from the same dealer, means any batch can be deadly even in small doses. One New Hampshire Fire Chief says that 10% of the overdose calls they respond to are fatal. But are these overdoses caused by Fentanyl? Unfortunately, yes. When the CDC examined unintentional overdose deaths in Ohio in January and February 2017, 90% of the deaths involved a type of Fentanyl while only 6% involved heroin.

Fentanyl truly is killing addicts, whether they are meaning to do Fentanyl or not. And as long as the opiate crisis grows, Fentanyl (and maybe stronger opiates) is going to continue to find its way into the market and into the little packets addicts buy each day. Truly, the heroin market has changed. Riskier than ever, these street drugs are also finding their way into more and more homes across the country. And unfortunately it shows no sign of stopping.

This shows why it’s so important to get help for heroin and opiate addiction while you still can.  Using is so inherently risky that there are no safeguards that will guarantee an addict will survive another day.  We can help heroin and opiod addicts learn about their options to attend top rehab centers based on their lifestyle and financial situation.  Just give us a call.

Addiction Doesn’t Wait.  Neither Should You.