Fentanyl-laced heroin overdoses rise California signaling higher need for clinical caution

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The CDC reports that opioids of all types have killed more than 33,000 people in 2015 alone, and the number is rising. A newer threat of mixed opioids plagues Ventura County in California and could signal a need for more caution across the country.

Ventura County has reported a rise in fatal opioid overdoses that could be attributed to the spread of heroin laced with fentanyl. “People are using these drugs expecting one result and getting a much more potent result, a result that can end up with death,” says Dr. Robert Levin, a physician and public health officer in the county. The public health officials of the county note that opiates can be accessed very easily, sometimes by mail order, and that there is very little oversight in the mixes of opioids that people are purchasing illegally.

Some forms of synthetic opioids are significantly easier to produce and sell illegally than are others. Carfentanyl and fentanyl are both extremely potent in small quantities and present an extreme health risk as a result. Synthetic opioids as a whole have caused 72.2% more deaths from 2014 to 2015, according to the CDC. The CDC also reports that the rates at which confiscated drugs testing positive for fentanyl are growing faster than prescription rates. This indicates that synthetic opioids like fentanyl are further infiltrating the street and illicit drug use scene.

It is the mixing of synthetic opioids with heroin that is most troubling, especially for Ventura County. Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. Heroin, in comparison, is two to four times as potent as morphine, according to a research article in the Journal of Pharmacology and Experimental Therapeutics. Mixing fentanyl and heroin can easily produce an opioid dose that exceeds the potency of safely prescribed amounts of opioids by several orders of magnitude.

What can be done about this problem?

Ultimately, opioid dependence and addiction must be resolved under supervision of a qualified health provider. A core component of any addiction or dependence treatment program is toxicology-based monitoring for compliance and for metrics. Acutis Diagnostics is a New York toxicology lab that works closely with the medical and patient community to ensure safe, healthy, and timely treatment of all disorders, including opioid dependence and addiction. Please contact Acutis Diagnostics to learn how the services offered here can help provide a path to treatment for all patients.

For more information about the recent events in Ventura County, please look at this article by the Ventura County Star.

For more information about fentanyl and to see a wealth of information about the opioid crisis, visit the CDC’s page about fentanyl here.

To read the Journal of Pharmacology and Experimental Therapeutics’ article about equivalent doses of heroin and morphine, please click here.

This article is written by Yusuf Sheth. Yusuf is a Masters of Public Health Candidate at Downstate Medical Center.