Fentanyl Awareness Day 2024
By now, you’ve heard about Fentanyl. We’ve raised awareness in prior blogs: The Game Has Changed and Meet Tranq. In 2024, the human toll of the crisis is becoming more evident in many of our communities across America as we witness the degradation, despair, and desperation in our midst. More than 40 percent of Americans know someone who has died of a drug overdose, according to a RAND study. Fentanyl overdose is the leading cause of death among 18–45-year-olds. It is the silent war of our generation.
The first phase of the crisis began with the overprescription of opioids, primarily OxyContin, and its proliferation in the legal and illicit supply. The second phase saw a tamping down of overprescription and an increasing addiction to heroin as a cheaper alternative. The third wave marked the rise of Fentanyl and other synthetics, some 50-100 times stronger than heroin. It has infiltrated the illicit drug supply, and according to the DEA, 70% of its confiscated drugs, including cocaine, contain Fentanyl. As the ever-deepening overdose crisis reaches its fourth wave, we increasingly see polysubstance addiction and complications with mental health and co-existing substance use disorder.
Prevention through awareness is the first defense. Many nonprofits are doing good work, and we are happy to collaborate and amplify their efforts. Watch a speaker or a video with Song for Charlie. Spread the word. See resources on the DEA One Pill Can Kill awareness campaign website. Never try a street drug. Carry Narcan and know how to use it. See Narcan access and training resources at SAFE Project.org.
Who is vulnerable?
- Low Tolerance
- Uninformed youth (first-time use/accidental poisoning)
- Those transitioning from incarceration
- Fresh out of inpatient rehab and susceptible to relapse
- Trauma
- Vets and other traumatic experiences like suicides, and shootings.
- ACE — adverse childhood experiences causing emotional trauma such as exposure to family strife, a parent with SUD, abuse, grief, divorce, systemic racism, discrimination, and bullying
- Those with Little support
- Those without positive family or peer support
- Those without access to quality health care
How has the game changed?
Treatment becomes more complex due to the strength of Fentanyl, especially with polysubstance use, and its effects on mental health. Stronger drugs might require longer to stabilize, and not all addictions have the same relapse rates or respond to the same treatment. Most who go through rehab do not get into sustained recovery the first try.
Harm Reduction is an increasing necessity to reduce the number of overdoses. Narcan saturation is a primary harm reduction strategy, but it does not necessarily mean an individual gets better, simply there is an opportunity for another chance. For those needing access to resources, the following patient guide may serve as a point of reference, but having a relationship with a provider who understands your needs can be invaluable.
Medication for Opioid Use Disorder (MOUD) includes Methadone and Buprenorphine (in Suboxone or monthly shots of Sublocade). In some cases, Naltrexone (Vivitrol) may be recommended. The National Institute on Drug Abuse (NIDA) advocates for the use of MOUD as the primary treatment standard. Still, not all private treatment centers and sober homes currently accommodate this approach. MOUD may be necessary as an interim step toward long-term wellness and safer than abstinence given the high risk of relapse.
Changes in the industry can lag conditions in the killing fields of the epidemic and rehabs need to keep pace with new evidentiary standards. This creates challenges even for the best of the best and the most well-intentioned in the treatment and recovery industry.
Right fit? For those seeking treatment, know your treatment options and consider your unique circumstances. This means questioning a fit with a particular rehab and sober home and seeking out additional support, especially to help mitigate risk around transitions. Given the higher probability of relapse with Fentanyl, those who adhere to strict abstinence practices may be doing more harm to your recovery than good. The risk is high coming out of a period of abstinence, and relapse with no tolerance is deadly. Recovery may take much longer and look much spottier. So, ask questions. Does the center accept the standard of MOUD? Are they qualified to handle co-existing disorders? Do they have a psychiatrist on staff? Will they coordinate care and consult with a prior doctor? Are you better off being treated on an outpatient basis? Do you have guidance from your clinician?
Likewise, not all sober homes are a good fit. Not all accommodate MOUD. Not all allow prescribed mental health medications. Not all will manage medications safely. Not all will help a client manage through a relapse or get them into safety should they fall. Sober homes can be an integral part of one’s recovery, but they also enter a person’s recovery journey at a highly vulnerable time. Without a safety plan in place, a sober home can also be the last stop before a fatal overdose.
Check the etiquette. This new game means more complexity in dealing with loved ones. “Hitting bottom” is now more likely to mean death. “Tough love” can further isolate the individual in the grasp of the disease just when they need a lifeline. “They have to want to change” is a statement that does not account for how addiction to powerful substances usurps executive functioning and motivation as part of its insidious hold on the individual. Motivation may not come intrinsically until the brain’s neurotransmitters are balanced.
Stay connected. We may be well-meaning individuals who want to help, but we don’t always understand that the game has changed. It is often very difficult for an individual to recognize the need for treatment and take action. Peers, family, and community organizations can sustain connections, offering empathy and encouragement, and provide a lifeline by removing barriers to treatment. But it is no easy task, and even family members need support.
Get Support. If you or a loved one needs support, Herren Project can help. Remember, you are not alone. Read Clinical Director Kristin Young’s blog, Supporting Loved Ones with Substance Use Disorder. See our family support services. Learn more about the disease; Kristin recommends The Neurobiology of Addiction by Nicole T. Labor, DO. For individuals in need of treatment or recovery support, our staff brings lived experience and will assist you without judgement:
WE’RE HERE TO HELP: (844) 543-8555
How Can We Help?
If you or a loved one are seeking help getting into addiction treatment, we can help – no matter what your circumstances may be. You are not alone.
