President Joe Biden will meet with Mexican officials on Monday to discuss how to keep illicit drugs from crossing the southern border, an issue that continues to fuel a new wave of the deadly fentanyl crisis in the United States.
CONTEXT: There were 107,622 drug overdose deaths in 2021, according to the Centers for Disease Control and Prevention, and two-thirds of those deaths were caused by fentanyl, a synthetic opioid.
Most of the illegal fentanyl is mass-produced in “secret factories” in Mexico with chemicals obtained from China, according to the Drug Enforcement Administration.
Fentanyl is addictive, 50 times more potent than heroin and just a small amount, enough to rest on the tip of a pencil, can be fatal.
Here’s what health researchers and overdose prevention officials say are the best ways to curb fentanyl addiction and overdose deaths in the United States:
More drugs needed to treat opioid addiction
People who use opioids need different “exit points” and “exit points” to get off drugs, said Susan Sherman, professor of health behavior at the John Hopkins Bloomberg School of Public Health in Maryland.
Whether the illicit fentanyl comes “from Mexico or China, the problem is here with consumption, with lack of evidence-based drug-assisted drug treatment,” Sherman said.
Only a small fraction — about 10 percent — of people with an opioid addiction take medication to treat it, according to Joseph Friedman, a substance use researcher at the University of California, Los Angeles.
“So there’s just this huge unmet need, and that’s an incontrovertible point of failure of our drug policy,” he said.
Unequal access to health care means many people have no way of getting life-saving drugs, unlike the more widely available government-funded treatment programs for other epidemics, such as HIV, he said.
Friedman said the government and the health care system should work in particular to make buprenorphine, which has “historically been prescribed to middle- and upper-class whites,” more accessible and affordable. Unlike other treatments that must be administered every day in a clinic, buprenorphine is the first opioid addiction treatment that can be administered by family doctors and everyday pharmacies, according to Substance Abuse and Mental Health Services. Administration.
It’s not difficult to accidentally consume fentanyl.
Illicit drug tablets laced with fentanyl are often disguised to look like prescription pain pills. Many non-opioid drugs including marijuana and cocaine can contain fentanyl, unbeknownst to the people using it.
Recent research has pointed to huge racial disparities in synthetic opioid deaths, with death rates for blacks more than tripled from 2010 to 2019, compared with a 58 percent increase for non-Hispanic whites.
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More tests are needed to check for fentanyl
Across the country, opioid addicts who use illicit drugs rely on fentanyl test strips to tell if the substance they are about to take contains fentanyl.
“Imagine you went to a bar and ordered a drink and you don’t know if they made your cocktail with a tenth of a shot of booze or ten shots of booze, and the only way to tell is to start drinking and see how are you feeling,” Friedman said.
The strips use the same technology as workplace drug tests, are cheap, and prevent overdoses because the fentanyl they detect is so potent.
“There are all these things that it would be nice to avoid, so drug control is a very sensible way to mitigate the harm of a really, really toxic drug market,” Friedman said.
But paper test strips, which are considered drug paraphernalia, are illegal under book laws in nearly every state designed to crack down on illicit drugs.
Drug paraphernalia laws make people who use illicit drugs fearful of seeking help to do so safely because “they are seen as criminals,” said Alex Kral, an epidemiologist and drug policy expert at the nonprofit Research Triangle Institute. for profit in North Carolina.
In addition to test strips, a small number of harm reduction programs in the United States have machines called Fourier Transform Infrared Spectrometers that can test a drug and detect each substance it contains and its concentration.
If more places in the US could access the machines, Kral said, they could act as a surveillance system to alert the community when dangerous substances enter the drug supply.
“If you keep testing people’s drugs, you get a sense of what’s in the overall drug supply in the city, neighborhood, or town,” Kral said.
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What are Overdose Prevention Centers?
The lives of vulnerable people are at risk every day, Kral said, because opioid addiction and overdoses result from poverty, poor mental health and the availability of tainted drugs. It’s important that people on the fringes of society have a “trusted” place where they can go to use drugs more safely, she said.
In New York City, two sanctioned safe-drinking sites allow people who use drugs to test them for fentanyl without worrying about getting arrested. The sites, operated by OnPoint NYC, have prevented nearly 700 overdoses in the past year, Executive Director Sam Rivera told USA TODAY.
The sanctioned sites in New York City were the first of their kind in the United States, according to the Drug Policy Alliance.
“Imagine: We had 700 overdose preventions in just over a year,” Rivera said. “What if we had 5 sites, 10 sites? That’s 7,000, right?”
Contributors: Kevin Johnson, Ken Alltucker