According to figures from the U.S. Department of Health and Human Services, the opioid epidemic continues to rage in the United States, with an estimated 2 million people suffering from an opioid use disorder in 2018. One of the biggest challenges in combating this epidemic is the constantly changing face of the problem, including the rise of synthetic opioids such as fentanyl. Fentanyl addiction now accounts for more opioid deaths than prescription opioids, presenting new difficulties for the public health response to opioid addiction.
Tracing the Roots of the Opioid Crisis
Anyone who remembers the heroin epidemic of the 1960s and ’70s knows that the opiate problem in the United States is not new. However, the more recent crisis is different in that it cuts across gender, socioeconomic status, race, and other demographic factors. People of all backgrounds are equally affected by opiates.
The current opioid crisis traced its roots to the 1990s when pharmaceutical companies informed the medical community that there were no long-term risks of prescribing opioids for pain. As a result, physicians began to prescribe opiate painkillers at significantly higher rates. By 2012, medical providers wrote 259 million prescriptions for opioids, according to the American Society of Addiction Medicine. That is enough for each American adult to have their own bottle of pills.
Suddenly, patients began to receive opiate painkillers for all sorts of conditions, ranging from acute pain to injuries or surgery to chronic pain. As the opioid epidemic gained momentum, physicians had realized that the pharmaceutical industry had misled them. Prescription painkillers have harmful properties and are associated with high dependence and addiction rates. In 2018, the Centers for Disease Control and Prevention (CDC) issued new prescribing guidelines for physicians, and these guidelines intend to limit the widespread prescription of opioids.
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As opioid prescriptions decreased and local governments cracked down on illegal diversion of pain pills, vulnerable individuals turned to other opiates to fill the gap. A recent analysis of CDC data conducted by the Washington Post demonstrated that counties across the country moved through three distinct phases of the opioid epidemic: first, a spike in overdose deaths related to prescription painkillers, then heroin, and ultimately the synthetic opioid fentanyl. This progression suggests that people initially abusing prescription painkillers switch to other opioids when pain pills are no longer available.
Opioid Crisis Geography
Geographically, the opioid epidemic began in New England and the Midwest. New Hampshire, Vermont, Ohio, and West Virginia were particularly hard hit in the early 2010s. Now, the trend appears to be moving westward. For example, the Orange County, CA, sheriff’s department recently announced that the amount of fentanyl seized has doubled for the third year in a row. A recent report by the RAND Institute indicates that the synthetic opioid epidemic is likely to worsen before it gets better, mainly because the fentanyl market may become more widespread.
Across the United States, fentanyl now causes more opioid-related deaths than heroin or prescription painkillers. So what is it about fentanyl that makes it so deadly?
What Is Fentanyl?
Fentanyl is a synthetic opioid, meaning it is created in a laboratory. Like all opioids, it binds to particular receptors throughout the brain and body. Once there, it triggers a pain-relieving response. When used appropriately for a specific health condition, fentanyl is an effective painkiller. Patients with cancer or severe chronic pain can benefit from its powerful effects. Prescription fentanyl is available as a shot, a patch, or tablet. This medication is currently available by the brand names Duragesic, Fentanyl Transdermal System, Sublimaze, Abstral, Fentora, Lazanda, Ionsis, and Onsolis. Typically, illegally produced fentanyl is sold as a powder, which may be dropped onto blotter paper, put into nasal sprays or eye droppers, or made into pills.
There are several reasons that fentanyl is so dangerous. Firstly, it is incredibly potent. Fentanyl is 50 to 100 times more potent than morphine, meaning that a tiny amount can have a substantial effect. Secondly, like all opioids, fentanyl binds to receptors in the brain’s reward centers. It also binds to the areas that control essential functions, such as breathing, which means that even a small dose of fentanyl can cause slowed, shallow breathing or even cause breathing to stop entirely.
Finally, fentanyl is often used for lacing other drugs to promote a more potent high. Drug dealers often mix this drug with heroin, ecstasy, amphetamines, and cocaine. Even a tiny amount dramatically increases the potency of these drugs. However, the risk of using them is much higher, as the person using them may not be aware of their presence or potency. Combining all these drugs drastically increases a person’s risk of overdose.
Risks of Fentanyl Addiction
To understand how fentanyl addiction develops, it is essential to distinguish between opiate dependence and opioid addiction. Anyone who uses opioids (whether prescription pain pills, heroin, or synthetic opioids) will develop some degree of physical dependence over a long period of time.
Opiate dependence refers to increased tolerance and withdrawal symptoms, and it occurs because the body’s opioid receptors become accustomed to the presence of the drug. Over time, the person needs a higher dose of opiates to achieve the same painkilling effect or euphoria). Additionally, the body’s typical state of balance becomes disrupted. In other words, when opiates are not present, a person often starts experiencing withdrawal. Withdrawal symptoms include muscle aches, runny nose, anxiety, restlessness, difficulty sleeping, and excessive sweating. Withdrawal symptoms are incredibly uncomfortable and extremely hard to overcome.
People who try to quit opioids “cold turkey” often begin to experience withdrawal symptoms that become so unpleasant that they resume taking opiates to make the symptoms stop. In some cases, withdrawal can even be dangerous due to the effects of opioids on breathing and other central nervous system activity.
Effects and Abuse
In contrast to opiate dependence, which is a physiological process, addiction refers to a behavioral response to chronic opiate use. Fentanyl binds to receptors in the brain’s emotion centers, triggering a reward response. This reward is incredibly intense for some people and causes cravings and an intense desire to continue using the drug. People suffering from fentanyl addiction experience an intense craving for the drug, and they also go to great lengths to obtain and use the drug. Fentanyl users often fail to meet responsibilities, leading to legal troubles or relationship conflict. Cravings are also one of the most prominent symptoms separating opiate dependence from addiction. For example, a long-time user of prescription painkillers may have increased tolerance but not crave the pills.
Just as opiate dependence and addiction symptoms differ, so do the treatments. The only treatment for opiate dependence is to become opiate-free. Only after the body is cleared of opioid molecules, a process known as detoxification, can it begin to reset its average balance. In contrast, addiction requires mental health treatment. Many people addicted to opiates begin using them to numb pain associated with trauma, depression, and other sources of distress. Opiates mask the pain for a short period of time but are not a long-term solution. Thus, effective treatment for fentanyl addiction must address the root causes of addiction. Once a person has undergone detox, they are in a better mental space to engage in psychological and emotional treatment. By addressing these sources of pain, the person can move forward with a healthier life.
The crisis of fentanyl overdose continues to spread, people are dying at an unimaginable rate. The data is old and does not reflect the present tragedy that goes on every day; it’s inconceivable how bad things have gotten and how many people have died. We as a community can do more and we can do much better. _Clare Waismann RAS/SUDCc
Medically Assisted Opioid Treatment: A Path Forward
Given the large number of people suffering from opioid addiction, there is a solid public health need for medically assisted opioid treatment. Unfortunately, many rehab facilities do not provide this much-needed medical care, proven to be the first necessary step for those who want to overcome addiction.
According to the Substance Abuse and Mental Health Services Administration, 42% of addiction treatment facilities offer medication-assisted treatment (MAT). Although MAT is currently considered the gold standard treatment, there is always a great concern about its long-term opioid effects.
Waismann Method® is one of the most successful medically assisted opioid detoxification available. We treat each patient as an individual, assessing the unique health needs and emotional factors that may contribute to addiction. Our team of medical professionals is available to provide you with the help you need to get you where you want to be.
Waismann Method® Fentanyl Abuse Treatment
If you or a loved one struggles with opioid or alcohol addiction, it isn’t too late to get help. At the Waismann Method® Opioid Treatment Center, we offer effective medical detox for those suffering from opioid use disorder and alcohol dependence. For over 22 years, we have helped thousands of people from the United States and other parts of the world find freedom from opioid addiction. We perform all of our detox services in a full-service, accredited hospital. An opioid detox in an accredited hospital provides a safe, dignified and comfortable setting for this private medical event. Furthermore, because our patients go through acute withdrawal in a hospital setting, nearly 100% achieve complete detoxification.
Once detox is complete, opioid-free patients are in a better emotional and psychological state to undergo assessment and diagnosis to address the root causes of their addiction. Additionally, opioid-free patients are more likely to complete and succeed with mental health treatment. The Waismann Method Medical Group provides personalized opioid detoxification and aftercare services by joining forces with the Domus Retreat. Our comprehensive approach gives our patients the best chance for a healthy, lifelong recovery from opioid addiction.
We understand you might be feeling shame, doubt, and distress, and we also understand that fentanyl addiction is not who you are but a condition you suffer from. We take an effective medical approach rather than casting blame and punishing people for their fentanyl addiction. We reverse physical dependence and help individuals overcome their struggles. Contact us today to learn how we can help you or your loved one achieve freedom from fentanyl addiction.