Tom Petty. Prince. Mac Miller. These music artists have made headlines over the last five years due to the growing impact of fentanyl abuse. Almost unheard of 30 years ago, fentanyl has rapidly become one of the most abused prescription drugs on the market. From 2010–2017, fentanyl-related deaths increased by 45%.1 In 2019 alone, federal health authorities counted over 37,000 fentanyl overdose deaths, and they say that the opioid crisis has gotten worse during the coronavirus pandemic. Teens and young adults (ages sixteen to thirty) are most at risk for prescription drug misuse, overdose, and death.2
As a synthetic opioid pain reliever, fentanyl treats pain in cancer patients and those with severe pain who have built up a tolerance to other opioids. For reference, fentanyl is fifty to one hundred times more potent than morphine.3 It’s prescribed as a shot, skin patch, or lozenge.
Fentanyl’s brand names include:
We will use the both “fentanyl” and “Fentora” to refer to this synthetic opioid. Legal forms of fentanyl can also resemble a tablet, spray, or lollipop. Illicitly manufactured fentanyl (IMF) often hides in mixtures with other drugs like heroin or cocaine. In its purest form, it resembles a powder or tablet.4
Fentanyl is considered a Schedule II drug in the U.S., a class of drugs considered dangerous by the Drug Enforcement Administration (DEA) due to a high chance of abuse and dependence. Other examples of Schedule II drugs include Vicodin, cocaine, OxyContin, Adderall, Ritalin, and meth. These synthetic opioids have become the primary source of drug overdose deaths in the U.S., with fentanyl overdose topping the list of offenders.
Unfortunately, fentanyl deaths increased from 2011–2018, likely in tandem with a growth in drug trafficking from Transnational Criminal Organizations (TCO) in China, Mexico, Canada, and the Caribbean.4 According to a DEA report, a single kilogram of fentanyl can transform into $1.5 million for traffickers and prove deadly for up to 500,000 people.5
Fentanyl was first created in 1959 and began circulating as an anesthetic during the 1960s. Initially applied intravenously; doctors eventually developed a fentanyl patch applied to the patient’s skin.6 In recent years, fentanyl prescriptions decreased from 6.5 million in 2015 to 4 million in 2018.7 Fewer prescriptions are one way healthcare practitioners are trying to address the growing opioid abuse problem in the United States.
Since the 1990s, legal fentanyl has become a black market item. Around that time, opioid prescriptions began to increase, and with them came a boom in opioid abuse. The second wave of abuse hit the U.S. around 2010, and the third wave in 2013 proved especially deadly.8
One kilogram may not sound like much, but therein lies its deadly nature—it doesn’t take much to ingest a lethal dose of Fentora. Unlike approved pharmaceutical forms of the medication, like the fentanyl patch, illegally manufactured Fentora (IMF) isn’t regulated, so you may not know exactly how much you are getting. Additionally, IMFs are often unknowingly combined with other drugs. Even if an overdose doesn’t occur, fentanyl is highly addictive.
Opioid related overdose deaths were four times higher in 2018 than in 1999, and nearly 68% of drug overdose deaths in 2017 were related to opioids.8 The 2017 numbers include increases across demographics like age, race, and region, showing that Fentora does not discriminate.
In just two years, from 2016 to 2017, synthetic opioid overdoses rose by 45.2%, plus another 10% between 2017 and 2018.9, 10 As mentioned earlier, even wealthy celebrities are not immune. Rapper Mac Miller, singer-songwriter Tom Petty, and pop artist Prince all died from accidental fentanyl overdoses.
Fentora provides a high similar to that of heroin and morphine. Chemically, it hitches onto opioid receptors in the brain that manage pain and emotions.11 Short-term fentanyl side effects include:
When Fentora repeatedly enters the body, the brain rewires, needing more of the drug to feel pleasure. Eventually, the brain is triggered to crave the drug by unrelated things it associates with the high.
When a lethal dose of fentanyl is accidentally or intentionally ingested, pupils will become tiny, and cold, sweaty skin will turn a bluish tint. If left untreated, breathing will slow to a dangerous rate (a condition called hypoxia), and there is an increased risk of coma, brain damage, and death. Call 911 immediately if you notice any fentanyl side effects. A medicine called Naloxone can treat a Fentora overdose if it’s given right away. If you have a friend or loved one who you suspect has an opioid use disorder, you may be eligible to receive a personal prescription of Naloxone to keep on hand.
Fentanyl withdrawal symptoms are very unpleasant and can contribute to a hesitancy to seek treatment. Symptoms include:
Most, if not all, people with an opioid use disorder need help with recovery from the addiction.
Substance use disorders can begin as dependence and develop into an addiction. Common signs of an opioid use disorder are usually related to changes in behavior. There may be signs of fentanyl side effects, such as elation, drowsiness, or nausea. If fentanyl withdrawal symptoms occur, they will have difficulty sleeping, keeping food down, and managing their physical pain. Fentora addiction also presents compulsive and erratic behaviors. A common side effect of substance use disorders is compulsively seeking the drug, even when issues arise personally or professionally.
According to the National Institute on Drug Abuse, opioid addiction is very treatable, but it’s a multi-step process. The goal of treatment is to stop drug use, help maintain a drug-free life, and improve relationships and careers.
Most recovery plans begin with a medically assisted detox. This treatment is only the first step in the recovery journey, and detox without ongoing supports and therapies usually results in relapse. Most detox programs incorporate medicines to help ease withdrawal symptoms, which can make behavioral treatment more comfortable. Several medications have proven to treat symptoms of Fentora addiction effectively. These medications include:
Additionally, a small electrical nerve stimulator called the NSS-2 Bridge can reduce withdrawal symptoms when secured behind the ear.
After detox, inpatient rehabilitation programs are beneficial to ongoing recovery success. These programs typically take place at licensed residential treatment facilities with around-the-clock care and therapy. Inpatient treatment lasts between one to three months, after which you can opt to transition into a therapeutic community (six to twelve months) or recovery housing. Outpatient treatment is another viable option, and involves intensive therapeutic sessions at a hospital several days a week. An FDA approved mobile app is also available. It’s called reSET, and it provides cognitive behavioral therapy (CBT) in tandem with outpatient treatment. CBT helps manage stress, change personal outlook, and overcome negative thought patterns.
Other effective behavioral treatments can address both the addiction and any underlying mental health issues. Besides CBT, different approaches include Contingency Management, which uses a point-based system to encourage healthy choices, and Motivational Interviewing, which deals with any mixed feelings about change. Ultimately, the most effective recovery plan includes lifetime community and family support.
Gregory Ng is the CEO of Brooks Bell. In his nearly 25 years in marketing, Greg has created innovative solutions leading to digital and cognitive transformations for the biggest high-tech, retail and financial brands in the world. Greg adds knowledge in marketing strategy, content production, and brand awareness to the AHV advisory board.
Hunt Broyhill holds several positions within the Broyhill family offices and serves as President, Chairman, and Chief Executive Officer of BMC Fund and Chief Executive Officer of Broyhill Asset Management. Hunt brings valuable experience in capital allocation, real estate, and investor relations to the AHV advisory board.
Alan Hughes was formerly the Executive Vice President and Chief Operating Officer at Blue Cross and Blue Shield of North Carolina. In addition to BCBS, Alan held officer positions in both operations and technology at GE Commercial Finance, Deutsche Bank, and American Express. Alan brings a unique combination of efficient process design and technological problem solving to the AHV advisory board.
Lynn is the CEO of Broadstep. Previously, Lynn held various roles in both healthcare and finance where she oversaw multi-site, multi-state organizations within primary care, acute and chronic services, hospitals, and pharmacies. Lynn brings valuable experience in healthcare leadership, recruiting, and growth strategy to the AHV advisory board.
John Roos is the retired Senior Vice President and Chief Growth Officer for Blue Cross and Blue Shield of North Carolina. Under Roos’s tenure, the company’s revenue grew from $1.5 billion to $9.5 billion, while adding 1 million members. John brings valuable experience in growth strategy, enterprise sales, and provider contracting to the AHV advisory board.
Dr. Hendree Jones is the Executive Director of UNC-Horizons and an internationally recognized expert in behavioral and pharmacologic treatments for pregnant women and their children. Dr. Jones has received continuous funding from the National Institutes of Health since 1994 and has over 200 peer-reviewed publications. Dr. Jones is an advisor to the UN, WHO, SAMHSA, ASAM, and ACOG through which she consults throughout the United States and internationally. Dr. Jones brings valuable experience in grant writing, research, and healthcare administration to the AHV advisory board.
Brad is the CEO Emeritus for BCBSNC and Chair of the BCBSNC Foundation. He served as Gov. Jim Hunt’s general counsel and is a past chair of the UNC Board of Governors. Brad serves on numerous public and private boards and is a lifelong North Carolinian with degrees from Appalachian State, Wake Forest, and Duke. He brings valuable experience in healthcare, law, higher education, and politics.
Jake Summers is a passionate entrepreneur who is dedicated to bringing the energy of change to existing healthcare business models and making higher quality healthcare more accessible. Jake co-founded a mango farming/export company in Cambodia and serves as an advisor for a number of small businesses. Jake is the co-founder of Advaita Integrated Medicine and is the Development Director and a Partner of Green Hill.
Tripp Johnson is a serial healthcare entrepreneur who’s dedicated his post-military professional life to serving young adults. He is the co-founder of Advaita Integrated Medicine, Advaita Health Ventures, and Green Hill Recovery. Tripp is passionate about making quality healthcare more affordable and accessible through innovative business models and technology-focused solutions.