Development of the opioid crisis and raising awareness around fentanyl

Nov 18 - Written by Lee Ables and Sarah Duval

This blog post is part two of a series that will cover different topics related to drug use and addiction, also known as substance use disorder, as it pertains to older adults. CELJ has received funding from the opioid settlements to work with adults ages 50 and older who have been impacted by drug use. The Substance Use Awareness and Advocacy Program for Older Adults seeks to provide education, outreach, and civil legal representation for this population. We will explore these topics in an informative and compassionate manner and intend to be a continued resource for the community no matter where an individual may be on their journey with substance use. This funding has been made possible through the hard work and dedication of many to hold pharmaceutical companies responsible for the hand they have played in the opioid crisis. We commemorate the lives that have been lost due to this crisis as we work together to put an end to the continued harm inflicted on our community. With this goal in mind, part two of this series aims to dispel some of the myths around drug use and offer resources so that individuals who may be experiencing this can make informed decisions. 

MYTH: Fentanyl isn’t my drug of choice, so I don’t have to worry about the risks associated with using it.    

  The second part of this series is focused on raising awareness around the progression of the opioid crisis. According to the CDC, from 1999-2022 nearly 727,000 people died from an opioid overdose. This includes overdose deaths involving prescription and illegal opioids.  It is generally accepted that there are four waves of the opioid crisis: 

• First Wave – 1990s: Overprescribing of opioids- pharmaceutical companies misled medical professionals by stating these medications weren’t addictive, and doctors overprescribed them even when they weren’t medically necessary.  This combination is seen as the catalyst for millions of Americans being impacted by opioid use disorder, opioid dependence, and the waves that follow.  

• Second Wave - 2010s: Increased regulations to combat overprescription and stem the tide of rising dependence on opioids leads to opioids being more difficult to obtain through prescriptions.  As individuals are cut off their prescriptions, facing debilitating withdrawal some turn to illegal opioids like heroin leading to an increase in overdose deaths from the use of heroin.  

• Third Wave – mid-2010s: Heroin is replaced by fentanyl being the leading contributor to overdose deaths  

• Fourth Wave – 2020s: Addition of fentanyl into all other substances, especially stimulants  

Nationwide, including Erie County, the majority of overdose deaths are now from fentanyl being mixed into a stimulant, such as cocaine or methamphetamines. The importance of this distinction in the fourth wave is clear, it is known that poly-substance use puts someone at an increased risk of a deathly overdose, and fentanyl is now reaching individuals who may not have intended to use it. Fentanyl is significantly more powerful than other types of opioids, and can be impossible to detect through sight, taste or smell if mixed into or posing as another substance.  

When people who use drugs are unaware of what is in the substances they are using, the risk for death and overdose significantly increase.  However, test strips are now available which will show if fentanyl has been mixed in with a drug, preventing unintended overdose.  Testing your drugs for fentanyl can be a lifesaving practice.  

 Another intervention to be aware of and always keep on hand is naloxone, commonly known as Narcan.  Naloxone aids in the overdose prevention of heroin, fentanyl, oxycodone, and morphine.   

Test strips and Narcan are available for free through the Erie County Department of Health and can be found here:  https://www3.erie.gov/health/fentanyl-test-strips | https://mattersnetwork.org/supplies/#vendingmachines | https://mattersnetwork.org/wp-content/uploads/2023/12/Vending-machine-one-pager.png

They are available in the 1st Floor Lobby at the Rath Building, 95 Franklin St, Buffalo, NY 14202. You can order them online at the Erie County Department of Health website, call (716)858-7695, text (716)225-5473, or email harm.reduction@erie.gov.  

If there are barriers to accessing these services, CELJ is here to help, Call us at (716)853-3087 or email lables@elderjusticeny.org.