Fentanyl was recently described by a DEA administrator as "the single deadliest drug threat our nation has ever encountered." National statistics show that this illicit drug accounts for more than half of overdose deaths nationwide. Drug and alcohol mortality rates in Orange county thankfully remain slightly lower than in California as a whole, and well below national trends. But this is still no cause to rejoice - in 2020, the Orange County Healthcare Agency recorded that 648 people died from the effects of drug abuse.
Overdose and Hospitalization Rates for Opioid Use
The pandemic caused a spike in drug and alcohol use throughout the nation, and Orange County was not spared its effects. Not only did drug and alcohol abuse increase significantly, the climate of anxiety and the hardships stemming from COVID-19 aggravated mental health disorders in the county too. To this was added the ongoing opioid crisis, which continues to worsen.
While hospitalization rates for drugs and alcohol have thankfully remained fairly stable in Orange county for many years, ED visits for opiates and opioids reached an all-time high in 2019, and account for more than four times visits for any other type of drug. And while stimulants like methamphetamine seem to similarly affect all Orange County residents regardless of ethnicity, non-hispanic whites and citizens of the 'other/unknown' category are far more impacted by synthetic opioids like fentanyl compared to other ethnic groups.
Read more: Fentanyl Detox
The Insidious Infiltration of Fentanyl
Fentanyl is now present in every corner of the US. In the words, once again, of DEA administrator Anne Milgram, "Fentanyl is everywhere. From large metropolitan areas to rural America, no community is safe from this poison." One problematic issue is that other drugs are increasingly cut with fentanyl, so that it finds its way into multiple other substances too. Users are often unaware their illicit drugs are laced with fentanyl. But they will face the consequences nevertheless - due to its highly addictive nature, even tiny amounts of fentanyl increase the risk of substance abuse issues developing.
Law enforcement authorities in Orange County have expressed concern that the drug has become so prevalent, and warn that, "Fentanyl is infiltrating our communities through counterfeit pills, cocaine and any other street drug you can name." Since 2019, overdose deaths have risen in the county across all age groups - though adults aged 45-54 remain the most at risk.
The male population of Orange County seems the most severely impacted. In 2020, male ED visits for alcohol and drugs were almost double that of females. And in the year ending May 2020, male overdose deaths had increased by 42%.
Fentanyl and Other Opioids Impacting Quality of Life
The pandemic saw an increase in drug overdoses across the nation. But even though substance use disorders worsened during this period, many of those affected by the condition or struggling with addiction were reluctant to seek treatment. COVID-19 restrictions affecting mobility, and anxiety regarding being around other people in healthcare facilities (fear of the risk of contamination), may have played a part in this.
Fentanyl is a synthetic opioid up to 300 times more powerful than morphine, and 50 times more potent than heroin. It therefore has an exponentially high potential for abuse, and a single dose may sow the seeds of a substance use disorder. People using fentanyl as their primary drug are contributing to rising addiction rates too.
Within Orange County, various risk factors may contribute to developing a drug addiction to fentanyl. Age group and ethnicity - as mentioned above, the Asian community and Hispanics are at a significantly lower risk than non-hispanic whites and those of unknown or other ethnicity, with the black population somewhere in between. But location also seems to play a part, with more opioid related deaths and hospital visits along the coast and in the south of the county. Indeed, regarding mortality, data shows an almost unbroken line of California cities, from Seal Beach to San Clemente, with mortality rates higher than anywhere else in the county.
In California, the rise in deaths caused by opiates and opioids between 2019 and 2020 was greater than for any other substance. The next biggest culprit were synthetic stimulants, followed by cocaine (classed separately).
An important step from a government perspective in preventing the further spread of fentanyl, and more overdose deaths from it and other synthetic opioids as a result, is information. People's educational status nowadays around the dangers of drug abuse is fairly high. But the extreme potency of fentanyl is something many people have not grasped. Nor are many aware of how often the substance is mixed with other drugs sold on the streets.
Once a person's fentanyl use habits have become firmly entrenched, a treatment program is generally the only way to enter recovery. California has many inpatient facilities, which are recommended as the most supportive environment for a person beginning treatment. Withdrawal is an inevitable and painful part of the process of becoming sober, one that can be dangerous if done without medical supervision.
During withdrawal, a person coming off fentanyl will experience similar symptoms to those caused by heroin and other opioids, such as:
- sweating and chills
- spasms, aches and pains
- upset stomach and stomach cramps
- disturbed sleep patterns, insomnia
- rapid heart rate, hypertension.
These symptoms can cause the subject considerable suffering, including severe drug cravings. This is why a medical detox is recommended, without which a person may feel so bad that more drugs may seem like the only solution. In a medical environment, doctors may decide to use prescription drugs such as buprenorphine, or sometimes methadone, to ease discomfort while the person's body rids itself of the illicit drugs in the system. Most treatment facilities offer medical detox, and indeed it is always the first part of treatment programs for synthetic opioids.
Once the detox process is complete, the next stage of treatment can begin. While medication does exist to help taper people off the use of opioids using FDA approved prescription drugs (as mentioned above), these only help the body transition from reliance on drugs. For long term recovery, a person's mental health and their behavior around drugs need to change. Behavioral therapy is based on the idea that most behaviors are learned, and can therefore be re-learned and changed. It is considered one of the most powerful approaches for treating substance use disorders, and some mental health disorders too, and can be an indispensable tool in supporting long-term recovery.
Many people with a substance use disorder often move on to outpatient treatment programs after a rehab or treatment center, in order to consolidate their recovery.
While all addictions are best treated in their early stages, before a person's drug abuse habits become too entrenched, this is particularly true for synthetic opioids like fentanyl. The long term dangers to health, not to mention short term consequences, are just too great not to take very seriously. However, it's also never too late to reach out for help. At Cornerstone, we meet each person at whatever stage of their journey away from drugs they are at. If you or a loved one are suffering, the combined decades of experience of our compassionate staff can help set you on the road to freedom.