NEW YORK (AP) The too-familiar yet still alarming rise in overdose deaths can no longer be blamed on heroin — at least not on heroin alone.
Fentanyl, a man-made pain reliever, is the new killer drug.
Cheaper and stronger than heroin, fentanyl has been driving an increase in overdose deaths since 2013, federal data revealed this year. The white powder, largely imported from China, is now so commonly found in illicit drugs in the Capital Region that those responding to overdoses or trying to prevent them just assume that’s what they’re dealing with.
“I hear estimates that eight or nine out of 10 bags of heroin these days are going to have fentanyl in them,” said Joseph Filippone, director of Project Safe Point, an Albany-based syringe exchange program.
Fentanyl is a synthetic opioid that is administered legally by doctors during surgical procedures, or in small doses during colonoscopies and endoscopies, said Dr. Charles Argoff, a pain specialist at Albany Medical Center. It may also be used, typically in a transdermal patch that releases the painkiller slowly, for patients with severe pain who need round-the-clock relief and have already developed a tolerance to less potent opioids, he said. Other forms of fentanyl are used for cancer patients who experience breakthrough pain despite being on other medications.
But when fentanyl is mixed with illicit drugs and injected, the potent pain reliever gets to the bloodstream fast. Federal health agencies estimate that it is 50 to 100 times stronger than heroin.
That means it is more likely to kill, especially if users do not know what they’re getting. Batches of fentanyl-laced heroin have been known to cause clusters of overdose deaths when they’ve turned up on the street.
Fentanyl’s deadliness frightens some drug users, while it entices others with the potential to get high after they’ve built up a tolerance for heroin. But increasingly, fentanyl is the drug that users are becoming addicted to; they seek it not for euphoria, but just to avoid getting sick from withdrawal, Filippone said.
The potency of the drug makes it tougher for community-based programs like Project Safe Point to prevent overdoses. The opioid antidote naloxone, known as Narcan, can be effective, but it may take a half-dozen or more doses to reverse the effects of fentanyl, as opposed to a single shot to override heroin.
And despite efforts to curb opioid use, overdose deaths keep rising. For 2015 and 2016, the latest years for which data is available, opioid overdose deaths statewide outside of New York City spiked from 764 to 1,879. Local experts say the data from 2017 will only be worse.
“I live it every day,” said Albany County Sheriff Craig Apple. “Trust me, it’s not getting any better.”
Project Safe Point sees the problem throughout a 12-county region.
“I’ve heard about an increase in deaths across all of them, from last year,” Filippone said. “It’s safe to say that what we’re doing isn’t stopping anything.”
Project Safe Point is focused on harm reduction — not eliminating drug use but limiting its harmful effects. The program is looking into distributing fentanyl test strips to users along with clean supplies. The strips, in use in other communities across the country, detect the presence of fentanyl in a batch of drugs.
“What we’re understanding is happening is that people who know there’s fentanyl in it are using less or going slower,” Filippone said.