Fentanyl: ‘We are in perfect storm for trouble’
(Editor’s note: This is the first in a series of articles about the fentanyl crisis that has killed thousands of people in Oklahoma and across the nation.)
By John Dobberstein, Editor
Cole Brown had his share of struggles as a teen-ager but was looking forward to the future. He’d graduated from high school in California a month ahead of his class, and he and his Mom and her parents were getting ready for a new start in Oklahoma.
Having already cheated death once from taking Percocet that was likely laced with fentanyl, Cole was especially looking forward to the move. He talked about getting a rescue dog and his grandfather wanted to help Cole buy a house.
But the pull of addiction was too much. On the day before they were to move, Cole died. That night he’d been kicked out of his grandparent’s house for vaping. He got a hotel room and bought what he was told was legitimate medication.
Aware of the danger, Brown texted to the dealer he didn’t want fake drugs. But the dealer, using a fake name, had given him Percocet laced with fentanyl and Cole passed.
“I know for a fact that Cole had no intent of having that happen to him. He did not want to die,” Rebekah said. “If he would have gotten just a Percocet, like he asked for, I know Cole would be here today.”
‘We’re in a epidemic’
Broken Arrow is perhaps the “it” suburb to live in the metro area, with its thriving Rose District, Bass Pro Shop and burgeoning Hillside Drive retail center and award-winning high school marching band and sports teams – and very few incidents of violent crime compared to Tulsa or Oklahoma City.
But Broken Arrow police and firefighters, along with health care providers, addiction clinics and families have been fighting a draining battle against fentanyl – a once obscure, expensive opioid that is turning lives upside down in households of all races, backgrounds and incomes.
Public safety officials, elected officials and school leaders in Broken Arrow and most other communities are concerned about what’s happening in homes, schools and on the streets.
When the Broken Arrow Police Department hosted a forum about fentanyl earlier this year, first responders said they often find themselves on the frontline of the epidemic. Officers alone have deployed Narcan – the ‘miracle’ drug that can revive overdosed people – an astounding 184 times. This year, as of July, they had already deployed it 176 times and they’re on a pace to easily break last year’s numbers.
Broken Arrow Mayor Debra Wimpee, who met with some local mothers whose children were victims of the substance, declared in October that there is an epidemic that is ongoing in the city and it’s borne out by the numbers shared by police and firefighters.
The city of Broken Arrow released its own series of PSAs about drug dangers working with the support group Families Supporting Families.
Some families who’ve been affected by drug deaths have complained about a lack of support from school districts. But this fall, Broken Arrow Public Schools Supt. Chuck Perry and Union Public Schools Supt. Kirk Hartzler released a public service announcement as part of the
#onepillcankill campaign, warning of the dangers of drugs and imploring parents to ask their children about what they’re seeing or hearing in their school or from their friends.
Some Families Supporting Families members have been going to area school districts in the state to speak to students and lobbying municipal leaders and state lawmakers for help.
Many people are being sickened or killed by fentanyl exposure because more established drugs like meth or heroin are being laced with it or they’re taking pills that look like another drug they’re taking but contain fentanyl. That could be fatal, even if minute amounts are ingested.
The fake pills are designed to appear identical to legitimate prescriptions such as Oxycontin, Percocet, Vicodin, Adderall, Xanax and other medicines.
Criminal drug networks are selling the pills through social media, e-commerce, the dark web and existing distribution networks. As a result, these fake pills are widely available.
What is fentanyl?
Fentanyl is a synthetic opioid that was first developed in 1959 for pain the management. Fentanyl is extremely potent – 50 times stronger than heroin and 100 times stronger than morphine. Medical fentanyl can be found in the form of liquid, powder, patch, tablet or lozenges.
Illicit fentanyl may be in powder, liquid or pills that mimic other medications. Drug dealers mix fentanyl with other drugs like heroin, cocaine, methamphetamine and MDMA because it takes less product to produce a “high,” making it cheaper to produce.
Currently fentanyl is the second most common drug and the most common opioid drug involved in overdose deaths, according to the Oklahoma Bureau of Narcotics (OBN).
Midst of an epidemic
Donnie Anderson, OBN’s director, said Oklahoma is in the midst of a “drug abuse and overdose epidemic,” with drug overdose deaths far exceeding vehicular and firearms fatalities.
Oklahoma has logged more than 1,300 overdose deaths in the last 5 years in Oklahoma, of which over 500 are fentanyl related, Anderson said.
“We’re in the third phase of the epidemic right now,” Anderson said. “Here in Oklahoma you are more likely to have an overdose death than to be shot and killed by a firearm. I don’t think saying that is anything for us to be proud of.”
It’s not lost on physicians that fentanyl has a legitimate medical use. It’s a synthetic opioid first developed in 1959 for pain management: it’s 50 times stronger than heroin and 100 times stronger than morphine. Medical fentanyl can be in the following forms: liquid, powder, patch, tablet or lozenges.
Illicit fentanyl may in powder, liquid or pills that mimic other medications.
The DEA in 2021 issued a Public Safety Alert on the widespread drug trafficking of fentanyl-laced fake prescription pills in American communities. The agency recently revealed that its lab testing showed 6 out of 10 fentanyl-laced fake prescription pills analyzed in 2022 contained a potentially lethal dose of fentanyl.
This is an increase from 2021 when the DEA found the same for 4 out of 10 of pills.
DEA administrator Anne Milgram said fake pills are being mass-produced by the Sinaloa and Jalisco cartels in Mexico and are designed to look identical to real prescription medications, including OxyContin, Percocet and Xanax.
In 2021, the DEA seized more than 20.4 million fake prescription pills. Earlier this year, the DEA conducted a nationwide operational “surge” to target the trafficking of fentanyl-laced fake prescription pills and, in just over three months, seized 10.2 million fake pills in all 50 states.
Naloxone, known commercially as “Narcan,” has been about the only line of defense against fentanyl overdoses.
Along with police, the Broken Arrow Fire Department is on the frontlines of responding to patients who ingested fentanyl, oftentimes unknowingly.
Most overdoses are among those who are opioid tolerant that have experience with them, said BAFD Assistant Chief Mark Steward, who’s been with the department 18 years and certified as a paramedic for more than 20 years.
“Illicit fentanyl has turned substance abuse disorder into Russian roulette. You don’t know what you’re taking,” Steward said during a fentanyl forum hosted by the Broken Arrow Police Department. “This is very much a human issue, concerning mental health, addiction and treatment of those issues. You have stresses on society and (fentanyl) is the strongest narcotic we’ve ever seen. So when you put those together we’re in a perfect storm for trouble.”
Eye of the storm
Paramedics on scene for a possible overdose typically assess and treat the airway and breathing status of the patient and if can deploy Narcan for a suspected overdose, but Steward notes the department rarely gets reports back from hospitals about it. “But we do know we’re seeing overdoses,” he said.
Overdose deaths in Oklahoma far exceed vehicular and firearm fatalities and are one of the top 10 leading causes of death in the state. Opioid abuse has led to over 1,300 overdose deaths in Oklahoma in the last 5 years, of which more than 500 were fentanyl related.
As of July, Broken Arrow police were running at 50% more medical overdose calls then were noted at the same time in 2021. But overdoses do not automatically mean death, just as drownings do not necessarily mean a person died in the water.
Broken Arrow Police Det. Eric Nester, the shift supervisor for the patrol division and a certified EMT for 18 years, has been handling medical liaison needs for the department for officers who encounter overdoses as they respond to calls.
Nester said there was a large surge in Narcan deployments at the end of 2021, with about 1 per month. But what was concerning was that from Thanksgiving to New Year’s Day there were more deployments than the previous 10½ months. “That should get everyone’s attention,” he said.
The biggest problem is the emergence of counterfeit pills on the market that are made to look like legitimate medications, which prompted him to call some community organizations to do some training to prevent potential exposure.
Often the fentanyl pills or meds laced with it look like oxycontin, Percocet, Vicodin, Adderall or even Xanax or Alprazolam.
Criminal drug networks are selling the pills through social media, e-commerce, through the “dark web” and existing distribution networks – so they’re widely available.
People are buying the pills on the street to abuse or self-medicate. “Either way, they’re not getting what they’re thinking they’re getting,” Nester said.
Statistics from Drug Enforcement Administration (DEA) lab testing shows that 6 out of 10 fentanyl-laced fake pills contain a potentially lethal dose of fentanyl, and the number of fake pills identified as containing fentanyl has jumped by 430% since 2019, he noted.
“We’ve also had people who weren’t even taking opiates but bought pills on the street, which they weren’t from the pharmacy, and it was laced with or completely fentanyl and overdosing, not thinking they were taking an opiate at all,” Nester said. “It’s an issue and our officers are having to make interventions to give people the best chance that they have to survive these overdoses.”
The importance of Narcan
The advantages of Narcan, Nester said, is that officers have open access for treatment through the nose and no invasive procedures are needed for treatment. After the drug is sprayed, officers typically do CPR to circulate the spray through the person’s system.
All police officers and jail personnel have training on administering Narcan, as do public safety dispatchers who may be walking 911 callers through the process.
“People will ask us, ‘If someone is unconscious and not breathing, how does spraying something up their nose help them out?’ Once we spray and do life-saving measures, it knocks the opioid off the receptor, taps the receptor and gives us a fighting chance to stop that overdose where it is and get some interventions from people at the hospital,” Nester said.
“Some people will choose to have it at their house if a family member is using opioids and has chance of an overdose.”
Having seen Narcan bring her son back to life, Rebekah said every parent should have at least four doses on them whenever possible, “because a lot of parents think, ‘It isn’t going to be my kid. But what if it is? And you could save them.”
“I have it in my cabinets at home. I have it in my purse. I take it with me because it could save a life.”