By Caitlyn Meisner | Staff Writer
In Texas, 1,672 opioid-related overdose deaths were recorded in 2021. All of these revolved around fentanyl — a highly addictive and lethal opioid, according to provisional data from the Texas Department of State Health Services.
Of all the opioid-related deaths among children and adolescents aged 0-17 in 2020, 92% involved a synthetic opioid like fentanyl. It takes 2 milligrams for the drug to be potentially lethal.
Pharmaceutical fentanyl is a Schedule II drug that is medically approved for treating severe pain, like morphine. Schedule II means the drug has a medical use under the Controlled Substances Act of 1971.
Dr. Jacques Nguyen, assistant professor of psychology and neuroscience, said legal fentanyl is not something to be scared of.
“Fentanyl is not some sort of ‘boogeyman’ drug that came out from the shadows,” Nguyen said. “It’s something that has been in use, and under proper guidance, monitoring and dosing, it’s a very useful tool to help people.”
Dr. Lara Hwa, assistant professor of neuroscience, said the benefits of painkillers cannot be overlooked, but there is a crisis in the U.S.
“Pain relief is meant to do a lot of good for society, and we shouldn’t necessarily overlook that,” Hwa said. “These drugs aren’t supposed to be taken off-prescription or off-label, which is problematic and leads to our issue.”
Hwa said the potency — or the amount needed to achieve behavioral effects — is much higher than that of other painkillers like morphine.
“Pharmacology-wise, you need a lesser dose [of fentanyl] to get the same pain-relieving effects, which can lead to overdose,” Hwa said. “As an example, you might have 0.1 milligrams of fentanyl that would achieve the same pain relief of 10 milligrams of morphine.”
Hwa also said it is not possible to tell if another drug is laced with fentanyl.
“One would need to be able to test for opioids, and special equipment would be needed,” Hwa said.
In recent months, national and state government organizations have issued health advisories about the potential risk of multicolored or “rainbow fentanyl.”
The Texas Department of State Health Services issued an advisory on Sept. 20, stating the federal Drug Enforcement Administration had seized multicolored fentanyl pills in at least 18 states.
According to the Drug Enforcement Administration, fake pills are created and falsely marketed as legitimate prescription pills and can be easily purchased; these pills are often made to look like real prescription pills to deceive customers.
Nguyen said this phenomenon is not new or unique to counterfeit fentanyl.
“We know this is a mechanism for distributors to manufacture and distribute their drugs,” Nguyen said. “Historically, we know that counterfeit pills have arrived in different colors. Colored pills are not unique.”
Nguyen said there is less incentive for drug dealers to place doses of fentanyl in children’s candy because of greed.
“It’s about making profit; it’s about selling as much as you can,” Nguyen said. “I think the idea of nefarious drug dealers slipping fentanyl pills into Halloween baskets or bowls is probably unlikely, [but] I’m not going to say it’s impossible.”
Nguyen said drug dealers giving fentanyl pills to children for free in the hopes that they will become customers later in life is not as much of a risk as people abusing and leaving the drug around for children to misuse.
Currently, there is a medication known as naloxone, or Narcan, that can reverse an opioid overdose, including that of fentanyl.
According to the Centers for Disease Control and Prevention, naloxone can reverse an overdose and restore normal breathing in two to three minutes; the effect of naloxone may take longer with stronger opioids like fentanyl. This drug is not harmful, and the CDC compared it to carrying an EpiPen.
Nguyen said there are misconceptions surrounding the use of naloxone.
“They assume that it’s just like any other opioid,” Nguyen said. “That’s not the mechanism in which Narcan works. It’s an antagonist — or it’s a blocker — of these other opioids.”
Nguyen also said the issue of fentanyl overdose is very important, but there must be a basic understanding the issue to properly address the crisis.
“It’s not something to ignore, but it’s not something to create hysteria or induce unnecessary panic,” Nguyen said. “Baylor has the opportunity to lead the way [in the local community], and I think the students are doing a great job in terms of voicing their concerns about substance use and opioid abuse.”
