Fentanyl makes fight on opioids crisis harder than ever

By: Dustin Racioppi
Trenton Bureau
USA Today Network - New Jersey

..... While the Murphy administration plots exactly how to spend $641 million from drug companies for their roles in the opioid epidemic, New Jersey faces a deadlier and more pervasive threat from fentanyl than it ever did from painkillers and heroin, according to advocates, expects and law enforcement.
..... The synthetic opioid is now found in virtually every drug on the street and was the leading cause of drug overdose deaths in 2018 and 2019 in New Jersey, according to the latest data form the state medical examiner. It is cheap, magnitudes more potent than heroin and reshaping notions of how to cut down abuse and deaths rates that have skyrocketed.
..... Whereas the Christie administration focused more on expanding treatment to those struggling with addiction, the Murphy administration has emphasized so-called harm reduction methods, which include broad social services and an approach by government and organizations to meet drug users"where they're at."
..... Advocates and experts say the windfall from opioid manufacturers would be best spent on expanding harm reduction programs like syringe exchanges and increasing the availability of fentanyl test strips; limiting or even abolishing criminal penalties for low-level possession offenses; and waging a strong public awareness campaign to educate people about the dangers and prevalence of fentanyl.
..... To put fentanyl's deadly reach into context: The state recorded 43 fentanyl-related deaths in 2012, the earliest year of public data available. There were 1,223 overdose deaths overall that year. In 2019, when 2,914 people died from an overdose, 2,248 of those were linked to fentanyl, twice as many as heroin.
..... "Substance use always had its inevitability that someone you'd be working with would overdose. But the rate and the frequency that it's been happening, since, I'd say, the end of 2019 [to] right in the beginning of the COVID pandemic, has become alarming," said Samantha Neville, a member of the nonprofit Prevention is Key and coordinator of the Overdose Fatality Review Team in Morris County. "COVID happened and everyone forgot about the opioid epidemic."
..... It's up to the Murphy administration, for now, to decide how most effectively to use the money New Jersey will get from opioid manufactures.
..... But for all the steps Governor Phil Murphy has taken to build on the work started by his predecessor Chris Christie a decade ago, he still has not decided exactly how to spend the substantial sum of money despite knowing last summer [2021] that the state stood to receive well over $600 million form the settlement.
..... Murphy has said repeatedly since taking office in 2018 that ending the opioid crisis is one of his highest priorities. his office said it is still reviewing data and will work with public health officials, advocates and experts to sue the settlement money most effectively.
..... "This through review will help our state determine the best use of these funds so that they may have the greats impact on our efforts to combat the opioid epidemic," said Christi Peace, a spokeswoman.

How NJ drug market is changing

..... When former Governor Chris Christie declared a statewide opioid criss in 2017, his executive order didn't even mention fentanyl; painkillers and heroin were the leading causes of drug deaths then, but not for long.
..... Two years before that, in 2015. 7% of suspected heroin seized by law enforcement and submitted to state forensic labs contained fentanyl. In 2021, 96% of suspected heroin submissions contained fentanyl, according to state police.
..... Fentanyl pills is also on the rise. In 2015, 1% of all pills contained fentanyl, state police said.
..... "Fentanyl is so inexpensive, it;s getting cut into every drug: into marijuana, into cocaine. There are pills being made that look like pills but they're actually fentanyl," said Angela Conover, director of opioid response and prevention at the Partnership for a Drug-Fee New Jersey.
..... New Jersey hasn't reported fentanyl in marijuana as other states have, state police said, but law enforcement data shows how dramatically the drug market has changed in just a few years.
..... A national analysis by the Drug enforcement Administration found that four of every 10 counterfeit pills contained lethal doses of fentanyl, said Daniel Kafafian, assistant special agent in charge of the agency's New Jersey division. A lethal dose of fentanyl is considered to be 2 milligrams, or a pinch that fits on a fraction of a penny.
..... "That's a staggering statistic," he said "Imagine going to Starbucks tomorrow and the barista puts up 10 cups of coffee and four of them have cyanide in them."
..... The agency has launched a nationwide public awareness campaign called "One Pill Can Kill" to highlight how widespread fentanyl has become in the form of counterfeit pills such as Xanax and Percocet.
..... Although fentanyl can be 50 times more potent than heroin, the ingredients are cheap and easy to mix in with other drugs or aide the profitability of the product on the street, Kafafian said. And for many users, fentanyl is highly sought after for a stronger high, he said.
..... "Once there's a sizable population in the area of fentanyl addictions ... if you're known to sell something that doesn't have fentanyl, you won;t have any customers," said Sam Quinones, a journalist and the author, most recently, of the book "The Least of Us: True Tales of America and Hope in the Time of Fentnyl and Meth."
..... Since New Jersey cerated an Opioid Enforcement Task Force in 2018. the largest net amount of drugs seized has been fentanyl: more than 167 kilograms, valued at $8.35 million, and more than 77,000, according to state police. It has also seized 110 kilograms of of raw heroin and 72 kilograms of cocaine, the agency said, and "dismantled" eight operational fentanyl pill operations.
..... Although enforcement to disrupt limiting the spread of drugs, advocates in New Jersey have pressed the Murphy administration to decriminalize small amounts of all drugs and shift financial resources away from jailing users to providing more treatment options.
..... The administration has done that in some ways. Murphy signed a law earlier this year [2022] decriminalizing fentanyl strips, which allows the administration to provide them to users to try to avoid overdoses. The Department of Human Services said in February [2022] that it was in "the planning state to ensure funding can be put toward making fentanyl test strips available to communities and providers."
..... Murphy also decriminalized possession of syringes, changed the restrictions of a state law that could pave the way for more needle exchange programs and created local overdose fatality review teams earlier this year. [2022]
..... The governor's office said its "compassionate and evidence-based policies" have helped in the opioid epidemic by increasing access to treatment and lifesaving resources.
..... "With fentanyl's increased involvement in overdose deaths in New Jersey, many of the state;s efforts have focused on overdose prevention by expanding access to naloxone - an opioid overdose antidote - training first responders in its sue, and distributing it to community partner, first responders and member of the public," Peace said in a statement.
..... Yet overdose deaths have not gone down in New Jersey. In 2021, 3,124 people died of a suspected drug overdose, according to the Office of the Chief State Medical Examiner. If confirmed, that would be slightly more than the 2020 total of 3,046, which was, the highest since the state started keeping track in 2012.
..... The office did not break down the types of drugs that caused those deaths last year, [2021] but the latest confirmed data showed fentanyl was by far the most prevalent fatal substance.
..... The state, all 21 counties and 241 municipalities will share $641 million paid through 2038 after settlement agreements last year [2021] with New Brunswick-based manufacturer Johnson & Johnson and three distributors: AmerisourceBergen, Cardianl Health and McKesson.
..... The settlement followed nearly 4,000 lawsuits nationwide by local governments against the companies for "their roles in fomenting the country's opioid crisis," the Attorney General's Office said a that time.

..... If you or someone you know is struggling with addiction, New Jersey has resources available through its 24/7 Reach NJ helpline, 844-732-2465, and website nj.gov/humanservices/reachnj .

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