As a public health professional working in overdose prevention tasked with writing an article about fentanyl overdose, I would like to ask you to walk through a visualization exercise. I would like you to close your eyes and imagine someone you think would be at risk of an overdose. What do they look like? How old are they? How are they dressed? Where are they? What environment are they in? What type of people or things are around them? Where are you in relation to them, close by or far away?
Now, I want you to wipe that image clean completely. In place of that image, I want you to imagine your grandmother suffering chronic back pain from years of hard work. She has prescribed pain medication but does not have enough to get her through an entire month and borrows pain medications from others. Imagine your teenager who is very active on a popular social media app and is approached through that app with an offer to purchase an anxiety medication. It will be conveniently delivered to their home as you order a pizza or takeout. Imagine your college student in the campus library studying for finals with friends, and someone offers them medication for attention deficit disorder to help them stay awake to study. Imagine your 25-year-old sibling, a young professional, attending a party where cocaine is available. Imagine your long-time neighbor, your favorite high school teacher, yourself, or anyone else you admire or care about instead. An accidental fentanyl overdose can happen to anyone from any community, socioeconomic status, age, race, ethnicity, religion, or gender who ingests a drug obtained outside of a pharmacy or healthcare provider’s office.
Fentanyl is a synthetic opioid available in prescription and illicitly manufactured forms. It is highly potent at tiny doses – fifty times more powerful than heroin and one hundred times more potent than morphine. An amount as small as a few grains of table salt can cause a fatal overdose. The risk of overdose from illicitly manufactured fentanyl is growing in our community. Jefferson County fentanyl overdose deaths were up 233% between 2019 and 2021, rising from 95 to 316. In 2022, through September, we have already lost 230 individuals in Jefferson County to a fentanyl overdose. Overdose is killing our friends, family members, and neighbors full of promise and ability to make a lifetime of positive contributions to our world.
Illicitly manufactured fentanyl is in the heroin, cocaine, and methamphetamine supply in Jefferson County, and users of those substances are at high risk of a fentanyl overdose. There are even reports of fentanyl contamination of the marijuana supply. Most people do not realize that illicitly manufactured fentanyl is also in counterfeit pills that are indistinguishable from legitimate prescription medications. Today’s overdose crisis is not the overdose crisis of five years ago when overdoses mainly occurred in injection drug users. Fentanyl overdoses are now happening in unsuspecting individuals who believe they are purchasing or borrowing legitimate prescription medications. Instead, they receive counterfeit medicines contaminated with fatal doses of illicitly manufactured fentanyl.
We must raise awareness about this public health crisis. Parents should discuss overdose risks with their middle-school, high school, and college students. Every household must be familiar with naloxone (an opioid overdose reversal drug) and have it available in their home.
There is hope for those using substances and resources available to guide these conversations. Parents may find resources on the Addiction Prevention Coalition website at apcbham.org, or the DEA One Pill Can Kill website at www.dea.gov/onepill. Free naloxone and fentanyl test strips are available to anyone in the State of Alabama and may be obtained through the Jefferson County Department of Health website at www.jcdh.org/naloxone. Alabama’s 24/7 substance use helpline, answered by individuals in recovery from substance use disorder, can be reached at 1-844-307-1760. Those in Birmingham and the surrounding areas can contact the Recovery Resource Center at 205-458-3377. A treatment locator can be found on the Connect Alabama app at https://mh.alabama.gov/connect-alabama-app/ or on the Substance Abuse and Mental Health Services Administration website at www.findtreatment.gov.
The Jefferson County Department of Health staff cares about you and your family. Our mission is for everyone in Jefferson County to live a long and healthy life. We are available to spread awareness by speaking to community groups, being present at community events, and working alongside you to reduce overdoses in your community. Our overdose prevention and response team can be reached at 205-930-1065 or naloxonetraining@jcdh.org. Let’s all work together to END OVERDOSE!
Written by: Darlene Traffanstedt, MD
Contributing Authors: Natasha Shumpert, LMSW, MBA, CCM, and Sarah Estopinal Howell, MSN, CRNP
