As if families needed worse news on the addiction front, a study published last week shows a troubling fact: Nearly half of all U.S. opioid-related deaths in 2016 involved fentanyl.
Maine appears to be in an even more disadvantageous position. Of the 313 opioid-related deaths in 2016, 195 — or 62 percent — involved fentanyl, according to the Maine attorney general’s office. In 2017 it was 70 percent: 247 of 354 opioid-related deaths.
Fentanyl, a synthetic opioid, is difficult to trace, and small amounts can be deadly. While 30 milligrams of heroin can be lethal, it can take just 3 milligrams of fentanyl to kill an average-sized adult male. It is often mixed with heroin or cocaine to enhance the euphoric effects — with or without the user’s knowledge.
In the research letter published May 1 in the Journal of the American Medical Association, scientists from the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration analyzed mortality data from 2010 to 2016 and discovered that overdose deaths involving fentanyl now surpass those involving prescription opioids.
Among the 42,249 opioid-related overdose deaths in 2016, 19,413 (45.9 percent) involved fentanyl; 17,087 (40.4 percent) involved prescription opioids; and 15,469 (36.6 percent) involved heroin. Some deaths involved multiple drugs.
The increase is significant, given that only 3,007 (14.3 percent) of opioid-related deaths involved fentanyl in 2010.
The lesson for Maine and the country is this: The opioid epidemic is not going away soon. People need help.
Many doctors have made important changes to reduce the number of painkillers they prescribe, but it must be done in tandem with increasing access to treatment. A substance use disorder isn’t likely to go away on its own.
Despite years of increasing deaths, and the rise of fentanyl, the state has still taken little concerted, systemic action to ramp up access to methadone and Suboxone.
Some individual providers have done good work. For instance Mid Coast Hospital in Brunswick recently became the first in the state to begin prescribing Suboxone in the emergency department — a practice that should be common but is not. Penobscot Community Health Care has ramped up its Suboxone prescribing, too: Its Brewer Medical Center provides the medication to anyone who needs it, not just PCHC’s own patients.
Many more changes must continue, including getting more naloxone — or Narcan — into the hands of people who could use it to reverse an overdose. People often need to use more doses of Narcan on someone who has overdosed on fentanyl than heroin, given how fentanyl binds so tightly to opioid receptors in the brain. Lawmakers on Wednesday overrode Gov. Paul LePage’s veto of a bill allowing pharmacists to dispense naloxone without a prescription to friends, family members and others, of any age, who can help those experiencing overdoses.
And the state needs to do far more to connect people leaving jail with a system of care that can support them at a most vulnerable time. This is where county decisionmakers and lawmakers could play a significant role by funding and guiding local jails through the process.
Most substance use disorders still go untreated. The deaths will continue without a major push on all fronts.
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