'People are going to die today': Inside the fourth wave of America's deadliest epidemic

[milestogo]

In Pawtucket, Rhode Island, near a storefront advertising “free” cellphones, J.R. sat in an empty back stairwell and showed a reporter how he tries to avoid overdosing when he smokes crack cocaine. KFF Health News is identifying him by his initials because he fears being arrested for using illegal drugs.

It had been several hours since his last hit, and the chatty, middle-aged man’s hands moved quickly. In one hand, he held a glass pipe. In the other, a lentil-size crumb of cocaine. Or at least J.R. hoped it was cocaine, pure cocaine — uncontaminated by fentanyl, a potent opioid that was linked to about 75% of all overdose deaths in Rhode Island in 2022. He flicked his lighter to “test” his supply. He believed that if it had a “cigar-like sweet smell,” he said, it would mean that the cocaine was laced with fentanyl. He put the pipe to his lips and took a tentative puff. “No sweet,” he said, reassured. But this method offers only false and dangerous reassurance. A mistake can be fatal.

It is impossible to tell whether a drug contains fentanyl by the taste or smell. “Somebody can believe that they can smell it or taste it, or see it … but that’s not a scientific test,” said Josiah “Jody” Rich, an addiction specialist and researcher who teaches at Brown University. “People are going to die today because they buy some cocaine that they don’t know has fentanyl in it.” The first wave of the long-running and devastating opioid epidemic began in the United States with the abuse of prescription painkillers in the early 2000s. The second wave involved an increase in heroin use, starting around 2010. The third wave began when powerful synthetic opioids such as fentanyl started appearing in the supply around 2015. Now experts are observing a fourth phase of the deadly epidemic.

The mix of stimulants such as cocaine and methamphetamines with fentanyl — a synthetic opioid 50 times as powerful as heroin — is driving what experts call the opioid epidemic’s “fourth wave.” The mixture of stimulants and fentanyl presents powerful challenges to efforts to reduce overdoses because many users of stimulants don’t know they are at risk of ingesting opioids, so they don’t take overdose precautions.

https://www.alternet.org/opioid-epidemic-2670734132/

[RAB910]

1. "A fentanyl test strip could have saved his life."

I have often questioned the effectiveness of those test strips. The thing is, illicit drugs are not cheap, and most dealers don't have a return policy. So when a user finds the drugs they purchased are contaminated with fentanyl, what do they do? Throw away their drugs and their high?

While I am not opposed to the test strips, I almost wonder if it's giving people trying to combat the overdose deaths a false sense of security.

[LymphocyteLover]

2. maybe they use less of it? But certainly I think it's better to know than not know

I wonder more about how sensitive and effective they are, and how many users take the time to do the test properly.

[Unladen Swallow]

3. Refund?

How about they recognize that its not pure and don't use it so they don't die?

[sheshe2]

4. I am sure that is easier said than done for someone addicted.

[Unladen Swallow]

5. The point is, the test strip gives the knowledge

what they do with that knowledge is up to them

[AZJonnie]

6. You seem to be missing something

RAB & sheshe's point is that making these strips available is a half-ass band-aid on the problem & probably won't save many people, because:

1) If you're addicted, you're probably also poor, and
2) You can't test before you buy, and
3) You don't get a money back guarantee

So if you find out later the drugs are laced, you're screwed because you have an addiction, no more money for drugs, and potentially dangerous drugs in hand, that you *need* to take. Also "just because there's fentanyl in it doesn't mean there's too much fentanyl in it" is exactly how most addicts are bound to think in that situation. All due respect, that's 'the point' of what you're responding to.

[Skittles]

8. that's not how an addiction works

nope

[sorcrow]

7. Medically an overdose

But isn't poisoning a better description? Most of these people aren't taking fentanyl so much as being given it under the guise of taking something else. Just some food for thought.

Regards,
Sorghum Crow