The Fentanyl Crisis

By: Dr. Raju Mangrola, MD – Chief Psychiatrist

The opioid crisis has generated significant discussion in the past decade. It may now be more appropriate to designate the opioid crisis more specifically as the fentanyl crisis or the fentanyl epidemic. More than 100,000 overdose deaths each year, close to 80% related to fentanyl, speak volumes to the severity of the crisis.

This article focuses on investigative findings related to the U.S. fentanyl crisis. The findings provide some insight into what is driving the crisis and the changing face of the victims.

The Crisis

• Cartels have built supply lines and clandestine factories to pump more illicit fentanyl into the U.S.
• Fentanyl is killing long-time users and novices alike because of its extreme potency. 
• Deadly encounters are climbing among users of illicit drugs, including cocaine. 
• More people are dying with the combination of methamphetamine and fentanyl in their system, often after mixing the drugs intentionally.
• Methamphetamine and fentanyl-related deaths that once were concentrated on the coasts of the U.S. have exploded into a nationwide crisis.
• Prisons and jails are mounting a real-time experiment in treating users with medication.
• Tense relations between the U.S. and China hurt efforts to stop the flow of fentanyl ingredients from China to the U.S.
• The fentanyl crisis is killing the most vulnerable victims, including small children.

Medication Assisted Treatment (MAT)

Suboxone

These startling findings highlight the seriousness of the crisis, which continues to mount. It is fair to say that the introduction of Suboxone treatment in 2001/2002 has not provided the intended safety net. Instead, we see more patients are now chemically addicted to Suboxone and have difficulty getting off it after being on it for a more extended period, sometimes for years. 

Vivitrol

At the same time, equally effective treatment using Vivitrol has been limited across the U.S. This could be related to difficulty in access because of insurance issues, the cost of the drug, and the lack of adequate medical providers. Studies have shown that using Vivitrol is a very effective treatment option for patients with opiate or fentanyl use disorder.

Comprehensive Treatment Model

It is also important to recognize that medication-assisted treatment (MAT) may not be sufficient to maintain sobriety from the use of opioids or fentanyl. A comprehensive treatment model should be utilized, including safe medical detox, residential care, if needed, and an ongoing continuum of care, including partial hospitalization (PHP) or an intensive outpatient program (IOP). Family intervention and therapy are also equally needed. The key includes the involvement of 12-Step programs, various forms of cognitive behavioral therapy (CBT), group therapy, and individual therapy. The dictum “the longer the treatment, the better the outcome” still holds. 

Mental Health Evaluations

Data indicates that some of these drug overdoses are suicide attempts. Appropriate mental health evaluation and treatment are equally crucial alongside the treatment for opiate or fentanyl addiction. Data also indicates a significant degree of depression, anxiety disorder, bipolar disorder, psychosocial stressors, and a constant sense of despair could be the driving force for the overdoses and suicide attempts. Therefore, appropriate psychiatric evaluation, medication, treatment, and therapy that may include family involvement are needed in these cases.

Many cases are also driven by underlying trauma, which can be overseen during treatment. It takes a comprehensive approach, a good understanding of a patient’s psychological issues, and approaching treatment meaningfully to help patients find long-term recovery. Community education is also essential, emphasizing the treatment options available for their loved ones.

Restoring Hope Through Treatment

Easy access to Naloxone is a life-saving measure. Local communities need to push for Naloxone with the help of education and easy availability.

Finally, it is fair to say the disease of addiction is devastating and can destroy a family and their loved ones. However, appropriate treatment related to addiction can bring the best recovery possible, with results better than any other medical condition.

Origins Behavioral Healthcare is a well-known care provider offering a range of treatment programs targeting the recovery from substance use, mental health issues, and beyond. Our primary mission is to provide a clear path to a life of healing and restoration. We offer renowned clinical care for addiction and have the compassion and professional expertise to guide you toward lasting sobriety.

For information on our programs, call us today: 561-841-1296.