The opioid epidemic has a deadly new star: fentanyl, which is easier to overdose with than prescription painkillers or heroin, kills quicker and has effectively taken over the illicit drug market in St. Louis and elsewhere.
Missouri has made progress in battling opioids generally, but this latest threat is a reminder that the problem is nowhere near solved.
Boosting law enforcement efforts against fentanyl and other illicit opioids is an obvious solution — but just as obvious should be the need to reduce demand by providing easy access to addiction treatment. And since heroin users may not even know their heroin could contain this deadly additive, public education needs to be a big part of the equation.
That's going to require political leadership in Missouri and nationally that goes beyond viewing this as a crime issue, and seeing it as the towering health crisis it is.
Opioids are highly addictive narcotics found in legally prescribed painkillers like oxycodone. Heroin is among the illegal substances classified as opioids. The first wave of the opioid crisis started in the late 1990s, due to overprescription of painkillers by doctors. As addictions increased, those affected gamed the system with "doctor shopping" to obtain more.
That, combined with heroin use, drove opioid overdose deaths to almost 50,000 in the U.S. by 2017. Today, it is by far the biggest cause of drug overdose deaths, which in turn have become the leading cause of death for Americans under 50.
America has finally started getting a handle on the prescription side of the opioid epidemic. Programs in Missouri and St. Louis County monitor opioid prescriptions with an eye toward identifying overprescription and doctor shopping. The fact that Missouri's opioid-related deaths overall rose by 4.7 percent from 2016 to 2017 actually counts as progress, given that the previous year's increase was 35 percent.
Addressing opioid deaths due to illegal heroin abuse is, obviously, more complicated. And as the Post-Dispatch's Blythe Bernhard reported last Monday, the spike in fentanyl-related deaths complicates it further.
Fentanyl is a synthetic opioid that has legitimate medical uses in pain management, but which is now booming on the illegal recreational market as an additive to cocaine, methamphetamines and heroin — though it is many times as powerful.
Because of its strength, a fentanyl overdose can kill quicker than other types of opioids. It is now a factor in most opioid deaths in the St. Louis region. By late November, with more than a month left in the year, Madison County, Missouri, for example, had already beat its all-time annual record for opioid deaths, mostly due to fentanyl, Bernhard reported.
"Fentanyl has taken over as the drug that is killing people here," Madison County Coroner Stephen Nonn told her.
From overprescription of drugs like Percocet to increased use of illegal heroin to, now, something worse, the opioid crisis is a shape-shifting threat that requires adjusted responses.
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