Fentanyl is a powerful synthetic opioid that is estimated to be 50-100 times more potent than morphine. Unfortunately, the use of this drug has become increasingly common in Arizona, leading to a rise in fentanyl-related deaths.

More than 2,000 Arizonans lost their lives to opioid overdoses in 2021, with fentanyl the most commonly reported drug in opioid overdoses.

Fentanyl is often mixed with other drugs such as heroin or cocaine, making it difficult for users to know what they are ingesting. Additionally, fentanyl is often sold on the street as counterfeit pills, making it even harder for users to identify its presence. The potency of fentanyl makes it very easy for users to overdose, especially if they are not aware that they are taking the drug.

The problem is not unique to Arizona. Fentanyl-related deaths have been on the rise across the United States in recent years. In fact, the Centers for Disease Control and Prevention (CDC) reported that there were over 93,000 drug overdose deaths in the United States in 2020, the highest number ever recorded. Of those deaths, more than 60% involved synthetic opioids like fentanyl.

WHAT ARE THE MAIN SYMPTOMS OF DETOXING FROM FENTANYL

Fentanyl detox can be a challenging and uncomfortable process as the body adjusts to the absence of the drug. The main symptoms of fentanyl detox include physical and psychological symptoms, which can range in severity depending on the individual's level of dependence and the duration and amount of drug use.

Some of the common physical symptoms of fentanyl detox include:

• Nausea and vomiting
• Diarrhea
• Abdominal cramps
• Muscle aches and pains
• Sweating and chills
• Rapid heartbeat
• High blood pressure
• Dilated pupils
• Runny nose and watery eyes

The psychological symptoms of fentanyl detox can include:

• Anxiety and restlessness
• Depression
• Irritability and mood swings
• Insomnia and sleep disturbances
• Cravings for the drug
• Confusion and difficulty concentrating
• Paranoia and hallucinations (in severe cases)

It is important to note that the severity and duration of fentanyl detox symptoms can vary depending on the individual's level of dependence and the duration and amount of drug use. Therefore, it is highly recommended that anyone looking to detox from fentanyl seek medical assistance and support from a qualified healthcare professional who can provide guidance and supervision during the process. Medical professionals may use medications and other treatments to manage symptoms and make the detox process more comfortable and safe.

WHAT IS PRECIPITATED WITHDRAW

Precipitated withdrawal is a rapid and intense onset of withdrawal symptoms that can occur when someone is given a medication that rapidly removes the effects of opioids, such as fentanyl, from their system. This can happen when a person takes a medication called an opioid antagonist, such as naloxone or naltrexone, or when they switch from a long-acting opioid medication to a shorter-acting one.

Precipitated withdrawal occurs because the opioid antagonist medication rapidly binds to the same receptors in the brain and body that fentanyl binds to. This causes the fentanyl to be rapidly removed from the person's system, leading to a sudden onset of withdrawal symptoms.

The symptoms of precipitated withdrawal can be severe and intense, including nausea, vomiting, diarrhea, abdominal cramps, muscle aches and pains, sweating, chills, anxiety, restlessness, and agitation. These symptoms can be more severe than typical opioid withdrawal symptoms and can last for several hours to a few days.

Precipitated withdrawal is a serious concern for individuals who are seeking to detox from fentanyl or other opioids. It is important that anyone who is considering switching to an opioid antagonist medication or who is receiving medication-assisted treatment for opioid addiction work closely with a qualified healthcare professional who can provide guidance and supervision throughout the process to minimize the risk of precipitated withdrawal.

WHAT CAN BE DONE TO SLOW DEATHS AND THE FENTANYL STREAM INTO AZ

To combat this problem, Arizona has implemented a number of initiatives to try to reduce fentanyl-related deaths. One approach has been to increase access to the overdose-reversal drug naloxone, which can quickly reverse the effects of an opioid overdose. In addition, Arizona has increased funding for drug treatment programs and has expanded its drug court program to help people with substance abuse issues get the help they need.

Another initiative is to crack down on the illegal distribution of fentanyl. Law enforcement agencies have been working to identify and prosecute those who are trafficking the drug. In addition, Arizona has implemented a drug take-back program, allowing people to safely dispose of unused prescription medications to prevent them from being misused or abused.

The rise in fentanyl-related deaths in Arizona is a serious issue that requires a comprehensive response. Efforts to increase access to naloxone, expand drug treatment programs, and crack down on illegal drug distribution are all steps in the right direction. However, addressing this problem will require a sustained effort from all stakeholders, including healthcare providers, law enforcement agencies, and community organizations. By working together, we can reduce the number of fentanyl-related deaths and help people struggling with addiction get the help they need.

HOW TO USE NALOXONE FOR OVERDOSE

Naloxone is a medication used to rapidly reverse the effects of opioids, including fentanyl, in the event of an overdose. It is a life-saving medication that can help to restore normal breathing in someone who has overdosed on fentanyl. Here are the steps for using naloxone for fentanyl overdose:

• Recognize the signs of an opioid overdose. These may include slow or shallow breathing, unresponsiveness, blue or purple lips or nails, and pinpoint pupils.
• Call 911 immediately. Time is critical in an overdose situation, so it is important to call for emergency medical assistance as soon as possible.
• Administer naloxone. If you have naloxone available, follow the instructions provided with the medication carefully. In general, naloxone can be administered as a nasal spray, injection, or auto-injector. If using a nasal spray, place the nozzle in one nostril and administer half the dose. Then, place the nozzle in the other nostril and administer the second half of the dose. If using an injection or auto-injector, administer the medication into a muscle, such as the thigh or upper arm.
• Continue monitoring the person's breathing and other vital signs. Naloxone can rapidly reverse the effects of opioids, but its effects may wear off before the opioid is completely metabolized by the body. Therefore, it is important to continue monitoring the person's breathing and other vital signs and administer additional doses of naloxone if necessary.
• Seek medical assistance. Even if the person appears to be recovering, it is important to seek medical assistance to ensure that they receive appropriate follow-up care and to address any underlying issues related to opioid use.

It is important to note that naloxone is a temporary solution and should not be considered a substitute for long-term treatment for opioid addiction. Anyone who has survived an opioid overdose should seek medical and psychological support to help them address their addiction and prevent future overdoses.

WHAT IS MEDICALLY ASSISTED TREATMENT FOR FENTANYL

Medication-assisted treatment (MAT) for fentanyl is a comprehensive treatment approach that combines the use of medication with behavioral therapies and support services to help individuals recover from opioid addiction, including fentanyl addiction. MAT is an evidence-based approach that has been shown to be effective in reducing opioid use and improving treatment outcomes.

There are three medications that are commonly used in MAT for fentanyl addiction:

1. Methadone: Methadone is a long-acting opioid medication that can help to reduce withdrawal symptoms and cravings for fentanyl. Methadone is typically administered on a daily basis under medical supervision and is only available through specialized opioid treatment programs.
2. Buprenorphine: Buprenorphine is a partial opioid agonist that can help to reduce withdrawal symptoms and cravings for fentanyl without producing the same level of euphoria or sedation as full opioid agonists like fentanyl. Buprenorphine is available as a sublingual tablet or film that is placed under the tongue and is often prescribed by healthcare providers who have completed specialized training in its use.
3. Naltrexone: Naltrexone is an opioid antagonist that blocks the effects of opioids like fentanyl and can help to reduce cravings for opioids. Naltrexone is available in an extended-release injectable form that is administered once a month or as a daily oral medication.

In addition to medication, MAT for fentanyl addiction may also include behavioral therapies and support services, such as individual and group counseling, cognitive-behavioral therapy, and support groups like Narcotics Anonymous. These services can help individuals address the underlying issues related to their addiction and develop skills and strategies to maintain long-term recovery.

It is important to note that MAT for fentanyl addiction should be tailored to the individual's unique needs and should be provided under the supervision of a qualified healthcare professional. MAT can be a highly effective approach to treating fentanyl addiction, but it is not a cure and requires ongoing commitment and support to maintain recovery.