On the street, they call it Apache, or China girl. To others it is TNT, dance fever or Tango and Cash. Another nickname for the drug fentanyl minces no words: Murder 8.
While heroin and oxycodone are household words for those trying to understand the opioid epidemic, or simply to survive it, the lesser-known fentanyl is believed to be significantly responsible for a rising number of unintentional overdose deaths.
This week, with ink still fresh on this state’s newest legislative attack on the problem, President Obama used a visit to Atlanta to again push national efforts against a scourge that he noted is killing more Americans than traffic accidents. As much is riding on the U.S. fight against opioid addiction, the president said, as on the military campaign against ISIS.
The body count in the war at home is horrifying. The year 2014 brought record overdose deaths nationally, with 80 percent of them concentrated in 10 states, including Massachusetts. The state Department of Public Health reports 1,099 confirmed unintentional overdose deaths in 2014, with another 74 suspected. Here in the Valley, fatal overdoses in 2012-2014 hit communities hard: Amherst (3), Belchertown (6), Easthampton (10), Greenfield (11), Holyoke (19), Northampton (12 — including eight in 2014) and South Hadley (5).
Deaths due to this epidemic came as well in Goshen, Hadley, Hatfield, Southampton, Sunderland and Williamsburg.
Even with legislative action, this awful problem is getting worse — in large measure due to the rise of fentanyl, a synthetic opioid that’s been used in medical settings since the 1960s but is now manufactured by drug cartels for the illicit market. It is up to 50 times more powerful than heroin, delivering a wallop of a high that addicts struggle to resist. It kills so fast that the anti-overdose drug naloxone often can’t be used to rescue victims.
Attorney General Maura Healey is now referring to the “fentanyl epidemic” — and for good reason. Though fentanyl was linked to the rise of overdose deaths that began in 2013, special toxicological tests are needed to pinpoint the role it plays in a fatality.
Nationwide, fentanyl was linked to 618 overdoses in 2012 — but to 4,585 in 2014, according to the Centers for Disease Control and Prevention. That’s a 642 percent increase. Here in Massachusetts, the state police crime lab linked fentanyl to six overdoses in 2013, but to hundreds last year, when the Drug Enforcement Administration issued a national alert about fentanyl’s involvement in an “alarming” rise in deaths. Between October 2014 and last October, 336 people died in fentanyl-related overdoses in Massachusetts, health officials say, a 53 percent increase over the year before.
Fentanyl is widely used by doctors for pain relief; physicians wrote an estimated 6.64 million prescriptions for it in 2015. But most deaths linked to the drug involved fentanyl obtained illegally.
A captain in the Haverhill Police Department told a New York Times reporter in a March 25 story that the drug “sort of snuck up on us.”
A former nurse told the Times fentanyl use killed several of her friends and is “everywhere” in the Lawrence area, adding, “It would be really hard to navigate through this city without being touched by it.”
The state’s new law setting a seven-day limit on initial adult opioid prescriptions will help curb the overall supply. A day after Gov. Charlie Baker signed that law, the federal Centers for Disease Control issued guidelines calling on physicians to prescribe fewer opioids and to try safer alternatives for pain control.
Such actions are likely to help prevent people from falling victim to the disease of addiction. But in the meantime, illegal manufacturers are flooding our communities with opioids like fentanyl. That means law enforcement — not just the enactment of laws — remains a frontline in this war.