The U.S. Drug Enforcement Agency seized more than 80 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder in 2023.
And yet, “Opioid-related overdose is the most common cause of accidental death in Pierce County, outnumbering motor-vehicle collisions and firearm deaths. Fentanyl is the main reason for the fast increase in those deaths,” according to the Tacoma-Pierce County Health Department.
An Oct. 21 town hall meeting at the Key Peninsula Civic Center explored the crisis. Approximately 65 community members attended to learn about fentanyl use and its consequences. The meeting was organized by Pierce County Council Member Robyn Denson (D-7th). Eleven community organizations from the Key Peninsula, Gig Harbor and Pierce County co-sponsored it.
The town hall featured a panel of nine speakers who described how the drug is used, both legitimately and illegally.
Anne Nesbit, public information officer and volunteer battalion chief for the Key Peninsula Fire Department, began with an overview of the drug and those who are using it.
Audience members asked questions for an hour, covering topics including overdose response, Narcan training (also known by the generic drug name naloxone), the Good Samaritan Law, and drug availability.
Panel member Dr. Nathan Schlicher explained the traditional uses of fentanyl in the medical setting. A synthetic opioid, the drug was developed in 1959 for use as an anesthetic and extreme pain control. Fentanyl is so powerful it is used in micro-grams rather than milligrams. It is 100 times more potent than morphine. “A lethal dose can fit on the head of a pin,” Schlicher said.
Fentanyl products are diverted by theft and fraudulent prescriptions for illicit use. Fentanyl is also manufactured in other countries such as China and India, then smuggled into the United States. Constituent elements are also exported from China to Mexico where drug cartels manufacture fentanyl. It is often added to other drugs, making them more powerful, addictive and dangerous.
Fentanyl is cheap, costing as “little as a dollar a pill” on the street, said Jeremiah Saucier of the Crossroads Treatment Center in Tacoma. “It is powerful and intense,” he said, but the high lasts just 20 minutes. Users who are addicted may take as many as 30 to 40 pills a day.
Nesbit said use is widespread in the community. “In every household, every economic level, and every culture ... there are no walls ... students of two-parent households, not just single moms. Emergency calls are answered in the nicest homes, with victims of overdose as old as 70.”
The extreme danger for anyone taking illicit fentanyl is that there is no way to tell how much of the drug they might ingest; therefore overdose is common.
“If you buy things like Percocet, Vicodin or OxyContin that you did not get at a pharmacy with a prescription, you need to assume they are fakes that contain fatal amounts of fentanyl,” according to the TPCHD.
“In the hospital setting, appropriate doses of opioids are given for pain control,” said Dr. Jay Miller of the TPCHD. “As you go up in the dose, you are going to get euphoria, and that high that people are trying to get. Fentanyl is very potent, so even a small amount will have an analgesic effect; that is a slippery slope if you don’t know what you are dosing or how much. You have an aggressive substance leading to your brain stem and that is what causes you to stop breathing.”
Nesbit demonstrated how to use a Narcan kit, and urged friends and family of users to have Narcan on hand. Narcan is the brand name of the antidote naloxone. It is administered as a nasal spray inhaler for overdose and is effective only for opioids. Signs of overdose can include decreased heart rate, clammy or shiny skin tone, a blue tinge to skin color, stupor, a choking sound with difficulty breathing, and coma leading to death. An overdosing person is not capable of applying the rescue treatment to themselves.
The kits contain two doses. If a person is found in distress and an overdose is suspected, emergency services should be called immediately followed by Narcan. If the victim does not rouse in two to three minutes, the second dose should be given. The rescued person must continue treatment in a hospital setting to help flush the remaining drug from the body.
A person without full treatment may still face a strong possibility of overdose death. Narcan is available to the community free of charge. No identification is required. Kits are available in a vending machine at the Key Center Library.
Fentanyl field test kits are another valuable tool for harm reduction with a 97% accuracy rate. The kits are available free at Tacoma Needle Exchange sites. Test strips can determine the presence of fentanyl in any type of drug, but do not measure the amount of fentanyl in a substance.
“We have a school policy that students and staff are allowed to carry Narcan,” said Becky Maffei, lead counselor at Peninsula School District. “Parents and educators work together to help our young people be armed with good information, so they know what to avoid. We want our young people to know there are healthier ways to deal with things that are difficult in their life.”
PSD Safety Officer Brent Campbell said, “We get the end user. If we get information we do follow up. Every school has these dealers. Drugs are in demand right now. If there is a demand, there will be a supplier. If someone gets arrested, someone else fills in. It’s a tough battle.”
Pierce County Sheriff ’s Deputy Nathan Betts, of the Peninsula Detachment, said, “These people want our help and do need our help. Maybe not today, maybe next week. They need an opportunity to survive, maybe with a referral or a phone call.”
Charnay DuCrest, health promotion coordinator at the TPCHD, said, “I did not grow up thinking I wanted to do heroin for years or experience homelessness for years. I graduated from college and ended up on the streets, overdosing multiple times. And I am very blessed to be here today. If you know anyone who is using, be sure to carry Narcan ... addiction is an actual disease. It’s not a matter of willpower.”
Dr. Tyler Owen of Saint Anthony Hospital said, “We can treat it, like any illness. If your neighbor had a heart attack, you would not lecture them about their behavior. You would be empathetic and wish them well. It’s about reframing it in our minds.”
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