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April 9, 2018 | by  | in Features |
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The New Drug on the Block

The opioid crisis is a real thing. Fentanyl was found in New Zealand. Let’s talk about what this means and why it matters.

Prescription pain relievers, the most common of which are methadone, oxycodone (such as OxyContin), and hydrocodone (such as Vicodin), are all opioids. The drugs we hear and talk about the most are heroin and morphine, which are derived naturally, and Fentanyl, a drug that is synthesized in a lab. Opioids are prescribed to dull pain, but they also boost dopamine, giving some people a high. They can also slow down your breathing, and are highly addictive.

It’s no secret that the United States of America has an opioid epidemic that’s out of control. They have the worst drug overdose rates in the world. There were more than 64,000 drug related deaths in the U.S. in 2016. That’s a 22% rise from the 49,369 drug deaths recorded the previous year. Two thirds of those deaths were from opioids, and nearly a third of those deaths were due to Fentanyl.

Back in October 2017, President Trump called the opioid epidemic a “national shame”, and declared opioid abuse a public health emergency. Recently, he announced his plans to combat the epidemic through an advertising campaign to discourage drug use, expanding addiction treatment, as well as pursuing a harsher and stricter approach when it comes to law enforcement.

But how did this epidemic come about?

It began in the 1990s. Legal opioids OxyContin and Percocet were on the market. There had been a single study done on the harm and addictiveness of opioids, by Jane Porter and Dr. Hershel Jick. They had written in New England Journal of Medicine in 1980 that “the development of addiction is rare in medical patients with no history of addiction”. Jick also told the Washington Post in 1977 that less than 1% of patients he studied died from a reaction to prescription painkillers. Pharmaceutical companies milked this (mis)information to the max, using it as evidence to persuade doctors to prescribe these new miracle drugs for effective relief of long term and chronic pain. Many patients became addicted. When they lost access to prescribed painkillers, they turned to buying heroin on the street to get their fix.

Fentanyl is the new drug on the block. It’s been in use for pharmaceutical purposes since the early 1990s but recently, it’s become more and more prevalent on the black market. It’s 100 times stronger than morphine, 50 times stronger than heroin, cheap to manufacture, easy to move, and dealers have been mixing it with other white powders and selling it as heroin or OxyContin. Since it’s so potent, it’s incredibly easy to overdose — just a few grains too many will kill you. 3mg is enough for an overdose. If a drug dealer makes even the slightest miscalculation, their product becomes lethal. . In the U.S., there has been a 540% increase in deaths from Fentanyl overdose in the past three years. The United States Drug Enforcement Administration (DEA) seized 239 kilograms of illegal Fentanyl from August 2013 through the end of 2015.

It makes sense from an economic point of view: heroin requires a lot of effort to transport. It is moved by truckloads, and it is expensive to produce at a high quantity. According to the DEA, Fentanyl provides a high profit margin for traffickers. If a particular batch has two milligrams of Fentanyl per pill, approximately 500,000 counterfeit pills can be manufactured from one kilogram of pure Fentanyl.

Fentanyl was found in New Zealand

The opioid crisis in the United States sets the stage for an alarming discovery: Fentanyl has been found in NZ at a music festival in February by KnowYourStuffNZ, a non-profit drug testing organization. Fentanyl has also been stopped by Customs at the border of our country. KnowYourStuffNZ says they don’t know how prevalent Fentanyl is throughout New Zealand.

The worsening situation in the U.S. should serve as a cautionary tale to us. Health Quality & Safety Commission New Zealand reports that rates of opioid prescription in NZ are increasing. The number of people who were prescribed a strong opioid at least once in a year has risen from 63,000 people in 2011 to 77,000 people in 2016. Fentanyl prescriptions have also risen drastically; 3410 New Zealanders were prescribed Fentanyl in 2011, compared with 8368 in 2017. Of those given Fentanyl, 23% took it for six or more weeks (fun fact about pesky prescription drugs: the longer you take them, the more dependent you become, the more likely you are to become addicted). Pathologist Dr. Paul Morrow notes that opioid-related deaths in NZ rose 33% from 2001 to 2012. 11 New Zealanders have died from Fentanyl since 2011.

New Zealand isn’t prepared for a crisis. Opioid-related deaths are rising. Rates of Fentanyl use are increasing. More people are being prescribed the drug, and they’re taking it for a long period of time. New Zealand may not be going through an epidemic as severe as that in the United States, but that is not to say that opioids are not an issue on home soil. It is important that the New Zealand Government takes steps to become better prepared.

What about testing?

To reduce the risks associated with  Fentanyl, KnowYourStuffNZ has put forward three policy recommendations for the Government to consider.

They ask that the Misuse of Drugs Act be updated to allow for forensic drug checking. Wendy Allison, director of KnowYourStuffNZ, said “lots of drug users say that they trust their dealer, but there is no way for the dealer to know unless they have access to testing, so really testing is the only way to be certain of what you’ve got”. Overdoses and bad reactions from taking a wrongly identified drug could be avoided.

Another step they suggest makes mention of Naloxone, an affordable and easy to use drug which is crucial in opioid drug overdoses as it blocks the effects of opioids. In an approved emergency overdose kit, Naloxone is legal. However, it is only available on prescription. KnowYourStuffNZ argues that if Naloxone is made readily available to opioid drug users and their friends, death due to opioid overdose can be avoidable.

They also urge the Government to implement an effective drug Early Warning System. Currently, government agencies such as Customs, Police, and emergency departments collect information about drugs, but it’s not shared with the public. KnowYourStuffNZ believe that the information about dodgy drugs that these agencies collect should be shared freely with the people of New Zealand, so we can be informed about the current trends and dangers of the illicit drug market.

Health Minister David Clark has declined to speak with Salient on this matter. A One News article has reported that he is unwilling to legalise drug testing. “As the law stands there is no wriggle room. Anyone can work out that as soon as you make one aspect of it legal that has implications right down the system,” he said.

Allison disagrees with that stance. “People choose to use drugs despite punishment being inflicted on them, and in some countries that punishment is death.” She says that drug testing is, in fact, “one of the more successful interventions that are making people change their minds about using drugs”. Around half the drug users choose not to take a drug when they were told by KnowYourStuffNZ it’s not the same drug they thought it was.

Clark has launched an independent inquiry into drug addiction, including the classification of Fentanyl. Currently Fentanyl is a Class B drug, the same class as MDMA. Reclassifying it up to Class A will put it in the same class as LSD and magic mushrooms. Allison argued against re-classifying Fentanyl higher. “Re-classifying it won’t make any difference in the illicit market but it makes access to the drug more difficult for legitimate users.” In fact, Allison believed that the classification system outlined in the Misuse of Drugs Act 1975 makes no sense and the Misuse of Drugs Act does not fit its purpose, which is to reduce drug use and drug harm. She said we should “just scrap the whole thing and start again based on evidence.”

Allison said KnowYourStuffNZ wasn’t intending to cause a nationwide frenzy. She said, “we found the Fentanyl and we put out a press release and I’ve spent most of my time since then telling people not to freak out”. She believes that the onus is on the organization to tell people when they find things of concern. “But what we don’t want is for everyone to think that we’re going down the track with America, because it’s unlikely.”

I don’t know if we’re going to go down the same track as America. Maybe we won’t. But I’d prefer our Government put in place preventative measures now, rather than waiting for the crisis to hit. If it weren’t for KnowYourStuffNZ, the New Zealand public wouldn’t have known that Fentanyl was being disguised as heroin and sold on the street — yet we still won’t legalize the work they do.

With Fentanyl found in NZ, the threat of an opioid crisis is here, now, and it’s time to talk about it.

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