The COVID-19 pandemic has turbo-charged the surge in fentanyl overdoses sweeping the western states, as drug experts warn of a crisis within a crisis

Drug Overdose
A drug user lies on the sidewalk in San Francisco, California on April 26, 2018.

  • Drug overdose deaths hit record levels last year with more than 81,000 fatalities, according to the CDC.
  • Fentanyl, involved in most of the deaths, is now sweeping the western US with a 98% rise in 10 states.
  • The synthetic opioid is 100 times more potent than morphine and 50 times more than heroin.
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US drug overdose deaths hit record levels last year with more than 81,000 fatalities, according to the CDC. Fentanyl was involved in almost all of them and the dangerous drug is now sweeping the western states, agitated by the COVID-19 pandemic.

The National Institute on Drug Abuse (NIDA) told Insider: “Fentanyl has been found mixed with many other drugs. People who buy drugs such as heroin, cocaine, methamphetamine, and MDMA are frequently not aware that these may be laced with fentanyl.”

Fentanyl, a synthetic opioid generally used in hospitals to treat pain after surgery, is up to 100 times more potent than morphine and 50 times more than heroin, meaning just two milligrams of it can be deadly, only a fraction of the lethal dose needed for the older opiate.

Fentanyl
A pharmacy technician prepares syringes containing fentanyl at the University of Utah Hospital, in Salt Lake City, Utah on June 1, 2018.

Dr. Paul H. Earley, an addiction medicine physician with the American Society of Addiction Medicine (ASAM) told Insider: “We’re in the middle of a crisis within a crisis. The substance use disorder crisis, which is already with us, is dramatically worsened by COVID-19. Why? Because addiction is a disease of isolation and despair.”

Over 40 states have reported an increase in opioid overdose deaths during the pandemic, accounting for a 38% rise across the country, according to the American Medical Association (AMA).

However, a CDC report revealed that western states have been most afflicted, with a 98% rise in 10 states, largely due to fentanyl use.

Data from California, Washington, Arizona, Texas, and Colorado showed fentanyl deaths increased by 371% between 2017 and 2019.

Jake, who only provided his first name in fear of being arrested for his addiction, told NPR that he has been addicted to opioids for the past six years. He was initially a heroin user and now a fentanyl user.

He said: “I just started smoking [fentanyl] pills because that was the thing that was around; it was so easy to get. Soon as I wake up, I have to have a pill. The high is not very long, so 20 minutes after I smoke a pill, I want to smoke another one, you know?”

COVID-19 is presenting a new set of challenges for drug users

Fentanyl
Travis Hayes, 65, injects what he says is the synthetic drug fentanyl in San Francisco, California on February 27, 2020.

There are over 2 million opioid users in the US, with an average of around 130 opioid overdose deaths a day, the CDC also noted.

Now, COVID-19 is presenting a new set of challenges for drug users.

NIDA also told Insider: “This increased risk of illness is not only due to potentially adverse social circumstances and living conditions, but also to the drugs’ physiological effects on pulmonary, cardiac, metabolic, and immune functions, all of which are targeted by COVID-19 as well.

“As a result, people with substance use disorders who develop coronavirus are much more likely to be hospitalized and to die, compared with the general population.”

According to the Overdose Detection Mapping Application Program (ODMAP), opioid overdoses rose by 18% in March 2020 compared to the previous year, 29% in April, and 42% in May 2020.

A JAMA Psychiatry report found that between March and October, the weekly rate of emergency department visits for drug overdoses increased by up to 45% compared to the same period in 2019.

Fentanyl
Emergency services investigate after four people were take to the hospital with possible fentanyl exposure in Los Angeles, California on December 31, 2019.

Fentanyl’s potency and the fact so little is needed to make it deadly is now killing people who had managed their addictions for years.

Help for drug users has also been partially shutdown. A National Council for Behavioral Health survey revealed that 54% of behavioral health organizations have closed their programs while 65% had to turn away, reschedule or cancel appointments due to financial losses and reduced capacity during the pandemic.

Although some of these programs have provided services online, they require the internet and a phone or computer to access.

Distributing naloxone to those at risk of overdosing

One possible solution is the use of naloxone, a medication which temporarily blocks the effects of opioids and ‘reverses’ overdoses. Administered by injection or nasal spray, the potency of fentanyl means extra doses may be needed compared to other opioids.

Naloxone
A Cincinnati Fire Department medic nasally administers Naloxone to a man while responding to a possible overdose report at a gas station in downtown Cincinnati, Ohio on November 2, 2017.

More than 700,000 doses of naloxone were distributed to people at risk of overdosing last year. However, almost one in three of the sterile syringe programs that offered the medication either ran out of it or had to ration it for three months, according to the CDC.

Dr. Paul H. Earley also told Insider: “I have a Naloxone overdose kit in my car, I have one in my home. And really, the more that that available that becomes, the more lives we’re going to save.”

Opening overdose prevention sites

Opening overdose prevention sites (OPSs), sometimes known as supervised injection sites (SISs) or safe consumption rooms (SCRs), has also been suggested after the success of similar facilities abroad.

Canada is home to the first legal OPS in North America, Insite. Insite opened its doors in Vancouver in 2003, and between 2017 and 2020, medical staff were able to prevent 4,763 drug overdoses.

Over 120 of them exist across 10 countries but there has never been an overdose death recorded in any, the Drug Policy Alliance notes.

Insite, Canada
Richard Chenery injects heroin he bought on the street at Insite in Vancouver, Canada on May 11, 2011.

An Institute for Clinical and Economic Review report also found that such sites also save money on a long-term basis.

Last month, almost 80 lawmakers sent a letter to Congress urging them to provide money for the Community Mental Health Services Block Grant (MHBG) as part of the upcoming COVID-19 relief bill.

The $5 billion grant would be used to assess communities’ situations and implement prevention and treatment strategies.

The money would be in addition to the $4.25 million approved by Congress as part of the omnibus spending bill in December 2020.

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McKinsey has agreed to pay $573 million over its role in boosting opioid sales during an epidemic that has killed more than 450,000 Americans

FILE PHOTO: Bottles of prescription painkiller OxyContin pills, made by Purdue Pharma LP sit on a counter at a local pharmacy in Provo, Utah, U.S., April 25, 2017.    REUTERS/George Frey/File Photo
Bottles of prescription painkiller OxyContin made by Purdue Pharma LP.

  • McKinsey has agreed to pay $573 million to settle investigations into its role in the opioid crisis.
  • The firm has been accused of boosting drug sales during the epidemic, but it won’t admit wrongdoing.
  • At least 450,000 Americans have died of an opioid overdose since 1999.
  • Visit the Business section of Insider for more stories.

Global consulting firm McKinsey & Company has agreed to pay $573 million to settle investigations into its role in boosting the sales of opioid drugs amid an epidemic that has killed nearly half a million Americans, The New York Times reported Wednesday.

McKinsey will not admit wrongdoing in the settlement, which is expected to be filed on Thursday, after coming to an agreement with attorneys general in 47 US states, the District of Columbia, and five territories, according to The Times.

The settlement comes after court documents recently revealed states were pursuing the firm for advising Purdue Pharma LP, maker of OxyContin painkiller, and other opioid manufacturers on how to sell more opioids at the same time the country was attempting to address the opioid crisis.

From 1999 to 2018, 450,000 people died from an opioid overdose, according to the Centers for Disease Control and Prevention.

Read more: McKinsey says COVID-19 is just one of many supply-chain disruptions CEOs need to prepare for going forward

McKinsey’s settlement also includes limiting its work with some narcotics and making thousands of pages of documents publicly available, sources told The Times. They also said states are expected to use the settlement money on opioid treatment, prevention, and recovery.

McKinsey did not immediately respond to Insider’s request for comment.

In a statement in December, McKinsey said “we recognize that we did not adequately acknowledge the epidemic unfolding in our communities or the terrible impact of opioid misuse and addiction on millions of families across the country.”

Because of this, the statement said, the company stopped working with opioid-specific businesses in 2019.

The statement also said McKinsey’s “work with Purdue was designed to support the legal prescription and use of opioids for patients with legitimate medical needs, and any suggestion that our work sought to increase overdoses or misuse and worsen a public health crisis is wrong.”

Purdue Pharma, one of McKinsey’s clients, pled guilty to three criminal charges over its marketing of OxyContin as part of an $8 billion settlement in October. At the time, the Associated Press said it was “the highest-profile display yet of the federal government seeking to hold a major drugmaker responsible” for the opioid crisis.

Read the full story at The New York Times »

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Walmart says the Justice Department’s opioid epidemic lawsuit is ‘tainted by historical ethics violations’

walmart pharmacy signs
  • The Justice Department is suing Walmart, accusing the retailer of playing a role in the opioid epidemic.
  • Walmart through a filing with the Securities and Exchange Commission responded to the suit “unlawfully forces pharmacists to come between patients and their doctors.”
  • The suit is a “transparent attempt to shift blame from DEA’s well-documented failures in keeping bad doctors from prescribing opioids in the first place,” Walmart said in an SEC filing.
  • The lawsuit alleges that Walmart pharmacies did not properly screen prescriptions, understaffed pharmacies, and pushed employees to fill prescriptions quickly.
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The Department of Justice’s is suing Walmart for its role in the opioid epidemic, The Wall Street Journal first reported, and Walmart just released a scathing response.

In a statement made through a Securities and Exchange Commission filing, Walmart said the suit is “tainted by historical ethics violations.” It also said the suit “unlawfully forces pharmacists to come between patients and their doctors.” Walmart’s statement questions every aspect of the DOJ’s case, which it says is “riddled with factual inaccuracies and cherry-picked documents taken out of context.”

The DOJ lawsuit against the retail giant accuses Walmart of not properly screening prescriptions for opioids, understaffing pharmacies, and pushing employees to fill prescriptions quickly, all of which contributed to rising rates of addiction and abuse, WSJ reported.

The suit is a “transparent attempt to shift blame from DEA’s well-documented failures in keeping bad doctors from prescribing opioids in the first place,” Walmart said in its SEC filing.

Read more: Meet the autonomous-vehicle startup tapped by Walmart to help cut down delivery times for online customer orders

The suit is seeking billions of dollars in civil penalties, accusing Walmart of violating the Controlled Substances Act (CSA).Walmart preempted the suit in October, by suing the DOJ and Drug Enforcement Agency, claiming that the federal government was attempting to shift blame to the retailer for its own regulatory failures.

“In contrast to DEA’s own failures, Walmart always empowered our pharmacists to refuse to fill problematic opioids prescriptions, and they refused to fill hundreds of thousands of such prescriptions. Walmart sent DEA tens of thousands of investigative leads, and we blocked thousands of questionable doctors from having their opioid prescriptions filled at our pharmacies,” Walmart said.

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