The House Hold Assassin: Fentanyl
Do you know there is an assassin in our house that has killed more Americans than entire Vietnam
War? And it is only warming up? Fentanyl-related deaths have grown 10-fold in the last year. And
Fentanyl has become the leading cause of death by overdose (it is hard not to overdose, as it is
enormously powerful). It is coming for us, or for someone dear to us. One way or another, many of us
will be badly hurt, unless we do something. And right now, we are not very well prepared.
As a pain specialist and anesthesiologist, I was awed by the power of this super-drug, created to blunt
the worst pains possible (as in being cut wide-open during surgery). It is an amazing product, that
revolutionized our field. But in the operating room, we have the supporting and monitoring systems that
would allow us to safely drive you back to a pleasant, albeit fuzzy-headed awakening.
Imagine boarding an airplane, strapping yourself in for turbulence, taxiing, taking off, and flying at 32000
feet, then, gently descending to the ground for a precise and timely arrival, under the care of a
competent, caring staff.
Outside the OR, at a party, at home chilling, or vacationing in paradise, you have no such protection.
Imagine being launched from a cannon at 32ooo feet. What are you going to do? Same path, not the
same outcome.
Fentanyl is a fine powder, 100 times stronger than Morphine, cheap to create, and extremely easy to
conceal for transport. It has been used to spike, lace, and adulterate every form of legal and illegal drug
(sedatives like Xanax, antidepressants like Prozac, other narcotics like heroin, Percocet, Hydrocodone,
stimulants like crystal meth, Adderall, MDMA). The presumption should be that any drug coming from a
person you know may have passed through 2-3 more pairs of hands that you will never know. Reassured
yet?
And while kids and other vulnerable people (along with a sizable number of innocent bystanders) die all
around us die every day, it is comforting to hear that the CDC, the elite forum of experts and policymakers
tasked with our safety and well-being, finally decided to call an emergency. For moneypox.
These are not serious people. While Fentanyl floods us through our porous borders, there is minimal
leadership and guidance from Washington, which is too busy with its own self-serving interests taking
center stage in this busy election season. This time bomb is left for the local leaders of communities like
ours to try to defuse and develop defensive systems.
As an initial kit of simple advice, I would humbly suggest:
-Narcan (a reversing and temporary antidote) stations backed by Narcan-specific trained people
everywhere drug use can take place (which means everywhere). Note: a single dose of Narcan will not
last too long, but only be able to buy the time needed to call first responders, who will continue the
necessary treatment.
-Fentanyl-testing strips that can identify its presence in other pills, powders, and liquids to be made
available in a similar manner.
-if you take drugs, do not do that alone; have a designated guardian everywhere you decide to use.
-if you receive your fix from anywhere else than a medical facility or pharmacy, understand that there is
a chance in 3 it will be contaminated with Fentanyl.
-dust from contaminated drugs can linger or float around and be ingested or inhaled, with dire
consequences, especially for the frail or very young; so, best not bring it in your house.
It is beyond my set of skills to devise a policy and its mechanisms. A nimble and rapidly responding blue-
ribbon group of healthcare and other first-responders, school administrators, local industry, and civic
leaders, as well as any others with experience, deemed useful would be a good start. I will contact the
City Hall, as well as the 2 great hospitals we are fortunate to have and ask for guidance.
I also would appreciate your thoughts, advice, and input at csavumd@gmail.com
I hope you will hear from us soon. Until then, be safe and take good care of yourselves. God Bless.