Fentanyl has grown in its infamy over the past few years as being an extremely dangerous, deadly drug. In fact, synthetic opioids like fentanyl were responsible for over 20,000 overdose deaths in 2016. Clearly, a fentanyl overdose death is not all that uncommon, despite the opportunity for detox. Unfortunately, the fentanyl deaths in 2016 are not the end of the story. The synthetic opioid continued to wreak havoc in 2017. More than that, fentanyl is considered so deadly that it’s now being used as part of a three-drug concoction used during death penalty executions in Nevada. That’s right. A synthetic opioid responsible for thousands of fentanyl overdose deaths in the United States each year will now be used by the government to bring about the death penalty for death row inmates.
The Headline: In November, Nevada will use fentanyl to execute an inmate on death row. That’s just how deadly the synthetic opioid drug is.
“After setting an execution date with no lethal injection drugs in stock, Nevada last month announced a solution to its death penalty dilemma—a three-drug protocol using fentanyl and Valium. The decision to use this particular combination of narcotics—along with a muscle relaxant called cisatracurium—may be a previously untried approach to carrying out capital punishment.” ~ Kerri Blakinger, writing for The Fix The use of fentanyl in death penalty executions is not all that surprising. After all, the synthetic narcotic is so potent that just three grains of fentanyl are considered lethal to an adult. It is 50 times stronger than heroin. Fentanyl was first synthesized half a century ago, and used extensively since it can treat severe pain. But today, the narcotic is one of the major factors behind the opioid crisis in the United States. Fentanyl clearly has deadly consequences, so what’s the rest of the story here? And what is fentanyl, anyway?
The Basics: Understanding Synthetic Opioids and Narcotics
In simple terms, fentanyl works similarly as morphine, one of its opioid cousins. In other words, fentanyl works as a powerful analgesic, or painkiller. But here’s the thing: fentanyl is at least fifty times more potent than morphine. Prescribed as Abstral, Subsys, Duragesic and Ionsys, fentanyl is used to help patients deal with severe pain after an injury or surgery. But like most synthetic opioids, fentanyl is not always limited to prescriptions. The synthetic opioid is also mixed with heroin and sold on the street. Its street names include China White, Tango, and Apache. “Fentanyl is a synthetic drug that has played a substantial role in the surge of opioid overdose deaths in the country. Just a few milligrams of the substance can be lethal, an amount equivalent to several grains of salt. Given that the drug has likely killed thousands of Americans already, its efficacy as a method of execution isn’t really in doubt.” ~ Alex Berezow, writing for the American Council on Science & Health While Abstral, or Duragesic, is 50 to 100 times stronger than other opioids, it works the same way as morphine or heroin. The drug reaches the brain’s opioid receptors – which control both emotions and pain. It is this combination that often causes people to abuse fentanyl. Fentanyl can treat severe pain, but it can do a lot more than that. When it is used in a way other than prescribed, Subsys can create a sense of euphoria or relaxation. In other words, it causes a high and indirectly causes addiction.
Fentanyl Toxicity Level: Extreme
But this high rarely lasts for long. Whether someone abuses prescription fentanyl by taking more than prescribed or buys heroin laced with fentanyl, the consequences can quite often be deadly. “Fentanyl is a synthetic (man-made) opioid that is 50x more potent than heroin and 100x more potent than morphine.” ~ Centers for Disease Control & Prevention The strength of fentanyl is not something to take lightly. Any opioid affects breathing, and Duragesic literally affects a person’s ability to breathe fifty times more than heroin and 100 times more than morphine. This becomes extremely dangerous when people take drugs that are laced with fentanyl without knowing it. There is know way to know exactly how large of a dose of fentanyl the street drug has; even a tiny dose can be fatal. This is why the news that fentanyl is being used as a lethal injection in Nevada is so ironic – and sobering for those of us addressing the issue of fentanyl addiction in the United States. “Fentanyl effects include euphoria, drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma, and death.” ~ The National Institute on Drug Abuse
The News: Nevada Officials Propose Using Fentanyl in the Death Penalty
Benjamin Franklin has said that only two things are certain in this world: death and taxes. But there is a third thing that is all but certain, at least in the United States: the divisive debate of the death penalty. This is a debate that has gone on for decades, and is unlikely to come to any kind of resolution any time soon. With the status of the death penalty left up to each individual state, the United States as a whole has no clear policy when it comes to lethal injections. Within this context, Nevada has recently decided to make new strides in both the use of Abstral and the death penalty in the state. That is, policymakers in Nevada have decided to use the synthetic opioid known as fentanyl in the state’s first execution in over a decade. “I have one word that summarizes all of it, and it’s ‘irony’. You got something that’s killing hundreds of people a day across the United States, and you got prisons who can’t get death penalty drugs, so they’re turning to the drug that’s killing hundreds of people across the United States. This sounds like an article from the Onion.” ~ Josh Bloom, director of the American Council on Science & Health The story began earlier this year, when death row inmate Scott Dozier decided that he wanted to be executed as soon as possible. Instead of continuing with the lengthy appeals process, Dozier gave up his right to appeal and made known to officials that he actually wanted to be executed. This left state officials in a pickle; Nevada didn’t actually have any narcotics that could be used in an execution.
The Drug: Narcotic Used as Part of a 3-Drug Combination for the Execution
This is part of the debate surrounding the death penalty around the United States. Pharmaceutical companies do not want to manufacture drugs specifically for executions in the face of the controversy. There is a trend in the entire pharmaceutical industry to oppose the use of drugs in executions. In fact, when Nevada asked for bids for drugs like midazolam and hydromorphone (often used in executions), the state received zero offers. But state officials did not let that stop them honoring the request of the death row inmate. In August, state officials announced that Scott Dozier would be executed using a three-drug solution: fentanyl, diazepam, and cisatracurium. We already know what fentanyl is – diazepam is a sedative sold under the brand name Valium, while cisatracurium is a muscle relaxant designed to induce paralysis. This combination of drugs has never before been used in a United States execution.
The Debate: Will Fentanyl Work as an Agent for the Death Penalty?
The decision to use Ionsys in a death penalty execution did not come without its own share of debate and backlash. Some people hold that the move pioneers a new step forward in using different chemicals for the death penalty. Others do not take as generous of a standpoint, holding that the move is both dangerous and insensitive to the plight of thousands of Americans who have died from a fentanyl overdose. “People are killing themselves, drug abusers, with fentanyl, and now the state is going to do the same thing to this guy.” ~ State Senator Tick Segerblom, sponsor for a Nevada bill to abolish the death penalty The major part of the debate comes from the combination of drugs in the planned execution; namely that both a paralytic and a drug that causes unconsciousness. The running theory is that the combination could result in something other than death – a reality experienced by many people around the country addicted to synthetic opioids. “Use of these drugs could result in a botched execution, leading to torture or a lingering death in violation of the protections of the United States Constitution.” ~ Tod Story, Nevada Executive Director for ACLU
Understanding the Danger of Synthetic Opioid Abuse
Of course, at the foundation of this debate lies the danger of Duragesic itself. The mere fact that the drug is being used in a planned execution shows just how dangerous the synthetic opioid can be. The debate surrounding the death penalty is important in the United States; but the lethal nature of fentanyl and other synthetic opioids has no room for debate. “The opioid works on the systems that control both sleep and breathing: At the base of your brain lies a respiratory control center that drives your breathing, reacting to the level of carbon dioxide and oxygen in your blood to spur you to breathe. During an overdose, the slowed breathing that occurs with opioid ingestion of any kind becomes dangerously slow, leading to a complete stop.” ~ Maggie May Ethridge, writing for Vice Magazine According to a recent report from the Deputy Director of the National Institute on Drug Abuse, the misuse of and addiction to opioids like Duragesic or Abstral “is a serious national problem that affects public health as well as social and economic welfare.” More than that, the Deputy Director noted that the opioid epidemic in the United States has had a negative impact on everything from health care costs to the number of drug overdose deaths in this country.
Narcotic Overdose: A Real Danger in the United States
The fentanyl overdose statistics in the United States are sobering, even in the face of the death penalty story coming out of Nevada. In 2016, there were a total of 64,000 drug overdose deaths. Among these deaths, the sharpest increase can be accounted for from fentanyl and other synthetic opioids made using fentanyl. More specifically, synthetic opioids accounted for over 20,000 overdose deaths. “Some opioid users are aware of the dangers of both fentanyl and heroin: According to the report, 30 percent of the respondents said that, in order to help protect themselves against a deadly overdose, they don’t use the drugs when they are alone.” ~ Sara G. Miller, writing for LiveScience Even more sobering is the fact that fentanyl related deaths are up by over 500% in just three years. In contrast, the total drug overdose statistics in the United States rose by 22% in the same period. Clearly, something has to be done other than using Abstral as an instrument for the death penalty in Nevada.
Avoiding Fentanyl Overdose – Getting Opioid Addiction Treatment
Beyond this story of the death penalty in Nevada, there is something even more important to discuss: the opportunity to avoid a Duragesic overdose by getting treated for opioid addiction. From drug detox to intensive outpatient treatment, addiction treatment can help anyone and everyone get on a better path to health and happiness. Addiction treatment – for both fentanyl and other forms of narcotics – helps to address the underlying issues of substance abuse and create strategies for dealing with the substance use disorder in the future. If you have questions about fentanyl overdose or fentanyl addiction, do not hesitate to contact us today.