Combatting the Fentanyl Crisis: Dr. Ray Ward

In 2021, 220 Americans died every day from an opioid overdose—that’s an epidemic. And of those overdoses, nearly 88% involved a synthetic opioid like fentanyl—that’s a crisis. Fentanyl is up to 50 times stronger than heroin and up to 100 times stronger than morphine. It’s cheap to produce and is now being laced in almost every illicit drug from cocaine to off-brand Adderall®.

Dr. Ray Ward is a Buprenorphine Practitioner and Physician at Cope Family Medicine | Ogden Clinic in Bountiful, Utah. He’s spent nearly two decades helping people struggling with substance dependence. He’s unpacking the sharp rise in opioid deaths over the last few years, and how users, family, and friends can together combat the ongoing fentanyl crisis.

“Utah’s opioid epidemic began more than 20 years ago with the overprescribing of legal prescription pain relievers,” says Dr. Ward. When these drugs became harder to get for nonmedical use, heroin use increased. Today, illegally manufactured fentanyl is being mixed with other drugs, which why overdose deaths are so high.

Most of the heroin comes to the United States from poppy farms in Mexico. Large quantities of heroin are also produced in South American countries, China, or shipped through Canada and trafficked to the United States by air and sea.

“Remember that a little fentanyl goes a long way,” says Dr. Ward, “It’s 100 times stronger than morphine.” Because of this, people who manufacture illegal drugs use fentanyl to make their drugs more powerful and less expensive to make. And the amount of fentanyl in illegal drugs as well as counterfeit pills is completely random, even from the same supply. One portion or pill may not contain any fentanyl, while others from the same supply may contain a large amounts.

“While some people seek out fentanyl, many folks don’t even know they’re taking it—it’s in many, many drugs these days,” says Dr. Ward.

Fentanyl is often found in counterfeit pills that are made to resemble prescription drugs. This includes prescription pain relievers, like oxycodone, and stimulants like Adderal®. You are at risk for a fentanyl overdose if you buy pills from any source that is not a licensed pharmacy. Fentanyl is also found in other drugs like cocaine, methamphetamine, and heroin. You are at risk of a fentanyl overdose if you use any of these drugs.

Because fentanyl is so potent, it does not take a lot to cause an overdose, especially in someone who does not usually take opioids. In 2021, the latest year in which data is available, nearly 645,000 people in America died from opioid overdose—an estimated 88% of them involved fentanyl.

Opioid use disorder is a medical condition that can affect anyone who uses opioids. Here are some signs to look for in friends or family.

NARCAN® is the opioid overdose reversal drug that can be used to save the life of someone experiencing a fentanyl-related overdose. NARCAN® kits are available over-the-counter in Utah at pharmacies across the state. Act fast in the case of a fentanyl-related overdose. Call 911, then administer NARCAN®. Keep in mind that than one dose of NARCAN® may be needed.

Fentanyl test strips (FTS) are small strips of paper that detect fentanyl in drug samples before ingestion, helping prevent unplanned fentanyl usage and overdose. Studies indicate that FTS usage:

Treatment is possible to overcome the negative effects of addiction and return to being a functional member of society. Look for a doctor in your area that prescribes buprenorphines like methadone or suboxone and oversees your wellbeing. "While these are still narcotics, the risk of overdose is much lower; they help people be productive and stable in a controlled way," adds Dr. Ward.

“If I could have one wish granted, I'd wish that doctors would be honest about the severity of pain medication and prescribe way, way less,” says Dr. Ward. “Long-term use of narcotics makes pain worse, not better. Best-case scenario: people can manage pain but they are addicted. Worse-case scenario: People harm themselves or die of overdose, which also harms their loved ones.” He adds that the treatments he uses (buprenorphine, suboxone, etc) are still narcotics—they’re not a silver bullet that cures addiction.

Prescription pain relievers should be used with caution. Ask your healthcare provider these questions when getting a prescription for an opioid.

Prescription opioids are not the only option for managing pain. An over-the-counter pain reliever may be enough. Other options like acupuncture, cognitive behavioral therapy, physical therapy, yoga, or massage therapy can also help you feel better with fewer risks and side effects. Discuss these options with your doctor.