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Late last fall the Ohio Narcotics Intelligence Center of the Ohio Department of Public Safety released a report about "Potentially Lethal Counterfeit Tablets in Ohio." The report said, "Counterfeit prescription tablets with fentanyl and other potentially lethal contents are present in Ohio and almost certainly growing in sophistication, likely impeding individuals, including law enforcement, from easily determining tablet legitimacy, as well as potentially contributing to an increase in accidental overdoses," the unclassified report advised.
Earlier the DEA (Drug Enforcement Administration) released "a public safety alert warning of a sharp increase in fake prescription tablets containing fentanyl and methamphetamine." The DEA had not issued such an alert in six years, so this is something to take seriously.
On Jan. 28, the CDC (Centers for Disease Control and Prevention) released its Morbidity and Mortality Weekly Report, Notes from the Field: "Increased incidence of fentanyl-related deaths involving para-fluorofentanyl or metonitazene - Knox County, Tennessee, November 2020-August 2021."
This report, authored by the DEA, Clinical Toxicology and Biomonitoring Laboratory at the University of California-San Francisco and the Knox County Regional Forensic Center in Knoxville, Tenn., states that drug overdose deaths increased from 78,056 to 100,306 in the period between April 2020 and April 2021. About 75 percent of drug overdose deaths during 2020 involved opioids," the CDC says. "With illicitly manufactured fentanyl continuing to supplant the heroin market, and increasing illicit use of counterfeit pills containing either fentanyl, various fentanyl-related compounds or other opioids, the risk for drug overdose deaths remains high.
"Recently, para-fluorofentanyl, a substance from research efforts in the 1960s, and referred to as 'China white' before it was classified as a schedule 1 substance in 1986, has begun to reemerge on the illicit drug market."
The drug, CDC says, is found in heroin packets, counterfeit pills, and is reported in autopsy findings and supporting toxicology results. The Knox County forensic center conducts autopsies for 23 counties, identifying para-fluorofentanyl in toxicology results in November 2020 and metonitazene, either alone or in combination with fentanyl or para-fluorofentanyl in January 2021. During the period November 2020 and August 2021, the forensic center reported:
--770 unintentional deaths by drug overdose.
--562 of those deaths (73 percent) tested positive for fentanyl, postmortem.
--192 fentanyl only positive tests.
--188 fentanyl and methamphetamine positive tests.
--48 involving para-fluorofentanyl.
--26 involving metonitazene.
"At FRC (Family Recovery Center) we are not aware of specific use of paera--fluorofentanyl and metonitazene by those we serve," said Amanda Kantaras, clinical supervisor at the agency. "However, that does not mean that it's not out there.
"We do screen for fentanyl and send it to the lab for confirmation testing which will list any derivatives," she said. It is not certain that these particular substances would show up on a lab test at this time.
Reportedly, these drugs are so strong that overdose death can be immediate. More Naloxone could be needed to reverse overdose death.
Ms. Kantaras said that while telehealth has been beneficial, there are still challenges: internet connectivity, people running out of phone minutes, and other technological barriers have limited the use of telehealth services for some clients.
"Here at FRC we continued to provide face-to-face services throughout the pandemic, but we found that some people in need assumed they could not receive treatment during that time. We have held hybrid groups, with some in person and some over Zoom, which still provides that group experience that we know is beneficial for those seeking sobriety."
Addiction has no address, but Family Recovery Center does. For more information about the education, prevention and treatment programs for substance abuse and related behavioral issues, contact the agency at 964 N. Market St., Lisbon; phone, 330-424-1468; or email, info@familyrecovery.org. Visit the website at familyrecovery.org. FRC is funded in part by Columbiana County Mental Health and Recovery Services Board.