Congress: Fentanyl Is ‘Third Wave’ Of Opioid Epidemic

A congressional panel heard from experts in the field about the impact of fentanyl and carfentanil and ways to combat the opioid crisis.

Members of Congress attended a hearing this week that discussed fentanyl use as the next wave of the opioid epidemic. The hearing, called “Fentanyl: The Next Wave of the Opioid Epidemic,” also examined the rise in overdose deaths related to the drug.

“Now illicit fentanyl has become a potent additive to heroin, cocaine, or even counterfeit prescription drugs," said Rep. Tim Murphy, a Republican from Pennsylvania. "This is the way the drug dealers increase profits, stretch out their supply, and expand the number of addicts, by juicing the potency of heroin or other street drugs.”

Overdose deaths related to synthetic opioids like fentanyl and carfentanil increased more than 72% between 2014 and 2015, according to the Centers for Disease Control and Prevention.

At the hearing, Debra Houry, MD, the director of the CDC's National Center for Injury Prevention and Control, testified that data from 2016 suggests that death rates continued to rise—although the full data is not yet available.

In many cases, deaths that involve fentanyl and other synthetic opioids aren’t reported as such because medical examiners do not have the resources to consistently test for these drugs in overdose victims, Houry said. The people most at risk from overdoses are those who have previously used opioids, including legal prescriptions, and men between the ages of 25 and 44.

"People are getting exposed to opioids and going on to fuel their addiction through heroin and fentanyl," Houry said.

Some areas of the country have seen an even more shocking rise in overdose rates. In Ohio, fentanyl-related deaths rose 500% between 2013 and 2014. Now the state is grappling with carfentanil, a large-animal tranquilizer that is 100 times more potent than fentanyl.

The panel at the hearing heard from Louis Milione, assistant administrator of the DEA's Diversion Control Division, which analyzes drugs seized by law enforcement. In 2013 just 1,041 samples contained fentanyl. Last year nearly 29,000 samples did, Milione testified.

The panel also heard about how carfentanil enters the United States through the postal service, often from China. Assistant Secretary of State for International Narcotics and Law Enforcement Affairs William Brownfield said that U.S. authorities have begun to slow that flow.

While the panel agreed that the rise in fentanyl use in the country needs to be addressed by a variety of agencies, Democrats and Republicans differed in their opinion of whether the effort to repeal and replace the Affordable Care Act would affect use.

Wilson M. Compton, MD, deputy director of the National Institute on Drug Abuse (NIDA), said that fentanyl is particularly dangerous because it enters the brain rapidly. Having access to treatment is essential for fentanyl users, he said.

"We do know that when treatment is interrupted or stopped, whether that's intentional or unintentional, the risk of relapse is extraordinary.”