Lil Peep was a performer who was said to be the future of rap. In only the last year, he uploaded his music to Soundcloud and abruptly appeared on the Billboard's Hot 100 for his infectious, dizzied and wounded take on an otherwise aggressive genre. Then, at age 21, he was found lifeless in Tucson, Arizona due an overdose. The last 24 hours of his life were filled with uninhibited social media accounts of drug use and death notes, and the very same music that shot him to fame included lyrics such as "Everybody telling me life's short, but I wanna die" and "Now I'm getting high again, tonight." While it is an unfortunate reality that his untimely death should be no surprise, what is surprising is the particular drug he is suspected to have overdosed on: fentanyl.
Rehabs and drug treatment centers can support research claims as they have also witnessed a firsthand drastic increase in the number of deaths in the past couple years specifically from fentanyl. Chris Osborn, operations director at 310 Recovery, weighed in on the phenomenon, “the current state of the opioid crisis, at least in California, is very concerning. A lot of clients we’ve seen who come in with heroin addictions had recent overdoses as a result of heroin cut with fentanyl. As some of them go out after periods of brief or long term sobriety, a lot of them are overdosing and dying.”
So what is fentanyl and why is it killing so many people? It was first introduced in 1959 as a painkiller and anesthetic said to be 100 times more powerful than morphine. What makes the fentanyl epidemic so difficult to defeat is that, when used properly, it can be positively life changing. In the mid 1990s a patch was developed to deliver the drug transdermally to manage the chronic pain of say, a cancer patient. The gel-infused patch was made to deliver pre-detemined doses and went through several trials before being popularized. Lollipops, sprays and lozenges were also introduced to carefully provide relief to patients.
Now, decades later, there are more than 12 illicit types of fentanyl, obviously with zero trials, that last in shorter, more powerful spurts than even heroin, but with similar feelings of euphoria. Dr. Timothy Fong, Clinical Professor of Psychiatry and Director of the UCLA Addiction Medicine Clinic, explains the strength of the synthetic opioid, “It’s incredibly lethal because it’s incredibly strong, in that it binds tightly and powerfully to the brain receptors that almost no other opiate can compete with its strength." He continues, "The overdose and lethality happen because when all of the body’s opiate receptors are occupied quickly the rest of the body shuts down, more specifically, the breathing center in the brain stops working.”
It is less common that an addict’s drug of choice is fentanyl, but for some, it becomes that. One recovering drug addict said his progression began with pills after a surgery, ”I was prescribed Percocet. Then I got into heroin when it got too expensive, after a few years, friends of mine that were dealers were cutting their stash with fentanyl. Then I just started buying it without the heroin at all because it was a little cheaper and stronger. You can even learn how to make it yourself with a high school chemistry education.”
What is especially terrifying, is the commonality of people putting it in drugs. Because it looks like many other drugs, dealers can use the pain reliever to cut heroin, cocaine, and even pills, to profit more. “I don’t know why anyone would knowingly do fentanyl,” Carl, a 25 year old ex drug addict says. Because Fentanyl looks just like cocaine and heroin, it is possible to take it by accident and because of its more powerful effect, it is easier for someone to overdose if they believe they're taking cocaine. The only way to know what is really in the drugs, is to buy testing strips that are around $20, or test them in a lab, something most people doing heroin aren’t doing.
How do we put a stop to the fentanyl-related deaths? According to The International Journal of Drug Policy, "U.S. and authorities will be helpless to prevent unheard of rates of overdose deaths unless the crisis is treated as a public health emergency." The declaration of a public health emergency would mean we would treat this epidemic as forcefully and tirelessly as any natural disaster or terrorism threat. In October, President Trump did declare the opiod crisis a public health emergency, but a lack of effective initiatives and Peep's recent death--combined with the issue's complexity—prove we are a long ways away from any end.