835 Alabamians killed by fentanyl in 2022
The surge of fentanyl in the state has resulted in increased deaths from the deadly drug. Alabama State Public Health Officer Scott Harris reports that fentanyl deaths have gone from 121 in 2018 to 835 in 2022. “Fentanyl abuse is a crisis nationwide, and the state of Alabama is no exception,” Harris reported in his recent column. “Alabama has experienced an alarming increase in the number of fentanyl-related overdose deaths in recent years—from 121 in 2018 to 193 in 2019, and to 428 in 2020. Preliminary numbers show 830 Alabama resident deaths in 2021 and 835 deaths in 2022 related to this powerful drug.” Fentanyl deaths were up in 2022 even though paramedics, police departments, schools, churches, and even parents are increasingly prepared to respond to overdose emergencies with products such as Narcan. ADPH is part of a statewide education campaign to inform the public about the dangers of the drug. “Our department is committed to fighting this growing epidemic and has joined a group of statewide organizations that have launched the “Odds Are Alabama” campaign to prevent fentanyl-related overdose deaths and poisonings,” Dr. Harris continued. “Other campaign sponsors include the following concerned organizations and agencies: Alabama Chapter of the Academy of Pediatrics, Alabama Chapter of the American College of Emergency Physicians, Alabama Department of Mental Health, Alabama Hospital Association, Blue Cross and Blue Shield of Alabama, Medical Association of the State of Alabama, Scout Branding Company, and VitAL Alabama.” “About two-thirds of all overdoses nationwide are attributed to synthetic drugs like fentanyl,” Dr. Harris explained. “While the synthetic opioid fentanyl was originally developed for pain management in cancer patients, illegal drug manufacturers have abused it by adding fentanyl to other drugs to increase their potency. Criminal drug networks are mass-producing counterfeit pills to deceive the public.” On Thursday, Governor Kay Ivey signed legislation that set mandatory minimum sentences for persons convicted of trafficking in fentanyl. “The entire nation should take note of what we accomplished today in Alabama with the passage of House Bill 1, the bill to help combat the fentanyl crisis,” Ivey said. “Every member of the Legislature – Republican and Democrat – came together to pass this critical piece of legislation.” Under this legislation, a person found with just six grams of fentanyl could spend the rest of their life as a guest of the Alabama Department of Corrections if convicted. “Combatting this deadly drug will continue to be a top priority for our Alabama Law Enforcement Agency, and I will do everything in my power to stop this drug from being a killer in Alabama,” Ivey said. “I commend Rep. Matt Simpson for his leadership on this issue, as well as all members of the Alabama Legislature for sending this bill to my desk.” Dr. Harris points out that drug dealers are selling fake prescription drugs that are, in reality, highly addictive fentanyl. “Many fake pills are made to look like prescription drugs such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®),” Harris said. “Six of 10 counterfeit prescription pills analyzed by the DEA Laboratory in 2022 contained a potentially deadly dose of fentanyl. A lethal dose of fentanyl is only about 2 milligrams, equivalent to just a few grains of salt. Fentanyl is inexpensive to manufacture, and in 2021 the DEA seized enough fentanyl to kill every American. In addition to pills, fentanyl is found in capsule form and can be disguised as gummies or candies to attract children.” Narcan, administered as a nasal spray, is now available over the counter. In addition to Narcan, naloxone is available in an injectable form and in other doses. The other formulations and dosages of naloxone will remain available by prescription only. Dr. Harris has a standing order in place that allows pharmacists to dispense naloxone formulations and dosages that are prescription only. Medicaid patients can access naloxone through prescription. “The Alabama Pharmacy Association applauds the FDA’s decision to make this life-saving drug available without a prescription to anyone who needs it,” said Louise Jones, APA chief executive officer. “Only the Narcan 4 mg nasal spray version has been approved for over-the-counter (OTC) use. The Alabama current statewide standing order issued by the state health officer will remain in place as the injectable version will still require a prescription. It should be noted that Alabama Medicaid recipients have coverage for the nasal spray, but Medicaid requires a prescription for OTC products. APA, in collaboration with the Alabama Department of Public Health and Alabama Medicaid, has worked to maintain access for our state’s most vulnerable population.” Given the growing propensity of drug dealers to spike their products with fentanyl, do not buy anything from street dealers or shadowy pharmacy sales sites. To connect with the author of this story or to comment, email brandonmreporter@gmail.com.
Narcan now available over-the-counter without a prescription
On Friday, the Alabama Department of Public Health (ADPH) announced that the U.S. Food and Drug Administration (FDA) had approved the Narcan®4 mg nasal spray medication for over-the-counter nonprescription use. Narcan is designed to help reverse the effects of an opioid overdose in minutes. Other options remain prescription only. In addition to Narcan, naloxone is available in an injectable form and other doses. The other formulations and dosages of naloxone will remain available by prescription only. ADPH said that the standing order by State Health Officer Dr. Scott Harris would remain in place for naloxone and does not expire. The standing order allows pharmacists to dispense naloxone formulations and dosages that are prescription only. Medicaid patients can access naloxone through prescription. Louise Jones is the Chief Executive Officer of the Alabama Pharmacy Association. “The Alabama Pharmacy Association applauds the FDA’s decision to make this life-saving drug available without a prescription to anyone who needs it,” said Jones. “Only the Narcan 4 mg nasal spray version has been approved for over-the-counter (OTC) use. The Alabama current statewide standing order issued by the state health officer will remain in place as the injectable version will still require a prescription. It should be noted that Alabama Medicaid recipients have coverage for the nasal spray, but Medicaid requires a prescription for OTC products. In collaboration with the Alabama Department of Public Health and Alabama Medicaid, APA has worked to maintain access for our state’s most vulnerable population.” Narcan nasal spray is the first naloxone product approved for use without a prescription. In the next few months, Narcan can be sold directly to consumers in locations such as drug stores, convenience stores, grocery stores, and gas stations, as well as online. “Pharmacists and pharmacy practices across Alabama who have participated in the Naloxone Statewide Standing Order have been, and will continue to be, instrumental in helping patients get access to naloxone and other supportive therapies to help reduce the risk of an opioid-related overdose,” Jones said. “Pharmacies are highly accessible, critical access points that allow patients, caregivers, and families to connect with their trusted pharmacist to learn more about naloxone and the risk associated with opioid medications.” NPR’s A Martinez on Friday spoke with pediatrician and addiction specialist Scott Hadland about the FDA’s decision. The nasal spray could be on store shelves and ready to buy without a prescription by late summer. “We’re at a point right now in this overdose crisis where since the turn of the century, we’ve had more than a million overdose deaths and where these are increasing,” Hadland said. “We’re now at a point where more than 100,000 people die every year. Narcan is a medication that is safe. It’s effective. It has virtually no downside to administering it. And there really is no reason that it shouldn’t be widely available to save the lives of the so many people who die each year.” “What happens when somebody overdoses is that opioids – and in this day and age, it’s most commonly fentanyl that’s getting into people’s systems – opioids bind to receptors in the body and make it so that a person stops breathing, and that’s what ultimately ends up killing a person,” Hadland explained. “And so what Narcan is doing is it’s getting in, and it’s releasing the fentanyl or other opioids from those receptors and essentially in just seconds or even just minutes reversing that overdose and saving a person’s life. And since Narcan is a medication that’s sprayed up the nose, it’s very easy to administer. Almost anybody can do it with very little training needed.” Cost remains a concern. “It’s one thing to make it available. It’s another thing to make it affordable to people,” Hadland said. “And as somebody who works with families that have been affected by this overdose crisis every day, I know that if the price is too high, many families and patients just simply won’t buy it.” “Yeah, according to GoodRx, 130 bucks for an average price of a two-dose box,” Martinez said. “I know if you make something more expensive, it makes it harder to get, and also, people might want to do something terrible to try and get it.” Drug use among high school students is on a historic decline, but the drugs they use are more dangerous than ever before, resulting in overdose deaths tripling in recent years. Fentanyl is the causative agent, and often the drugs are laced with fentanyl. Only a tiny amount of fentanyl is needed to kill a person, especially someone younger and inexperienced with drugs. Most teenagers who overdose on fentanyl likely did not know it was in the drug they were taking. To connect with the author of this story or to comment, email brandonmreporter@gmail.com.
