‘It’s devastating’: how fentanyl is unfolding as one of America’s greatest tragedies

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It was August 2020, and Luca Manuel, 13, was starting eighth grade the next day in Redding, California. He was excited to see his friends; His mother bought him a bunch of masks and school supplies for his first personal school day in six months.

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But a week ago, she had a root canal, and her mouth still hurt. He sent a message on Snapchat to find marijuana for pain. Instead, the dealer said he had something better: Percocet.

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Little did Luca know that the pill that had been pressed to look like real pain medication was actually a fake containing fentanyl, a substance 30 times more potent than heroin. He died of drug poisoning that afternoon, with a video game looping in front of him like a ghost on the screen.

Over 100,000 people died of overdoses in the US in the 12-month period ending in April, according to the US Centers for Disease Control and Prevention.

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Drug researchers say this is the biggest increase ever in the US – and it is increasing every month.

Nora Volkow, director of the National Institute on Drug Abuse, told the Granthshala that fentanyl is driving the majority of these deaths, which are associated with at least 60% of fatal overdoses — a 50% increase in a single year.

“It’s devastating,” she said. “It’s an epidemic within an epidemic.” Fentanyl deaths were already on the rise across the country, but the pandemic supercharged their speed and intensity.

Volkow said it is not unusual to see people turn to drugs or alcohol in times of crisis. “But we did not expect that there would be a huge increase in the entry of these illegal substances into the country during that period.”

Dramatically more fentanyl is arriving in the US, making supplies of the drug increasingly dangerous.

“The trajectory is up, without any leveling off,” said Daniel Cicarone, a professor of addiction medicine at the University of California, San Francisco, Justin Minor. “There’s nothing that says it’s slowing down.”

From pain pills to heroin to fentanyl, the “triple wave” of opioids is wreaking havoc, he said.

“Fentanyl is an extraordinarily potent drug. It was specifically manufactured to be much more potent than morphine,” Volkow said. It’s also incredibly profitable, she said. “If someone is a drug dealer, they make a lot more money selling fentanyl than selling heroin or selling cocaine.”

Luca Manuel, a 13-year-old who died of an accidental overdose in August 2020 after what he thought was a pill laced with Percocet Fentanyl. Photo: Amanda Faith/Reuters

Another alarming trend is arising with the dominance of fentanyl. People who have never used opioids before are dying from a single fatal encounter with fentanyl. “They are not opioid users, and they don’t know that these drugs are contaminated and they die from a single exposure,” Volkow said.

Even for people who are addicted to opioids, it can be difficult to judge a safe dosage of fentanyl. Most experienced drug users don’t like it, but as prescription pills and heroin became more difficult to obtain, dealers increasingly began adding fentanyl to the supply.

Experts and bereaved families are seeing an alarming number of people, even children, who they believe are taking legitimate Percocet or Xanax pills with friends.

“Fake pills are a big part of the story,” Ciccarone said. A high-quality pill press can make the substance look like a legitimate drug. “They explore the whole world like the real thing.”

Fentanyl has been circulating along the East Coast for about a decade, but is now moving west, where “people aren’t used to it, and don’t know how to use it”, he said. While fentanyl overdoses were previously primarily concentrated among the white population, communities of color are now being hit harder than ever before.

“It’s going into new clusters and causing devastation,” Ciccarone said.

However, there are some solutions. One drug, buprenorphine, can help people who are addicted to opioids and prevent overdoses, and inexpensive test strips can detect the presence of fentanyl in other drugs. Housing stability can also help prevent substance use.

Fentanyl overdoses are reversible with quick access to a drug called naloxone — but the price of naloxone has increased dramatically this year, leaving shortages for many of those who need the drug most. “We just need it more,” said Ciccarone.

The Biden administration recently announced harm-reduction policies to stem the wave of overdoses, an encouraging move, Ciccarone said.

Ciccarone said it is also important to address the fundamental inequalities that fuel the extreme crisis. “Unless we address the inequalities in our society, we will continue to do wave upon wave of drug overdoses. This is a wake-up call, and civilizations collapse if they do not address the instability in their populations. We do.”

Luca’s mother Amanda Faith Eubanks remembers her son as a kind, loving, trustworthy child. On the morning of her last day, she shopped for groceries as she asked to cook for a nearby homeless camp. “He flourished in service to others,” she told the Granthshala. “He was just the kid you could go to on any bad day. He had a heart of gold.”

“Fentanyl is unlike anything anyone has ever seen before,” Eubanks said. “This is a public safety crisis.”

In Luca’s case, detectives have accused the dealer of murder; their preliminary hearing Will start at the end of this month. And Eubanks has begun speaking out, creating a support group for families who have lost loved ones to fentanyl poisoning.

“I don’t want more people to die from this,” she said. “I didn’t want another mom to ever feel it.”

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