The Connection

Street names like, Dance Fever, Friend, Goodfellas and Jackpot are meant to appeal to the young. There is easy access through sales on social media and e-commerce, making it available to anyone with a smartphone. It is easy to see why the Drug Enforcement Agency says, “Fentanyl is the single deadliest drug threat our nation has ever encountered.” The CDC reports that fentanyl, and other synthetic opioids, are now the most common drugs involved in overdose deaths. Over 150 people die every day from these overdoses, many of them children and young people below the age of 24. 

An average of five Virginians die from fentanyl poisoning every day, 2,490 drug overdose deaths in 2023 

Virginia officials in both state and local governments are taking action to combat the scourge. Virginia First Lady Suzanne S. Youngkin, with Attorney General Jason Miyares, recently announced the launch of a Fentanyl Awareness Pilot Program. The Virginia Department of Health awareness initiative is being implemented with support from the Virginia Foundation for Healthy Youth, in partnership with the Attorney General’s ‘One Pill Can Kill’ campaign. The campaign strives to warn parents and caregivers that “it only takes one.” One bad decision, one counterfeit pill, can cost a life. An average of five Virginians die from fentanyl poisoning every day, becoming the leading cause of unnatural death in the Commonwealth. Since 2019, deaths have more than doubled in the Roanoke region, where the campaign was kicked off on Jan. 30. “Fentanyl is killing our young people and hurting families across the Commonwealth,” said First Lady Youngkin. “By bringing attention to the dangers of this illicit drug, while giving a voice to victims, we aspire to save lives.” For more information and additional resources on the campaign, visit ItOnlyTakesOneVA.com.

General Assembly Takes Action

In the General Assembly this session, House Joint Resolution, HJ 41, sponsored by Del. Kannan Srinivasan (D-26), and Sen. Saddam Salim (D-37), was one of several bills related to fentanyl. If passed, HJ 41 would direct that the Joint Commission on Health Care study policy solutions to the Commonwealth’s fentanyl crisis. The resolution cited 2,490 drug overdose deaths among Virginians in 2023 that were caused by fentanyl and related drugs. There were 22,398 drug overdose emergency department visits among Virginians in 2022 an increase of five percent over the prior year. [Note - the bill was tabled in the Appropriations Subcommittee for lack of state study resources. An amended fentanyl study bill passed and was on its way to the House for consideration at this writing.]

Fairfax County’s Response 

The Fairfax County Board of Supervisors Safety & Security Committee, chaired by Supervisor Rodney Lusk, (D-Franconia) heard testimony on the opioid/fentanyl crisis and Fairfax County’s strategy on Jan. 30. Speakers included members of the substance abuse task force, police department, and public schools. A cross-systems approach employs about 40 programs aimed at education and prevention, early intervention and treatment, harm reduction, recovery, criminal justice and enforcement, and data and monitoring. 

In FY 2022 and 2023 the county received an approximately $4 million share of opioid settlement case funds, which have been used for prevention and support programs. Funding might continue in future years but is uncertain. 

The presentation to the county committee highlighted opioid settlement funded projects including Drug Court expansion, a diversion program; jail based medications for opioid use disorder (MOUD) impact on post release overdose and recidivism; partnership with public schools on a prevention campaign and anti-stigma initiative targeting youth risky behaviors; and an expanded program to treat opioid use disorder. The effort seeks to use grant and local matching funds to bring a residential youth detox/substance use treatment service facility to the Northern Virginia region, since potential patients must now travel out of state to receive such services. 

What Is Fentanyl?

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. There are two types of fentanyl: pharmaceutical fentanyl and illegally made fentanyl. Both are considered synthetic opioids. Medical fentanyl was approved for use in the U.S. in 1968 and is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer. It is also used as a sedative. 

Illegally made fentanyl (IMF) is available on the drug market in different forms, including liquid and powder. Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine, and made into pills that resemble other prescription opioids. Locally the ‘street price’ has dropped to less than $10 per pill, as compared to $30 in recent years. Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl since it can’t be seen, tasted or smelled. It is nearly impossible to tell if drugs have been laced with fentanyl unless you test drugs with fentanyl test strips. Test strips are inexpensive and typically give results within 5 minutes, which can be the difference between life or death. Even if the test is negative, test strips might not detect more potent fentanyl-like drugs. This is why fentanyl awareness campaigns suggest, one pill can kill. 

Fentanyl is the major contributor to fatal and nonfatal overdoses in the U.S. In 2023 fentanyl overdose deaths topped 112,000 in a 12 month period for the first time, according to the Centers for Disease Control and Prevention. Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Even in small doses, these illegally made opioids can be deadly. Fentanyl poses an exceptionally high overdose risk in humans, since the amount required to cause toxicity is unpredictable. It overtook heroin as the most deadly drug in 2018. DEA warns, “The ease of its manufacture, its high potency and relatively low price; and being easier to produce and smuggle, results in fentanyl replacing other abused narcotics and becoming more widely used.

The Only Safe Meds 

The DEA warns, “the only safe medications are ones prescribed by a trusted medical professional and dispensed by a licensed pharmacist. Any pills that do not meet this standard are unsafe and potentially deadly.” DEA launched the public awareness campaign, One Pill Can Kill, to educate the public on dangers of counterfeit pills and how to keep Americans safe from the increase in the lethality and availability of fake prescription pills containing fentanyl and methamphetamine. International and domestic criminal drug networks are mass-producing fake pills, falsely marketing them as legitimate prescription pills, and killing unsuspecting Americans. These counterfeit pills are easy to purchase, widely available, and often contain deadly doses of fentanyl. Pills purchased outside of a licensed pharmacy are illegal, dangerous, and potentially lethal. 

Fake prescription pills are widely accessible and often sold on social media and e-commerce platforms. These counterfeit pills have been seized by DEA in every U.S. state, and in unprecedented quantities. Criminal drug network are mass-producing deadly fentanyl and fentanyl-laced, fake prescription pills, using chemicals sourced largely from China, according to alerts. 

“These fake prescription pills are designed to appear nearly identical to legitimate prescriptions and have been found in every state in the country,” DEA Administrator Anne Milgram says. “Criminal drug networks are harnessing the perfect drug trafficking tool: social media applications that are available on every smartphone. They are using these platforms to flood our country with fentanyl.” For more information, visit DEA.gov/onepill

What Happens in Fentanyl Overdose?

According to the CDC, “fentanyl’s adverse effects are identical to those of other narcotic opioids, including: addiction; confusion; respiratory depression, which if extensive and untreated may lead to breathing arrest; drowsiness; nausea; visual disturbances; dyskinesia [involuntary muscle movements]; hallucinations; delirium; … loss of consciousness; hypotension; coma; and death. Alcohol and other drugs (e.g., cocaine and heroin) can exacerbate fentanyl's effects. 

Naloxone (also known as Narcan) can reverse the effects of an opioid overdose; however, because fentanyl is so potent, multiple doses might be necessary. Fentanyl users may be observed having difficulty staying awake and exhibit labored breathing or snoring. 

The Fairfax County Community Services Board provides Opioid Overdose and Naloxone Education trainings (REVIVE! kit training) that includes a free box of naloxone — often referred to by the brand name Narcan — upon completion of the training. A free box of naloxone is only available to residents of Fairfax County and the Cities of Fairfax and Falls Church upon request. See https://www.fairfaxcounty.gov/community-services-board/heroin-opioids/revive

Those who find someone or have a friend who might be experiencing an overdose should call for 911 help immediately, without fear of reprisal in Virginia due to ‘safe harbor’ provisions. Your quick response could make a life over death difference. No individual is subject to arrest or prosecution for the unlawful purchase, possession, or consumption of controlled substances or paraphernalia, if the person seeks or obtains emergency medical attention for himself in overdose, or for another individual experiencing an overdose, if remaining at the scene of the overdose until a law-enforcement officer responds. (VA Code §18-2-250.03)

For those who suspect a person is using drugs or dealing with addiction, parents or guardians can speak to their school’s Substance Abuse Prevention Specialist, reached through the school’s office or counselor. A Peer Outreach Response Team (PORT) provides help to individuals who have opioid and other substance use challenges. If you or someone you know could benefit from PORT services, find more information at https://bit.ly/35ibMB5 or call 703 559-3199. 

For more information and resources: https://www.fairfaxcounty.gov/topics/opioids and https://www.fairfaxcounty.gov/news/opioid-overdoses-continue-learn-how-get-help-1