Opioid reform advocate pushes for syringe service programs that could help flush fentanyl out of black market

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KANSAS CITY, Mo. — An overwhelming spike in overdoses from counterfeit pills laced with fentanyl prompted the Drug Enforcement Administration to release a public safety announcement warning Kansas and Missouri residents of the “alarming increase” in fake prescription pills being sold and distributed throughout the region.

The announcement follows the death of 16-year-old Cooper Davis of Shawnee, Kansas, who overdosed on counterfeit pills laced with fentanyl in August.

“We want to use Cooper’s story to save lives,” Libby Davis, Cooper’s mother, told FOX4 in September.

Before his death, Cooper sent a picture to a friend of two blue pills, which he believed to be Percocet. They each took one, but his friend survived and Cooper died. 

It is likely one of the pills was laced with a fatal dose of fentanyl.

Chad Sabora, executive director of MO Network, an organization focused on opioid reform and recovery, says distinguishing real pills from fake pills is practically impossible.

“There’s really no way to tell [apart real from counterfeit pills],” Sabora said. “The most important thing is don’t use alone.”

Data from the Missouri Department of Health and Senior Services shows overdoses linked to synthetic opiates like fentanyl have increased since July 2019, from 851 overdoses to 1,237 by December 2020, roughly a 45.4% spike.

In Kansas, data from the National Center for Health Statistics predicts synthetic opioid overdoses increased by nearly 153% the following year, from 80 overdoses in March 2020, to 202 overdoses by March 2021.

But what some experts call an “opioid crisis,” Sabora calls a “drug poisoning crisis.”

“Never was there an overdose crisis,” Sabora said. “This is a drug poisoning crisis, and our supply is clearly poisoned.”

The Drug Poisoning Problem

Opioid overdoses steadily increased in Missouri by nearly 28.3% since January of last year, from 1,100 opioid overdoses to 1,411 by December 2020. In Kansas, opioid overdoses spiked by roughly 36% in the same period, from 185 to 252 overdoses by January 2020.

“Nobody chooses to get addicted,” Sabora said. “If you’re putting saccharin into your coffee this morning, are you choosing to get cancer? No. Are you engaging in activity that is going to increase your chances of unintended, negative life consequences? Without a f—— doubt.”

Sabora said COVID-19 forced people into dangerous scenarios where they were using alone, due to social-distancing regulations, rather than with other people. 

He said this is especially risky because if someone overdoses, they would not have someone else with them who can immediately act, whether that be by administering Narcan or calling 911.

This is why in December 2020, the anti-drug organization Truth Pharm partnered with Never Use Alone, whose mission is to increase users’ odds of surviving an overdose. It launched a hotline, (800) 484-3731, which offers users moderation while administering drugs alone, something Sabora said he encourages more than anything else.

“Somebody calls that line, somebody in recovery, in a non-judgmental form, will stay on the phone with them while they use,” he said. “Most overdoses occur within 10 to 20 minutes after use. At that point, if the person becomes unresponsive, they will call 911.”

Sabora said programs like Never Use Alone are crucial because fentanyl suppresses breathing much faster than heroin, meaning the response time for administering naloxone has to be quicker.

“You have to be there sooner than you typically would for a heroin overdose so that’s a huge difference,” he said. “There’s a huge misconception that people think that they need tons of naloxone to reverse a fentanyl overdose. No, you just didn’t get there soon enough, and you probably over-ramped, which means you used too much.”

Combatting the Crisis

In the 1970s, the Netherlands sanctioned government-funded syringe service programs (SSPs), community-based prevention programs that provide sterile needles to users, as well as establishing its first supervised injection site in the mid-80s.

Around the same time, the United States enacted a prohibition on the use of federal funds for National Security Education Programs through the Public Health and Welfare Act. 

The Ryan White CARE Act renewed this ban in 1990 with little modifications, prohibiting the purchasing of sterile needles or syringes for the use of illegal drugs by injection.

Sabora said if the United States would stop sitting “on our hands” and implement these programs, we’d see our drug overdose death rates drop.

“All of these life-saving interventions, other countries have, and they don’t have the death rates we have and the fentanyl poisoning we have,” he said. “So, we’re doing this to ourselves.”

The Netherlands saw 252 drug overdose deaths in 2019, according to Statista, roughly 98% fewer than Missouri’s 2019 overdose death count of 19,399. FOX4 obtained the Missouri data through records requests.

In fact, the United States saw nearly 280 times the number of drug overdose deaths in 2019 than the Netherlands did, according to the CDC’s website

Having been saved from an overdose nearly a decade ago, Sabora likened his potential death to a loss in tax revenue for the state and federal governments.

“In the course of my lifetime, I will probably pay $1.5 million in taxes,” he said. “If I had died, that’s $1.5 million lost in revenue to the state and federal government, so people don’t look at that. I don’t like that argument. I think it’s just soulless, but sometimes, that’s the only way to get through to some people.”

He said a change in intervention policy could help flush fentanyl out of the black market, a move Canada recently made after establishing a safe supply program, which offers a safe and regulated supply of drugs to users.

“This is just what happens when you continually cut off access to substances,” Sabora said. “Individuals that are either dependent, using them for misuse, or for a legit medical reason with no alternatives or help, you drive them to the black market, where heroin is cheaper.”

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