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Fentanyl and Opioid Addiction

Fentanyl is the super powerful opioid that contributes to much of the recent increase in US overdose deaths. Many of us have already seen the cross-over from prescription pills to fentanyl ravish our communities.
But who is choosing fentanyl over other opioids?

Morales and associates studied 308 people who use substances in three cities in order to improve harm-reduction measures.

They found:

  • 27 % preferred opioids containing fentanyl
  • People who prefer fentanyl:
  • Are likely to be younger
  • 51% were non-Hispanic white
  • Daily users
  • With a median age of 38
  • Compared to 45 years for those who do not prefer fentanyl

The researchers hoped that these findings would translate into better ways to target interventions to help reduce the incidence of opioid overdoses.

Are there Consequences of Focusing on Prescription Painkillers Instead of People at Risk for Addiction?

Psychiatrist Sally Satel had the courage to keep one answer simple and to the point: “Doctors felt Drug Enforcement Administration agents, their state medical boards, attorneys general, and other health-care agencies breathing down their neck. They reduced patients’ dosages or cut them off altogether, leaving them in misery, unable to find another physician who would treat them, and sometimes contemplating suicide.”

Many did commit suicide after subsequently losing their jobs and families. Countless others converted to less expensive and more available street hydrocodone, heroin, fentanyl, carfentanil and others; frequently graduating from pill popping and intra-nasal use, to even more addicting smoking and IV shooting. The opioid epidemic raged on as did the causalities of epic proportions.

The Governments Attempts to Remedy the Opioid Crisis

The DEA may have sobered up by mid-March 2015 when the leading world expert in opioid addiction was appointed to start advising agencies tasked with quashing the opioid epidemic. Things improved, but the emphasis on opioid medication-assistance and opioid-antagonist medication-assistance continued to eclipse the primary opioid epidemic extinguishing agent: Identification of people suffering from opioid dependence with prompt referral for opioid dependence detoxification, rehabilitation, and aftercare, or recovery, either via high-value low-cost treatment centers or free 90 meetings in 90 days Narcotics Anonymous (NA) offers.
After all, decreased demand for opioids is as important, if not more important, as reducing street availability of prescription and non-prescription opioids. By the way, public health and epidemiological statistics do not appear to differentiate between the number of prescription opioid overdoses stemming from physician prescriptions and street vendors.

Regardless, all in all, the various ad hoc strategies seemed to have helped alter the trajectory of the opioid epidemic to some degree. For example, the Centers for Disease Control and Prevention (CDC) reported overdoses slowed by approximately 5 percent in 2018. This slight reduction in overdoses was almost exclusively the result of less deaths from oxycodone, hydrocodone, and other prescription opioids, while fentanyl deaths remain on the rise.

Lessons Learned

The opioid epidemic may have recently peaked, not only due to the ongoing efforts of opioid-expert advised government agencies, but also the absence of huge numbers of opioid dependent people who have passed away; their example serving as stern instruction to the living, or more descriptively, the surviving. In addition, many of us knew of at least one friend or family member that died from opioids, which prompted another friend or family member to call and seek admission to a recovery program, if they did not first grieve themselves into their own body-bag.

Hopefully this current drug epidemic will soon fade, as did the last one (Cocores). Regardless, we have learned many things from this current war on drugs—many of which, newer generations did not research, nor asked about from opioid expert vets of the last war on drugs—that we can catalogue for the next war on drugs. Hopefully, future generations will research the past two drug war battle plans and failures before they act. This is reminiscent of what the Dalai Lama says: When you lose, don’t lose the lesson. So what are some of the lessons we learned from the current drug crisis?

Again, Dr. Satel summed it up succinctly: “Did policy makers and public-health experts correctly assess who was at risk of becoming addicted to opioid medications? Were their views on the addictive potential of such drugs realistic? Did they anticipate the consequences of policies devised to constrain doctors from overprescribing? In retrospect, policy makers seriously misjudged the answers to these questions, overestimating the risk that these drugs posed to the average patient while simultaneously doing too little to urge clinicians to identify those most vulnerable to addiction.”

Big Brother logistics aside, in recovery we learn that nobody forced drugs or alcohol on us. We chose to flirt with them, embrace them, become intimate with them, spend our waking hours with them, celebrate with them, mourn with them, talk to them, listen to them, love them, and hate them. We thought we would always be in control and the good times would continue to roll, and just get a divorce one day if things got really bad. We thought that we would never let it get out of hand.
Then one day, we found ourselves shackled in the un-lit, cold, damp and creepy dungeon of our mind’s castle. We had no one else to blame for the tyranny we had insidiously and stealthily imposed upon ourselves, and clearly recalled what Pogo said: We have met the enemy and he is us.

Recovery pointed the way for us to rekindle a healthy relationship with ourselves and with those we love. Recovery is regained freedom, liberty and happiness.
Take a bite out of the opioid epidemic by giving us a call today.

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Cocores JA. The 800-COCAINE Book of Drug and Alcohol Recovery. Villard Books, a division of Random House (1990), Fireside Books, a division of Simon & Schuster (1991), NY.

Morales KB, Park JN, Glick JL, et al. Preference for drugs containing fentanyl from a cross-sectional survey of people who use illicit opioids in three United States cities. Drug and Alcohol Dependence, 2019; 204: 107547 DOI: 10.1016/j.drugalcdep.2019.107547

Satel S. The Truth About Painkiller Addiction. The Atlantic Magazine. August 2019.

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