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The fentanyl epidemic: Experts discuss impact on college students, UH vaccine

The CDC must give guidance on booster shots

Juana Garcia/The Cougar

Fentanyl, the dangerously potent opioid, has swept the nation over the past decade. The drug is roughly 50 times stronger than heroin and has led to a dramatic spike in overdose deaths in many cities. 

The fentanyl epidemic, as many are now labeling it, has claimed thousands of lives and continues to reap its bloody toll on Americans from all walks of life. Considering college students are at high risk for substance abuse, understanding the scale of the crisis and the associated risk factors is key to avoiding a potentially life-shattering experience. 

“The fentanyl threat is impacting communities across the country and knows no socioeconomic boundaries,” said DEA public information officer Sally Sparks in an email. “Fentanyl is the leading cause of death for adults ages 18-45 in the U.S.”

A major driving force behind the fentanyl epidemic is the production of counterfeit prescription pharmaceuticals. The drug has been found in pills made to resemble everything from Xanax to Oxycontin, according to the DEA.

“Chemical precursors are manufactured by companies in China. Mexican cartels then use these precursors to synthesize fentanyl and mass produce fake prescription pills that are deadly,” Sparks said. “Six out of 10 fake pills seized in the U.S. have a lethal dose in them, which is two milligrams of fentanyl.”

The chemical precursors are substances that could be used to manufacture legitimate products but are used by cartels to synthesize fentanyl, Sparks said. 

Dr. Cristy Schade is the former president of the Texas Pain Society and a specialist in pain medicine and anesthesiology. He has been practicing medicine for over 50 years and has watched the opioid crisis evolve over time into the national emergency it is today.

Two key factors gave rise to the fentanyl epidemic, according to Schade. The first stems from procedural failures by state and federal agencies that set overly restrictive controls on prescription pain medicine. 

“Suddenly, thousands upon thousands of legitimate patients could not get their pain medicine,” Schade said. “So they had a choice of living in misery, buying their pills on the street or committing suicide.” 

This led directly to the second factor, as many turned to street suppliers to fulfill their needs. The now heavily regulated supply led to inflated demand for illicit alternatives. The stage was then set for fentanyl, a quickly produced, low-volume substitute to steal the show. 

“So the legislature cut off the supply and didn’t do anything about the demand,” Schade said. “That demand then turned to the black market, which it quickly satisfied in the most economically efficient way possible.” 

The extraordinarily inflated demand proved too much even for other narcotics to fulfill. Drugs like heroin and other traditional opiates require large amounts of time and energy to grow, produce and refine. Fentanyl, on the other hand, is easily shipped and manufactured with the most basic of materials. 

While the situation may seem grim, Schade is not without solutions. In September, he testified before the Texas House Committee on Public Health, in which he suggested an awareness-based approach to combatting the fentanyl epidemic. 

“We need to look at this in the same way we look at safe sex,” Schade said. “Yes, it would be nice if people practiced abstinence, but we all know they won’t. So we need to start by educating people of the dangers, making Narcan more accessible and legalizing test strips.” 

Currently, under Texas law, fentanyl test strips are considered drug paraphernalia. Despite a bipartisan bill that sought to legalize the strips gaining some traction in the last legislative session and Gov. Greg Abbott expressing support for their decriminalization, possessing these potentially life-saving products remains illegal.

In terms of the vaccine recently developed by a team of UH researchers, Schade said that while he’s excited to see its potential applications, he remains cautiously skeptical about its efficacy. 

“If it pans out, and I hope it does, it could be a game changer,” Schade said. “That being said, it’s important to note that this is early animal research, and a lot could go wrong.”

Schade also has concerns about the administration of such a vaccine. Fentanyl’s presence in counterfeit prescription drugs and its tendency to strike populations not traditionally considered “at risk” means a vaccine would save only those who buy and use fentanyl knowingly. 

Ultimately, Schade said, while vaccination is a step in the right direction, it does little to solve the issues that arise from fentanyl disguised as prescription medication. Doing that will require a nuanced approach encompassing everything from education to law enforcement.

“It’s important people understand that this drug can take literally any form,” Schade said. “They tend to target the popular stuff too. The pills are visually indistinguishable, so you really have no idea what you’re getting these days unless you test it.” 

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