Of the 7 million people abusing prescription drugs, 5 million are abusing opiate painkillers. With the reformulation of OxyContin limiting abuse, the prevalence of other prescription painkillers is increasing.
Oxycodone -Percocet & Roxicodone:
Oxycodone is among the fastest growing of all prescriptiondrugs people abuse in the United States. Percocet is the brand name of apainkiller containing oxycodone and acetaminophen (Tylenol). Overdose cancause, abdominal pain, dark urine, clay-colored stools, liver damage, andjaundice. Percocet known as Perc’s onthe street, can be smoked, snorted, and injected. Percocet taken in largedoses, or when the tablet is crushed for snorting, smoking or injecting(destroying the time-release mechanism) and can cause a “high” similar to usingto heroin.
Roxicodone is a painkiller in the oxycodone family with a high potential for abuse. It is in an immediate-release form and acts more quickly than the timed-release forms of opiate pain-killers. Addicts and treatment providers state that 30mg of Roxicodone when abused by snorting, smoking, or injecting is the painkiller that produces effects most similar to heroin. On the street it is known as Blues, Oxy IR, Blueberry, Thirties, OC, or Roxys.
Oxymorphone – Opana:
Opana became more sought after once OxyContin was reformulated. Opana is an extended release opiate painkiller in the oxymorphone family. Many think oxymorphone has less potential for abuse than OxyContin (oxycodone), however oxymorphone is metabolized oxycodone. Opana is extremely potent with many experts claiming it is more addictive than cocaine or heroin. Opana can be snorted, smoked, or injected.
In 2011, Indiana’s state health department investigated an increase in Hepatitis C cases in a county in southeastern Indiana. As more Opana users transitioned to injection, hepatitis C spread quickly through sharing of syringes. The CDC estimated that between 2010 and 2012, new hepatitis C infections rose 75%, to about 23,000 new cases a year. In January 2015, the Indiana State Health Department began an ongoing investigation of a rise in HIV cases in this county. Of the 135 confirmed cases of HIV, 108 cases report dissolving and injecting Opana as their drug of choice. This is the first documented HIV outbreak in the United States associated with injection of a prescription painkiller. (CDC, Morbidity & Mortality Weekly Report, April 2015)
In August 2012, three cases of unexplained thrombotic thrombocytopenic purpura (TTP), a rare but serious blood disorder, were reported by a nephrologist to the Tennessee Department of Health(TDH). By the end of October, 15 such cases had been reported. A case-control study was conducted, and investigators determined that the cases of TTP-like illness were associated with dissolving and injecting tablets of Opana ER.Seven of the 15 were treated for sepsis and TTP-like illness, 12 patients reported chronic hepatitis C or had a positive test for anti HCV antibodies.Health care providers and pharmacists who prescribe or dispense Opana ER should inform patients of the risks associated with the drug being used in ways other than being prescribed. Health care providers should ask patients with TTP like illness of unknown origin about any IV drug use. (CDC, Morbidity & Mortality Weekly Report, Jan 2013)
Signs of Opana overdose:
- Suppression of breathing
- Cold or clammy skin
- Muscle flaccidity
- Chest pain
- Drop in blood pressure & heart rate
- Numbness in arms and legs
- Circulatory collapse
- Cardiac Arrest
**OPANA was pulled off the market in June 2018 due to the above health issue
Dilaudid & Fentanyl
Dilaudid on the street is known as “Big D” “M-80’s” and “Peaches”. Dilaudid is a schedule II drug and often used to manage moderate to severe pain. Dilaudid is hydromorphone hydrochloride and is a very powerful semi-synthetic opioid narcotic painkiller considered to be almost 10 times stronger than morphine. Dilaudid is often used as an alternative to morphine. Dilaudid takes effect within 15 minutes and lasts for longer than six hours. It can be addictive like all other opiates. Tolerance and dependence can occur within a couple weeks of use. Dilaudid can be ingested, smoked, snorted or injected.
Common indicators of Dilaudid abuse:
- Nausea and vomiting
- Respiratory depression
- Stomach pain
- Difficulties urinating
- Track marks on arms, legs, between toes
- Circulatory collapse
- Heart attack
- Worsening of emotional wellbeing
- Exacerbation of mental illness symptoms
- Mood swings
The FDA and CDC announced in February of 2018 that more people are dying from Fentanyl than die from Heroin or Prescription drugs.Fentanyl is one of the strongest opiate drugs on the market. It is a synthetic drug, is 50-100 times more potent than morphine, and 15 times more potent than Heroin. It is used to treat severe pain in individuals with injuries or chronic illness, after surgery or prescribed for individuals who are tolerant to other opiates. It can be powdered out, liquid, pill, lollipop, or gel patch form. It can be ingested, smoked, snorted, injected, or addicts will chew on the patch. Fentanyl is often stolen from hospitals, pharmacies, and home hospice care.
Fentanyl is often added to Heroin on the street when Heroin is dirty or of poor quality. Powdered fentanyl is indistinguishable from heroin so users have no way of knowing if it’s mixed in heroin or being sold in replacement of heroin (china white). This potent drug can be used alone or in combination with another substance and just one use, can kill you. More and more states are seeing death from fentanyl overdose alone, indicating it is being sold as heroin or being used as its replacement.
Indicators of Fentanyl abuse:
- Dizziness and lightheadedness
- Dry mouth
- Retention of urine
- Suppression of breathing
- Severe constipation
- Itching or hives
- Nausea and vomiting
- Loss of appetite
- Weight loss
- Difficulty seeing
- Bad dreams
- Swelling of arms and legs
**Note, “fake” or “mock” Xanax pills laced withFentanyl have been found on the street causing overdoses and death across the nation.
Due to the potency of these new designer opiates, Narcon (Naloxone) needs to be administered in high doses. Doctors and EMS across the country report using upwards of 10+ doses toan IV Narcon drip. Even with high doses, the lifesaving efforts often are resulting in death.
Acetyl Fentanyl: Acetyl fentanyl is a new and lethal drug and is becoming more popular among narcotic abusers. The drug looks similar to heroin and is being sold as heroin. Numerous deaths among intravenous users of this drug have been reported across the US. In fact, the drug came to the attention of authorities after several deaths of narcotic addicts were investigated and the drug was identified in blood samples by ELISA testing (using antibodies) but not detected by GC/MS (detects chemical molecules). The drug is not available by prescription and said not to be available in the US. However, the drug is available online and sold without questions as a “research chemical.” Overdoses are treated the same as any opiate overdose. However, the drug is 15X more potent than heroin and larger doses of rescue medications are often necessary.
Carfentanil: This new opiate was first created by Janssen Pharmaceuticals in 1974 and is an analogue of Fentanyl. It is marketed under the trade name Wildnil and used as a general anesthetic for large animals, i.e.elephants, rhino’s, hippo’s and bears. It is extremely potent, and claimed to be 10,000 times more potent than Morphine. It is a white powder that can be used anyway, and sold on the street as Heroin. It can be added in Heroin to make it more potent, and can be mixed with Cocaine as a “speed ball.” It is causing deaths across the nation.
U-47700: Known as “pink” on the street, it has been a problem since beginning of 2016. It is a designer opiate being made in drug labs in China. The U in the name stands for Upjohn, a pharmaceutical manufacturer that developed the drug in the mid-1970s.Scientists were looking for a synthetic alternative to morphine. Effects are similar to Tramadol. It is about 8X more potent than Morphine, and can be used any way – injected, snorted, smoked or put in pills and swallowed. Some people have “plugged” it, meaning dissolving it in a little water and using rectally, it will absorb very quickly like a suppository U-47700 works as a selective μ-opioid receptor. The drug is sold in pill, powder and liquid form, and can be bought online for less than $40 for a bottle of pills. It has been linked to 50 deaths across the nation. It is mixed with Heroin, sold as Heroin, and can be mixed with Cocaine.
Effects from use can be:
- Muscle aches
- nausea & vomiting
- mood swings
- pain relief
- difficulty urinating
- constricted pupils
- respiratory depression
- anxiety suppression
Short duration of effects can cause double dosing. It is corrosive to mucous membranes, and vaporizing the substance can damage the lungs. Sublingual administration is likely to damage the skin in the mouth. At least three states — Ohio, Wyoming and Georgia — already have taken action to ban U-47700 after it was connected to overdoses. Wisconsin has banned it – it is illegal to buy or possess. A spokeswoman for the U.S. Drug EnforcementAdministration said that the agency is studying the opioid but hasn’t yet moved to control it. Since Sept of 2016, 15 fatalities have been confirmed. Belgium had a death from U-47700 being mixed with Fentanyl.
Furanyl Fentanyl: This is an illicit designer version of fentanyl being mass-produced in clandestine labs in China – then smuggled into the United States via traditional distribution routes through Mexico. It was first described in patent literature in 1986 and has no approved medical use, and it has also not been approved by the FDA for human consumption.Research shows it to be 5X more potent than fentanyl – has an ED50 value of0.02 mg/kg in mice. It has been encountered as a single substance as well as in combination with other substances of abuse, including heroin, fentanyl, butyryl fentanyl, and U-47700.This potent drug has killed hundreds of people throughout Europe and the formerSoviet republics, and the US has confirmed 128 fatalities associated with furanyl fentanyl in 2016. It was detected in 24 states in 2016, and is still available across the country. DEA reports use of powder can cause seizures, and treatment centers report users are not responding to normal protocol when trying to get someone off of these powerful drugs – requires higher doses of methadone for detox.
W-18: This designer opiate is likely coming from Chinese drug labs where little-known drugs and analogues of known drugs are mass-produced and sold online. It is 100 times more powerful than fentanyl and 10,000 times more powerful than morphine. It is known on the street asW-18, “beans” or “shady 80’s” – a play on 80mg OxyContin pills. This drug can be in powder form and it can also come as little green round pills looking similar to 80mg OxyContin. Close examination reveals they are not Oxy pills. Recently it has been seen on the street sold as Fentanyl pills. The powder has been mixed with heroin, and found cut with Cocaine.
This drug was first synthesized in 1980 at the University of Alberta where scientists were looking at new analgesic drugs, where studies in animals showed it had pain-killing activity in mice. It has no therapeutic use, and due to potency is causing deaths all overCanada and the USA.