Fentanyl contributed to teen deaths in the US, studies found

Claire Peterson on May 22, 2023

Fentanyl — Fentanyl is an extremely strong synthetic opioid that has been linked to a recent increase in drug overdose deaths among adults in the United States.

According to the Centers for Disease Control and Prevention, 36,000 people died from drug overdoses using synthetic opioids such as fentanyl in 2019 alone, which represents more than 60% of all opioid-related overdose deaths.

Fentanyl’s potency, along with its widespread availability and low cost, has resulted in its domination in the illicit drug market, ending in a public health crisis that is currently causing devastation across the country.

Affecting the youth

While fentanyl has mostly been linked to adult deaths, it has recently been linked to the deaths of a large number of children and teenagers in the United States.

Over 1,500 children under the age of 20 will die from fentanyl in 2021, according to Julie Gaither, an epidemiologist at Yale School of Medicine.

The number of deaths has risen by four since 2018.

Fentanyl fatalities accounted for nearly all opioid-related deaths in this age group in 2021.

The drug

Fentanyl is a synthetic opioid that is used to treat cancer patients’ acute pain.

It is also manufactured and supplied illegally as a street drug.

The drug is significantly more potent than other opioids such as morphine and heroin, making it very dangerous for recreational users.

The opioid fentanyl is manufactured in laboratories, primarily in China, and then smuggled into other countries.

Illicit fentanyl is commonly mixed with other opioids, such as heroin or cocaine, without the user’s knowledge, increasing the risk of overdose.

Fentanyl trafficking has worsened a serious public health issue in several countries, most notably the United States, where fentanyl overdose deaths have surged in recent years.

Replacing prescription drugs

Because it is less expensive and easier to obtain illegally, fentanyl is rapidly replacing prescription opioids such as oxycodone.

As a result, there has been an increase in overdoses since patients may not realize they are taking fentanyl instead of the prescribed prescription.

Because traffickers frequently mix fentanyl with other opiates to boost their potency or imitate the effects of other prescription medications, counterfeit prescription drugs are being infected with illicit fentanyl.

As a result, people seeking pain treatment with authorized prescription medications may be unintentionally ingesting a lethal dose of fentanyl.

“That’s primarily the story of what’s happening among teenagers,” said Sarah Bagley, the pediatrician and addiction provider of the Boston University Chobanian & Avedisian School of Medicine.

Bagley believes that teenagers purchase and use drugs or substances without recognizing it is fentanyl.

“People are not anticipating that they are going to be exposed to fentanyl, and then they are, and that results in overdose.”

Overdoses

Some of the symptoms of a drug overdose include:

Falling asleep
Losing consciousness
Gurgling
Choking sounds
Weak/no breathing

“This change in the drug supply, where you have a much more potent opioid, is really driving it all,” said Bagley.

The bulk of fentanyl deaths among adolescents and teens, according to Gaither, happened at home.

“For smaller kids, kids who are mobile, they would be taking a drug that’s off the floor,” she said.

Gaither also emphasized the significance of more education to assist parents understand how dangerous fentanyl is and the importance of keeping drugs out of the reach of children.

Mortality rate

Julie Gaither reviewed pediatric mortality statistics from the Centers for Disease Control and Prevention from 1999 through 2021.

The fentanyl death rate more than quadrupled during that time period, rising from 0.47 to 1.92 per 100,000 children.

In 2021, fentanyl suffocated 40 babies and 93 children aged one to four.

Adult overdose deaths have also increased.

In 2021, synthetic opioids, mostly fentanyl, were responsible for more than 70,000 deaths in the United States, with more than 106,000 drug overdose deaths expected in 2022.

A counter to overdose

The US Food and Drug Administration approved Naloxone, an opioid overdose reversal medication, for over-the-counter use in March.

In late summer, it will be sold at a number of retailers.

Some communities teach residents how to use nasal spray medications and distribute them to victims.

Narcan, an opiate antidote that is safe for children of all ages, is the medication, according to Gaither.

Parents who have Narcan on hand can counteract the effects of opioids rapidly.

Bagley, on the other hand, stressed the need of educating teenagers about Narcan.

She has spoken with teenagers who have asked how they can keep their friends safe.

Addressing overdoses with children, according to Bagley, entails discussing the hazards as well as how they care for others in their lives and respond in a crisis.

Drug shortages persist across the US as pharmacy shelves remain empty

Jason Robinson on December 19, 2022

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Customers are searching pharmacies around the United States as demand surges due to drug shortages.

Due to the shortage of popular prescription drugs like Adderall and amoxicillin, pharmacies are compelled to restrict the number of pills they sell.

Another justification for travel by parents of unwell kids is the quest for over-the-counter medications.

Shortages

Drug shortages, according to experts, are not uncommon.

They assert that although it usually happens more quietly, it occurs regularly in the US.

David Margraf, a pharmaceutical research scientist from the Resilient Drug Supply Project at the University of Minnesota’s Center for Infectious Disease Research and Policy, said:

“Shortages hit a lot of different patient populations with different drugs and whatnot, but many of those don’t get a lot of headline news because they’re very niche.”

The reason for the empty shelves can vary based on the place and the drug at any given time because every shortage has its own unique causes.

“They’re all a different tale,” said Margraf.

“There’s commonalities between them, but each one is a little bit different, and it’s very tedious trying to figure out what’s going on sometimes.”

Factors

Drug shortages are frequently problematic since there aren’t enough economic incentives to develop them.

However, availability may also be impacted by a scarcity of ingredients, labor issues, or production delays.

Despite being a global leader in developing novel therapies, the US nevertheless depends on other countries for the production of its medications.

Bindiya Vakil claims that imports from China and India account for a large portion of the raw ingredients required to make new drugs.

Vakil is the CEO of Resilinc, a company that tracks supply chains and maps them to notify clients as soon as danger arises.

Disruptions in China or India could have a cascading effect on goods supplies (such as a work stoppage at a Chinese firm because of its recently relaxed zero Covid policy).

Despite normal product levels, the current cold and flu season in the US may make it difficult for families to find what they need due to high demand.

Reports

Several groups around the nation are tracking drug shortages.

The nonprofit American Society of Health-Systems Pharmacists represents hospital pharmacists.

It keeps track of claims of drug shortages in the US and verifies the information by getting in touch with manufacturers.

Nonprofit organizations define drug shortages as issues with the supply that affect how a pharmacy prepares or dispenses pharmaceuticals or that have an impact on patient care if doctors are obliged to use alternatives.

Data from the American Society of Health-Systems Pharmacists show that as of late September, there were 260 active drug shortages, down from the 264 shortages reported in the second quarter of 2022.

Two hundred eighty-two active shortages were present in the second quarter of 2019, which was close to the record high.

The FDA keeps an eye on drug shortages and receives information directly from manufacturers.

However, it defines shortages differently.

Pharmaceuticals are said to be in short supply when all commercially available goods are insufficient to meet the current demand.

Additionally, shortages occur when a legitimate alternative producer cannot meet present or future demand, keeping patients in the dark.

According to the FDA, there are currently fewer drugs in limited supply than there were in 2011 when there were 251.

They kept an eye on 41 drug shortages in 2021.

Three hundred seventeen shortages were averted that year.

To address the “persistent problem” of medicine shortages, the FDA formed a task force in 2019.

It could be challenging to resolve when they occur because some situations last for years.

For instance, the demand for Adderall surged considerably between 2020 and 2021.

Leading manufacturer Teva attributed the delays to a lack of laborers.

But the problem has since been resolved.

Because Adderall is a controlled substance, it is governed by tight government laws.

The Drug Enforcement Administration imposes manufacturing limitations to prevent patient misuse.

According to David Margraf, Adderall shortages are anticipated to last until 2023.

Vulnerability

Typically, generic medications that run out are affordable injections.

They have strict production requirements, which makes them expensive to produce.

Additionally, because of their lower profit margins, firms find it less viable to produce them.

Some generics, like antibiotics, are vulnerable to shortages, though.

Researchers claim that the problem recently affected a few amoxicillin formulations.

Companies generally produce generic pharmaceuticals on demand rather than keeping stock on warehouse shelves.

Several manufacturers claim that the 2022 orders did not cover the increased demand.

Even when companies become aware of scarcity, manufacturing and shipping different products takes weeks or months.

Senior Director Vimala Raghavendran works for the US Pharmacopeia (USP), a nonprofit group that sets high standards for the following:

Dietary supplements
Food
Medications

“Really, it comes down to economics,” offered Raghavendran.

USP has tracked pharmaceutical supply chains for the past three years using its Medicine Supply Map to identify and stave off potential shortages.

“Antibiotics are 42% more likely to be in shortage compared to other classes of drugs,” said Raghavendran.

“They have lower price points, so there’s less incentive for manufacturers to invest in excess capacity.”

“And then you throw in an unexpected shock, like a demand increase because of the surge in RSV and the flu and Covid, and the supply chain is not able to absorb that shock.”

Staying ahead

There are systems and backup plans in place to avoid drug shortages.

If there is an interruption in the supply or production of medicine, manufacturers are required to inform the FDA.

It frequently makes it possible for the business to avoid problems.

However, companies are not currently required to alert the FDA to increased demand.

“But that’s something we’re really encouraging companies to do,” said an official.

“Let us know if there’s a spike in demand so that we can work with them early on, just as they can with supply disruptions.”

Drug shortages are a primary priority for the Biden administration, according to the White House.

The government highlighted the executive order on America’s supply chains that President Joe Biden signed in February of the prior year.

It instructed the secretary of the Department of Health and Human Services to identify and record risks in the supply chain for pharmaceuticals and their active ingredients and make recommendations for reducing those risks.

Reference:

Empty pharmacy shelves shine a light on vulnerabilities in US drug supplies

Ozzy Osbourne recounts quitting LSD after a conversation with a horse

Leah Cooper on September 5, 2022

The 1970s are memorable for the many musical personalities (especially rock stars) who defined an era, including Ozzy Osbourne.

Ozzy Osbourne is a wildly eccentric character whose lifestyle has sometimes overshadowed his musical career.

At the height of his career, Osbourne (like most rock stars at the time) was more into alcohol and drugs.

He recently shared how he quit using acid.

The horse

Classic rock animated the rise of Black Sabbath and the making of the classic 1972 album, Volume 4, as Osbourne recounted how he held himself back.

“We lived together in a house in Los Angeles, rehearsed there, did loads of drugs and made an album: simple,” said Osbourne.

“Those were good times.”

“At that time in America, people were very fond of lacing your drinks with acid. I didn’t care. I used to swallow handfuls of tabs at a time. The end of it came when we got back to England.”

“I took ten tabs of acid then went for a walk in a field,” he continued.

“I ended up standing there talking to this horse for about an hour. In the end, the horse turned round and told me to fuck off. That was it for me.”

Black Sabbath and their drug experiences

Ozzy Osbourne wasn’t the only one involved in psychedelic drugs, as the other members also shared their experiences.

In 2017, drummer Bill Ward talked about drug use before performing in front of a large crowd.

“It’s interesting to talk about the phenomena of LSD when you’re playing in front of 25-30,000 people,” he said.

“But in hindsight, I was taking huge risks with not only my performance but the entire performance.”

Guitarist Tony Iommi told Classic Rock in 2016 that LSD was the worst drug he had ever taken.

“I hate being out of control. With cocaine, I felt I was in control, I knew what was going on. But acid…”

“I was in America and I had a terrible headache, and this girl said she had a couple of pills for it. And she gave me some acid,” he revealed.

“Bloody hell, I didn’t know what hit me! Thank God the rest of the band came and sat in my room and calmed me down. I was gonna jump out the window.”

In 2020 bassist Geezer Butler talked about his first trip to Metal Hammer, saying:

“I thought I was a skeleton. I got in the van and they all went ‘What’s wrong with you?’ I said ‘Can’t you see? I’m a skeleton.’”

“We were driving along and there was a park on the side of us with all these flowers in it, and I thought the flowers were trying to get into the van.”

“I went onstage and thought it was on a boat and the crowds were waves. It was horrendous. I was watching my hand playing the songs and I thought it wasn’t connected to my body. Scary.”

Ozzy talks about his past

Ozzy Osbourne has already talked about his past with the Orange County Register and revealed that he no longer indulges in vices.

“I don’t drink alcohol anymore… I don’t smoke tobacco. I don’t use drugs… I’m doing good right now.”

“I now think, ‘How did I think going into a bar and getting smashed and doing all that cocaine was fun?’”

“I have come to think that if right now you had a gun, a bag of cocaine, and a gallon of booze and you said ‘Take your pick,’ I’d pick up the gun. It’s not worth it.”

References:

Ozzy Osbourne gave up LSD after talking to a horse for an hour