Fentanyl: The Deadly Cousin (Annotated Bibliography

Fentanyl: The Deadly Cousin (Annotated Bibliography

 

Pardo, B., Taylor, J., Caulkins, J. P., Kilmer, B., Reuter, P., & Stein, B. D. (2019). Understanding America’s Surge in Fentanyl and Other Synthetic Opioids.

In this article, Pardo et al. examine the recent surge in the number of fentanyl users, the availability of fentanyl and other opioids, and the number of opioid-related deaths in the United States. According to these authors, the number of deaths from prescription opioids and heroin has reduced in the United States in the last decade. However, in the same period, the number of deaths from synthetic fentanyl and other synthetic opioids have skyrocketed in just a few years. The authors go on to note that much of the current upsurge in the number of overdoses is linked to at least one synthetic opioid. In 2008 alone, synthetic opioids were responsible for more than 47,000 deaths in the United States. That said, fentanyl is seen to have become the most commonly abused synthetic opioid. In this article, the rise of fentanyl and other synthetic opioids is said to have increased because of their availability and the fact that they are cheaper than the other drugs such as cocaine and heroin. Since 2013, the distribution of opioid overdoses has expanded to cover more states in the continental United States, with other markets extending to Canada and even Europe. The authors identify the most distinctive difference between fentanyl and other drugs is that most other drugs begin with their introduction, where use grows from a small number until the point where it becomes recognizable.

However, fentanyl and other opioids do not follow this trend. Instead, these opioids enter markets where they are sold by suppliers dealing with other drugs. This makes it difficult for governments and policymakers to use the traditional frameworks to capture the dynamics of the crisis. This article proposes that policy should consider the use of responses that are innovative and adaptive to deal with the unknown dynamics of the crisis. Also, policy responses should focus on the improvement of surveillance and techniques to monitor new markets and trends. Lastly, the article proposes that future research focus on the study of supplier behavior and the collection of longitudinal data.

Han, Y., Yan, W., Zheng, Y., Khan, M. Z., Yuan, K., & Lu, L. (2019). The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies. Translational psychiatry, 9(1), 1-9.

The purpose of this article is to summarize the recent epidemic and evolution of the illegal use of fentanyl. The article also focuses on the pharmacological mechanisms of the drugs and their side effects. The authors recognize fentanyl as a powerful opioid anesthetic that is also used as an analgesic, whose use in recent years has created a serious threat against public health in the United States and beyond. The article touches on the history and origins of fentanyl use in the clinical treatment of both mild and severe pain. However, recent years have witnessed fentanyl become an issue of concern, especially in the united states, where it has led to an exponential increase in the number of overdoses and related deaths. The authors also note that the illicit synthesis of fentanyl and its adulteration with other drugs such as methamphetamine, cocaine, and heroin has made it even more dangerous for users. The authors conclude that the use of fentanyl is encouraged by health, social, and economic problems, which are continually fueling its growing use. Therefore, three is a need for the implementation of safe and effective large-scale strategies that will reduce harm and prevent overdoses and deaths.

Stanley, T. H. (2014). The Fentanyl Story. The Journal of Pain, 15(12), 1215-1226.

This article seeks to provide a historical coverage on the development use of fentanyl for various medical applications. The author highlights the importance of fentanyl in the treatment of pain in modern clinical practice. Stanley (2014) begins by recognizing the original use of fentanyl, which was for medical intraoperative analgesia. In the early 1990s, the drug would be modified to be used in the management of chronic pain, for diseases like cancer and other noncancerous maladies. Over the years, fentanyl has been prepared and produced in various forms that have undergone development, approval, and popularization in the hands of medical experts and practitioners. The article goes on to analyze data which reveal that fentanyl has become popular in the management of pain because it has minimal effects on the patient. The popularity of fentanyl and its continued use can be attributed to the fact that it is inexpensive, easy to prepare, and is accepted by clinicians around the world. While the article does not cover the illegal use of synthetic fentanyl, it provides a comprehensive historical perspective on the origins of fentanyl, its introduction into clinical medicine, and subsequent use in the treatment of pain. Understanding the history of the drug enables one to connect its origins how they paved the way for illegal use and abuse, up to its current as a substance that has contributed significantly to the opioid crisis.

Bate, R. (2018). Fentanyl and fatal overdoses: From chemical production in China to users in Pennsylvania. AEI Paper & Studies, 1.

This research article focuses on the process of fentanyl production, transport, and marketing, originating from China, through Mexico, and entrance into the lucrative opioid market in the United States. First, the authors identify the ongoing efforts of the Trump administration to curb the spread and continued abuse of synthetic fentanyl. The author goes on to identify a characteristic of the drug that makes it ideal for suppliers and manufacturers. In this regard, the author notes that only a small amount of the drug is required to provide the needed amount or level of “high.” This characteristic makes it easier for suppliers, users, and transporters to evade authorities. China comes into the picture as the primary source for fentanyl base, whose illegal sales have increased in the last few years. Chinese fentanyl is preferred by producers because of its high quality and low cost. From China, the chemical is transported into the United States and Canada. Mexico has been identified as another key player in the fentanyl crisis because of its crucial role in the final preparation and the convenience of its borders when smuggling the drug into the United States. The author concludes that the current measures to reduce fentanyl prescriptions have only helped boost the market for illicit versions of the drug. Therefore, the author proposes a system that will involve medical examiners, state health departments, and law enforcement working collectively and cooperatively to track abuse and sources of the drug.

Ostling, P. S., Davidson, K. S., Anyama, B. O., Helander, E. M., Wyche, M. Q., & Kaye, A. D. (2018). America’s opioid epidemic: a comprehensive review and look into the rising crisis. Current pain and headache reports, 22(5), 32.

This article takes a closer look at the fentanyl and opioid crisis in the United States, through a comprehensive review of facts and factors involved in the epidemic that has become an issue of national concern. The authors begin by identifying the fact that fentanyl and other opiates have been increasing in the United States, in their use, both prescription and illicit abuse. According to this article, the use of opiates has tripled in the United States since the 1990s. Besides, a number of states have been identified as “high burden” states because of their high numbers of users of fentanyl and other opiates. The authors note that the opiate epidemic is a nationwide problem that needs to be addressed and acted upon. This article presents recent findings related to fentanyl and opiate use in the United States. Based on these findings, the authors are able to construct a narrative of how fentanyl-related deaths have increased fourfold between 1999 and 2008. As a result, many states have been forced to restrict access to opioid medications that have even been approved by the Food and Drug Agency (FDA). The findings also reveal a factor that has exacerbated the fentanyl and opioid crisis, which is the costs of naloxone have increased significantly in the last few years. The authors summarize the article by proposing two main recommendations that should be utilized in the fight against the fentanyl and opioid abuse crisis. First, prescription practices should be regulated by the implementation of stricter programs from the federal governments. According to the authors, this would ensure uniformity in the prescription practices across all states, to ensure nationwide success. The next proposal is the improvement of abuse-deterrent strategies that apply to the preparation of all opioids. The implementation of this recommendation would ensure that safety is increased for all medications and that the FDA pays the right level of attention to the importance of a drug-free society.