Across Alaska, Dr. Zink said, fentanyl kills many overdose victims before bystanders or emergency services can revive them with naloxone, a drug that can quickly reverse an opioid overdose.
“You don’t get a second chance if you don’t have naloxone immediately available,” he said.
A recent study of illicit pills seized by drug authorities found that a substantial portion of what is marketed as OxyContin, Xanax or the attention deficit hyperactivity disorder drug Adderall now contains fentanyl. The spread of these counterfeit pills may explain a recent sharp rise in overdose deaths among teenagers, who are less likely to inject drugs than older people.
Pat Allen, director of the Oregon Health Authority, said that, like other states with rising overdose deaths, the clear difference in 2021 had been the ubiquity of fentanyl. Children as young as 12 are considered to be at high risk of obtaining counterfeit fentanyl-containing pills, and high school students are overdosing on them, believing them to be opioid painkillers or anti-anxiety medications. The state was working to send naloxone tool kits to schools, a similar program it has used at fast-food restaurants, where people were overdosing in bathrooms.
Mr. Allen said he had seen an alarming phenomenon among those who overdose: they perceive the risk of fentanyl to be low, even though the actual risk is “severely higher”.
“We’ve had an addiction problem in Oregon that we’ve known about for a long time,” he said. “This takes that existing addiction problem and makes it much more dangerous.”
In 2021, overdoses represented a leading cause of death in the United States, similar to the number of people who died from diabetes and Alzheimer’s disease, and about a quarter of the number of people who died from cause of covid-19, the third leading cause of death, according to the CDC
In Vermont, which saw one of the largest increases in overdose deaths last year, 93 percent of opioid deaths were related to fentanyl, according to Kelly Dougherty, the state’s deputy health commissioner.