Combatting the Fentanyl Crisis: Dr. Ray Ward

In 2021, 220 Americans died every day from an opioid overdose—that’s an epidemic. And of those overdoses, nearly 88% involved a synthetic opioid like fentanyl—that’s a crisis. Fentanyl is up to 50 times stronger than heroin and up to 100 times stronger than morphine. It’s cheap to produce and is now being laced in almost every illicit drug from cocaine to off-brand Adderall®.

Dr. Ray Ward is a Buprenorphine Practitioner and Physician at Cope Family Medicine | Ogden Clinic in Bountiful, Utah. He’s spent nearly two decades helping people struggling with substance dependence. He’s unpacking the sharp rise in opioid deaths over the last few years, and how users, family, and friends can together combat the ongoing fentanyl crisis.

Where the Synthetic Opioid Epidemic Started

“Utah’s opioid epidemic began more than 20 years ago with the overprescribing of legal prescription pain relievers,” says Dr. Ward. When these drugs became harder to get for nonmedical use, heroin use increased. Today, illegally manufactured fentanyl is being mixed with other drugs, which why overdose deaths are so high.

Most of the heroin comes to the United States from poppy farms in Mexico. Large quantities of heroin are also produced in South American countries, China, or shipped through Canada and trafficked to the United States by air and sea.

Fentanyl is Strong and Cheap to Produce

“Remember that a little fentanyl goes a long way,” says Dr. Ward, “It’s 100 times stronger than morphine.” Because of this, people who manufacture illegal drugs use fentanyl to make their drugs more powerful and less expensive to make. And the amount of fentanyl in illegal drugs as well as counterfeit pills is completely random, even from the same supply. One portion or pill may not contain any fentanyl, while others from the same supply may contain a large amounts.

Inadvertent Use is On the Rise

“While some people seek out fentanyl, many folks don’t even know they’re taking it—it’s in many, many drugs these days,” says Dr. Ward.

Fentanyl is often found in counterfeit pills that are made to resemble prescription drugs. This includes prescription pain relievers, like oxycodone, and stimulants like Adderall®. You are at risk for a fentanyl overdose if you buy pills from any source that is not a licensed pharmacy. Fentanyl is also found in other drugs like cocaine, methamphetamine, and heroin. You are at risk of a fentanyl overdose if you use any of these drugs.

Fentanyl Overdoses are Often Fatal

Because fentanyl is so potent, it does not take a lot to cause an overdose, especially in someone who does not usually take opioids. In 2021, the latest year in which data is available, nearly 645,000 people in America died from opioid overdose—an estimated 88% of them involved fentanyl.

Combatting the Fentanyl Crisis

Friends and Family

Recognize the Signs of Opioid Use

Opioid use disorder is a medical condition that can affect anyone who uses opioids. Here are some signs to look for in friends or family.

• Unexplained changes in behavior, such as attitude, appetite, mood swings, sleep patterns, and irritability.
• Sudden changes in activities, such as friends or social activities or sudden shifts in jobs or hobbies.

Carry a NARCAN®Rescue Kit

Find NARCAN in Utah

NARCAN® is the opioid overdose reversal drug that can be used to save the life of someone experiencing a fentanyl-related overdose. NARCAN® kits are available over-the-counter in Utah at pharmacies across the state. Act fast in the case of a fentanyl-related overdose. Call 911, then administer NARCAN®. Keep in mind that than one dose of NARCAN® may be needed.

People Struggling with Substance Dependence

Get Fentanyl Test Strips

Find Fentanyl Test Strips in Utah

Fentanyl test strips (FTS) are small strips of paper that detect fentanyl in drug samples before ingestion, helping prevent unplanned fentanyl usage and overdose. Studies indicate that FTS usage:

• Initiates a change in drug use behavior in up to 43% of users,
• Causes slower usage in up to 42% of users,
• Encourages up to 39% of users to have someone else present with them.

Seek Intervention with a Healthcare Provider

Find a Buprenorphine Practitioner

Treatment is possible to overcome the negative effects of addiction and return to being a functional member of society. Look for a doctor in your area that prescribes buprenorphines like methadone or suboxone and oversees your wellbeing. "While these are still narcotics, the risk of overdose is much lower; they help people be productive and stable in a controlled way," adds Dr. Ward.

People Taking Prescription Pain Relievers (And Prescribers)

“If I could have one wish granted, I'd wish that doctors would be honest about the severity of pain medication and prescribe way, way less,” says Dr. Ward. “Long-term use of narcotics makes pain worse, not better. Best-case scenario: people can manage pain but they are addicted. Worse-case scenario: People harm themselves or die of overdose, which also harms their loved ones.” He adds that the treatments he uses (buprenorphine, suboxone, etc) are still narcotics—they’re not a silver bullet that cures addiction.

Take Prescription Pain Relievers Seriously

Prescription pain relievers should be used with caution. Ask your healthcare provider these questions when getting a prescription for an opioid.

• Why do I need this drug?
• What are the most common side effects?
• Are there ways to minimize sideeffects?
• Can I lower the dosage or length of time that I need this drug?
• How long should I take this opioid? How do I wean myself off?
• Does this opioid interact with any other drug I’m currently taking?
• Can I drink alcohol while taking this?
• Do any of my medical conditions increase my risk of a bad reaction to this drug?
• What should I do with leftover doses of this drug?
• What if I have a history of misusing drugs?
• What if there’s a history of substance use disorder in my family?

Prescription opioids are not the only option for managing pain. An over-the-counter pain reliever may be enough. Other options like acupuncture, cognitive behavioral therapy, physical therapy, yoga, or massage therapy can also help you feel better with fewer risks and side effects. Discuss these options with your doctor.

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Dr. Raymond Ward is a Buprenorphine Practitioner in Bountiful, Utah. If you or a loved one are stuggling with any type of substance abuse, seek help by calling the SAMHSA National Help Hotline at 1-800-662-4357. Those in Northern Utah are welcome to schedule their first appointment with Dr. Ward and his team.