Fentanyl: Deadly on the streets but lifesaver in the operating room

(Photo: WKRN)

NASHVILLE, Tenn. (WKRN) – Heroin can have a potent and scary additive credited with fatal overdoses around Middle Tennessee: Fentanyl.

It’s a painkiller 100 times more potent than morphine. It is a synthetic opioid that can be added to heroin to make it more powerful and cheaper to make.

“I use Fentanyl every day,” said Dr. David A. Edwards, Clinical Chief of Chronic Pain Service at Vanderbilt University Medical Center.

“Actually, if you are having general anesthesia, one of the ways to get the endotracheal tube in is to use Fentanyl. It blunts those reflects to keep you from coughing,” he continued.

Dr. Edwards said Fentanyl is also very good for major surgery. Without it, patients would not be able to stay under anesthesia as long.

“It is also very cardiovascularly stable so you can do major surgery without feeling the pain because you have a potent medication like Fentanyl,” Dr. Edwards said. “All this heart surgery we are doing these days is a result of having medications like Fentanyl.”

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In the hospital setting, doctors administer Fentanyl under very close supervision that includes calculations for each patient’s age, gender, weight, medical condition, and surgical procedure.

Plus, in the operating room, a number of monitors keep track of the patient’s vital statistics, and machines help the patient continue to breath.

“At home, if you are getting it in heroin or you don’t know the dose you are taking, you are doing it all on your own,” Dr. Edwards said.

Those circumstances have deadly consequences. In some cases, people may not know they are taking Fentanyl because drug dealers can press it into pills that appear to be other drugs like hydrocodone, OxyContin or Percocet.

A federal grand jury indicted five men tied to the sale of counterfeit Percocet pills that contained Fentanyl.

Those pills lead to a string of overdoses in the summer of 2016 and at least two deaths.

For drug users addicted to opiates, transitioning to heroin can happen as the cost of pills becoming too expensive, or their bodies build up a tolerance and they require stronger medicine to feel the effects.

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Andrew Cuomo never wanted to take painkillers as a teenager, but at the age of 19 he was in a serious car crash that changed everything.

“I broke 33 bones, broke my lower back, and sustained a serious head injury,” he said. “When I got out of the hospital there was a lot of stuff going on in my life. My parents were getting divorced, both my brothers were off to the military. “

Cuomo also said the brain injury impacted two parts of his brain, including his short-term memory and his decision-making.

After his release from the hospital, Cuomo began seeing a doctor in his hometown of Camden, New Jersey, who wrote prescriptions to him for various painkillers and other narcotics.

The doctor did not prescribe the drugs because Cuomo needed them. Cuomo said the doctor prescribed them because he wanted them and when.

“This guy, because I had good insurance, gave me anything I wanted, like liquid cocaine, morphine, steroids, Percocet, Vicodin, morphine, needles, and anything else,” he explained. “Usually I would get 20 scripts a month.”

Andrew Cuomo (Photo: WKRN)

But then, Cuomo moved to using heroin, and like many, he started to experiment with Fentanyl. So did his friends, and it had deadly consequences.

“I lost eight friends in less than a year, and I mean close friends, not just people that I knew,” Cuomo told News 2. “Fentanyl hit where I was a long time ago.”

The overdoses did not scare Cuomo or his friends away from the drug. In fact, it drew them to the dealers their friends went to before they died.

“When they died that meant the dealer had the best dope. That is how messed up you’re thinking is when you are an addict,” Cuomo said. “It is not that you want to die; you just don’t want to live.”

Davidson County’s Department of Health tracks all drug deaths that occurred in the county.

According to the department, there is often overlap in heroin and fentanyl deaths due to fentanyl being mixed in with heroin possibly unbeknownst to the user.

“Quite frequently, deaths due to overdoses involve multiple drugs, so it is often not solely attributable to heroin, fentanyl, etc., but they are involved as part of multiple combined drug toxicity that can involve cocaine, alcohol, or any number of other drugs,” Department of Health spokesman Brian Todd said via email.

He continued, “Due to the length of time it takes for toxicology tests to be completed, the reporting of drug deaths does not occur in real time. Once toxicology reports come in, the Medical Examiner’s Office can make a final determination on cause of death and complete the case.”

In 2016, there were 55 drug-related deaths and 79 heroin-related deaths.

Cuomo said he went to rehabilitation programs 16 times before he was able to successfully enter a long period of recovery.

He’s now been sober since 2009.

“Most of the people I grew up with who were my friends, 80 percent are dead,” Cuomo said. “One thing that always kept me going was I wasn’t going to give up.”

Andrew Cuomo (Photo: WKRN)

Cuomo spent years visiting schools and talking to young people about his addiction. He is now a treatment specialist at Addiction Campuses.

He works to help people struggling with addiction enter into a recovery program.

Dr. Edwards said it is important people heed the dangers of Fentanyl because it is easily synthesized and it is an inexpensive additive.

“We are seeing it come from China, and we are having Fentanyl labs start to pop up in the United States,” he said. “You do not know what you are getting when you take it on the street.”

Dr. Edwards continued, “We are finding pills that look like oxycodone, but it’s Fentanyl.”

Fentanyl is about 50 times more potent than oxycodone.

If you or someone you know is struggling with addiction, you can contact Addiction Campuses 24 hours a day, 7 days a week at 1-888-614-2251.

You can also get more information at AddictionCampuses.com.