Overdose deaths from synthetic opioids — specifically fentanyl, a fast-acting pain medication that can be up to 100 times more potent than morphine — is the fastest-growing category in Frederick County and across the state, according to recent data released by the Maryland Department of Health.
From January to June, 25 people in Frederick County died from fentanyl intoxication, an increase of seven over the same period last year. The county has also seen an exponential increase in the number of fentanyl-related deaths in recent years, from two in 2013 to 49 in 2016.
Overall in Maryland, the number of fatal fentanyl overdoses increased from 469 in the first half of 2016 to 799 in the same period this year. Carfentanil — a synthetic opioid used as a tranquilizer for large animals — has also become a growing concern since the state began screening for the substance in 2016.
While there were no recorded carfentanil-related deaths in the first half of 2016, 49 fatal overdoses occurred over the same period in 2017.
“Probably the majority are people who are trying to use heroin and discover that it’s cut with something,” said Paul Wolford, the coordinator of the Frederick County Drug Treatment Court.
The prevalence of fentanyl, especially, has become such a problem that the program began testing participants specifically for the substance last year, and purchased a more sophisticated analyzer in May.
The potency of fentanyl and other synthetic opioids also poses a huge concern for Wolford and other local drug treatment experts. The strength of those substances makes lethal overdoses more likely and bystander intervention even more crucial, given that emergency responders might not always reach the scene of an overdose in time to save the person, said Andrea Walker, the director of Behavioral Health Services for the Frederick County Health Department.
Naloxone, the overdose reversal medication, is also less effective against synthetic opioids. In 2015, the Centers for Disease Control and Prevention found that multiple doses of the drug are often needed to treat fentanyl overdoses.
“With fentanyl, it doesn’t take as much to get the same high,” Wolford said. “And I think that’s what leads to a lot of overdoses. You see that with people who have gone through treatment, too. Maybe they had some clean time and then relapsed and tried to take the same amount of heroin as they used to. Well, their body can’t handle it, and then fentanyl’s mixed in. It’s just a deadly cocktail.”
The county is continuing to expand its peer recovery support program as a way of encouraging more people into treatment, Walker said. The Health Department has embedded a peer support specialist at the Frederick Community Action Agency, a local service provider for homeless and low-income residents, and recently hired a new peer to embed with the mobile crisis unit run by the Way Station in Frederick.
Despite the county’s interventions, there’s little indication that the opioid crisis is near a close. While the number of prescription-opioid-related deaths declined slightly from 2016 to 2017, heroin-related deaths remained flat in Frederick County and across the state. Deaths from heroin or fentanyl in combination with other drugs, such as cocaine or benzodiazepines, are also growing.
“I don’t know exactly how much it’s gone up, but I know it’s continuing to be a problem,” Wolford said. “I don’t see how it can continue to go up, because it’s already so huge.”