Recent statistics reveal that men are dying of opioid overdoses at almost three times the rate of women in the United States, and overdose deaths are increasing more quickly among Black and Latino Americans.  There has also been a spike in the number of young adults 25 to 34 who have passed from some sort of fentanyl use.  This data was published this month by the Centers for Disease Control and Prevention (CDC) and points to a third wave in the nation’s opioid crisis.  The first wave included prescription pain medicine, the second involved street drugs, and the third is centered around fentanyl.Fentanyl is a powerful synthetic opioid that can shut down breathing in less than a minute, according to experts, and began to increase in popularity starting in late 2013.  For each of the next three years, fatal overdoses involving fentanyl doubled, “rising at an exponential rate,” says Merianne Rose Spencer, a statistician at the CDC and one of the study’s authors.Spencer’s research shows a 113 percent average annual increase from 2013 to 2016.  That total was first reported in 2018, but Spencer looked deeper into the demographic characteristics of those dying from fentanyl overdoses.

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Increased trafficking of fentanyl and increased use are “both fueling the spike in fentanyl deaths,” the study reports.  For drug dealers, fentanyl is easier to produce, because its ingredients are easily supplied.  These are simply a combination of chemicals typically produced in China and packaged in Mexico.  Since fentanyl can be 50 times more powerful than heroin, smaller amounts translate to larger profits.Jon DeLena, assistant special agent who heads the Drug Enforcement Agency (DEA)’s New England Field Division, says one kilogram of fentanyl can be mixed with fillers or other drugs to create six or eight kilograms for sale.  “I mean, imagine that business model,” DeLena says. “If you went to any small-business owner and said, ‘Hey, I have a way to make your product eight times the product that you have now,’ there’s a tremendous windfall in there.”Fentanyl is more likely to cause an overdose than heroin because of its strength and because the high fades more quickly than with heroin, meaning users have to inject it more often.  Fentanyl is also showing up in cocaine and methamphetamines.  Dealers may add fentanyl to expand their clientele of users addicted to the drug.“That’s something we have to consider,” says David Kelley.  Kelley is deputy director of the New England High Intensity Drug Trafficking Area. “The fact that we’ve had instances where it’s been present with different drugs leads one to believe that could be a possibility.”The highest rates of fentanyl-involved overdose deaths were found in New England, according to the study, followed by states in the Mid-Atlantic and Upper Midwest.  There is an existing hypothesis that drug cartels used New England as a test market for fentanyl because the region has a strong, long-standing market for opioids.One question that arises from the CDC’s findings regarding this third wave: Why, for example, did the influx of fentanyl increase the overdose death rate among men to nearly three times the rate of overdose deaths among women?  Some suggest men are more likely to use drugs alone.Ricky Bluthenthal, a professor of preventive medicine at the University of Southern California’s Keck School of Medicine, said, “You have stigma around your drug use, so you hide it.  You use by yourself in an unsupervised setting.  [If] there’s fentanyl in it, then you die.”

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Fentanyl-Linked Deaths: The U.S. Opioid Epidemic's Third Wave BeginsOpioid Overdose Deaths Quadruple, Centered in 8 States