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Synthetic opioids contribute to the rising rate of drug overdoses

LEILA FADEL, HOST:

OK. Here's a sobering fact. Drug overdoses claim more American lives each year than firearms, homicides and car crashes. The numbers have been rising sharply in the past few years, but a new report says 100,000 people died from drug-related deaths in a 12-month period. The majority of those were due to synthetic opioids like fentanyl. The study was commissioned by a task force including members of Congress, federal agencies and experts in the field.

Bryce Pardo, associate director at RAND Drug Policy Research Center, which provided analysis to the report, spoke with my co-host, A Martinez.

A MARTINEZ, HOST:

Bryce, two-thirds of drug-related deaths were caused by synthetics such as fentanyl. Off the top of my head, I mean, is that because they're just easier to get a hold of?

BRYCE PARDO: Yes, it's the availability and access to these drugs, which can be shipped by mail. They're also permeating into traditional drug markets like heroin markets, and in some cases they're showing up in cocaine. And that's what's driving - in addition to the accessibility, it's just the scariness with which these drugs are making their way into other drugs. They're concealed as heroin. In some cases, they're pressed into counterfeit tablets, confusing and misleading users. And really, what's the key point here is that the potency of fentanyl - it is more potent than heroin by a factor of 25, at least. And so that, in addition to it being concealed as other drugs, is just confusing individuals, resulting in overdose deaths.

MARTINEZ: And you don't need to grow it, right? I mean, you could just make it.

PARDO: Correct. It's a synthetic opioid. It doesn't come from poppy, so it takes very little time to produce. It's very cheap to obtain. You can make it with access to the right chemicals and the right know-how. And so it's a more profitable drug, at least in the short term, from the drug traffickers' standpoint, to move away from heroin towards fentanyl. And so that's an addition to why we're seeing so much of it showing up now.

MARTINEZ: Now, the report says the vast majority of synthetic opioids come into the country from Mexico or are sourced from China. So what can the U.S. do to stop that flow or at least maybe slow it down a bit?

PARDO: That's a very tricky proposal. We - in the commission's report, the commission looked at this from many different angles and on the supply side, things like trying to get China to do a better job regulating its large chemical pharmaceutical sectors, which are the largest in the world, working with Mexico to improve container shipments at ports of entry, to work to target some of the clandestine manufacturing labs. But ultimately, the commission realizes that this is going to be a much trickier problem to solve through the supply side lens and needed to really boost more of the responses on the demand side - so doing things like increasing the access to medications used to treat opioid use disorder, reducing barriers to build access, promoting kind of recovery in the workplace, reducing stigma for drug use and also things like harm reduction, which we recognize are going to be a growing part of the kind of toolkit response to this problem.

MARTINEZ: And I know that people can mail small amounts. So does that make it harder to track?

PARDO: Indeed. So there was a good segment of the fentanyl that was arriving into the United States that was mailed directly from China. It no longer is the case, though there's still some synthetic opioids arriving from what we think is China to the United States to buyers here. And in addition to kind of the Mexican drug trafficking organizations increasingly operating in the States, the ability with which people can go online and obtain a sizable amount of a synthetic opioid that is retailed online - vended online is contributing to a large - an increase in the amount and the availability of these drugs that are arriving. And again, it's just because fentanyl and some of these other synthetic opioids are more potent, meaning that you need a few grams to really be able to supply a kind of a wholesale level of a market.

MARTINEZ: Wow. OK, now drug-related deaths are also a big burden on the economy. Can you explain the connection there?

PARDO: Yes, absolutely. So the report looks at the recent overdose deaths in the United States, and there have been some additional economic analyses of the cost associated with the overdose crisis, the opioid crisis in general. Some of these costs are what you would think to be pretty typical. So when a person shows up at an ER and needs to be attended to, there's a cost there that society has to bear, health care insurance has to bear for that, as well as incarceration cost associated with drug use - of retailing. But really, the largest driver of these costs is lost productivity due to early death. Those that are dying from - those are overdosing and dying from synthetic opioids, in particular, are between the ages of 25 and 55. These are people in the prime of their lives. They have families. They are, you know, productive economically in their communities, and they're dying. And because they're not living their full life, those, you know, 30 or 40 years of expected life lost is really what's driving the largest segment of those costs associated to the overdose crisis.

MARTINEZ: Bryce Pardo is associate director at RAND Drug Policy Research Center. Bryce, thank you. Transcript provided by NPR, Copyright NPR.

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