Fake Adderall containing fentanyl linked to U.S. deaths a reminder of overdose crisis

The vast majority of accidental overdoses involve unknowingly taking fentanyl, an opioid that's 50 times stronger than heroin.

Maija Kappler 5 minute read May 12, 2022
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Two Ohio State University students died in early May after overdosing on fake Adderall pills containing fentanyl. GETTY

Two Ohio State University students died in early May, according to the Columbus Division of Police. They say the cause of death in both cases was overdose of fake Adderall pills that actually contained fentanyl.

Three university students were taken to the hospital for apparent overdoses on May 4, the New York Times reported. One died that night, and another died two days later. The third student was released from the hospital, the university’s president Kristina M. Johnson wrote in a statement.

The school also released an alert about “fake Adderall pills, which appear to contain fentanyl, causing an increase in overdoses and hospitalizations.” They suggested students confidentially pick up a Naloxone kit (which can temporarily reverse an overdose) or fentanyl test strips (which can detect the drug either in a urine sample of someone who’s taken it, or in samples of the drug itself dissolved in water) from their health centre.

Now, health authorities more widely are warning people of the dangers of unknowingly taking fentanyl.

“If you’re getting a pill from social media, the internet, off the street, from a friend, from a dealer — you don’t know what’s in that pill,” Tom Synan of the Hamilton County Addiction Response Coalition in Cincinnati, Ohio told the local ABC News station. “If you don’t get it from a doctor or pharmacist, you don’t know what’s in that drug. There’s a high chance that fentanyl can be in it.”

Fentanyl is an opioid that’s 50 times stronger than heroin and between 50 and 100 times more potent than morphine, according to the U.S. National Institute on Drug Abuse. It’s also cheaper to produce than heroin. Even a small amount of fentanyl can be fatal to people who don’t have a tolerance to it. But fentanyl is virtually impossible to detect without testing because it’s odourless, tasteless and often looks just like other, less powerful drugs.

Fentanyl involved in almost all accidental overdoses

The vast majority of accidental overdoses in Canada — 86 per cent — involved fentanyl. Those numbers have increased significantly during the pandemic: there was a 95 per cent increased in “apparent opioid toxicity deaths” between April 2020 and March 2021 compared to the same period the year before. Last March, the total opioid deaths for the past year was 7,224.

This grim statistic is similar in the U.S., where 2021 was the highest year on record for drug overdoses. About 14,000 more people died of overdose deaths in than in 2020, the CDC said this week. The total number of drug deaths was more than 100,000 people; about two-thirds of those deaths involved fentanyl.

Some public health bodies, including Public Health Manitoba, prefer the term “drug poisoning” to”drug overdose,” arguing that overdose sounds intentional, when a significant amount of fentanyl-related deaths are happening because people didn’t realize that what they thought was heroin or another drug was in fact poisoned with fentanyl.

Adderall is a stimulant used to treat ADHD. It can help people diagnosed with attention deficit hyperactivity disorder to maintain focus. But there’s a thriving black market selling Adderall to people who don’t actually have ADHD, especially on university campuses, where it’s sometimes used by people who don’t medically need it to remain alert and increase productivity.

That’s dangerous in itself: long-term Adderall abuse can lead to depression, heart disease, aggression, mood swings and panic attacks, among many other undesirable symptoms. But the risk of accidentally taking a drug that contains fentanyl is substantially higher.

Last fall, the U.S. Drug Enforcement Agency released its first public safety alert in six years, warning of the dangers of fake prescription pills. They had seized 9.5 million pills that contained lethal amounts of fentanyl, which they said accounted for nearly half of all the illegal pills they had seized in total. Fake pills are often made to resemble Adderall, Xanax or OxyContin.

“The United States is facing an unprecedented crisis of overdose deaths fuelled by illegally manufactured fentanyl and methamphetamine,” DEA administrator Anne Milgram said in a statement at the time. “Counterfeit pills that contain these dangerous and extremely addictive drugs are more lethal and more accessible than ever before.”

Harm reduction measures

Some university campuses, including USC, have started campaigning to release fentanyl testing strips, which were only recently decriminalized in states including New Mexico, Wisconsin, Tennessee and Alabama. (They’re still illegal in many states, including Florida.)

Test strips are legal in Canada, although Health Canada has warned drug users about their limits.

“No fentanyl test strips are specifically designed to check street drugs before consumption,” the agency says on its website. “Therefore, it is important that people who are using fentanyl test strips to check street drugs before consuming them understand the limitations and use the necessary precautions.” The test may not detect carfentanil, an even stronger variation of fentanyl, for instance.

Drug users can also test drugs at supervised consumption sites, if they’re available. (As of January 2021, there were 37 such sites across the country.)

Naloxone, which temporarily reverses an overdose to give drug users time to get to a hospital, is available either as an injectable or as a nasal spray. They’re often available for free at pharmacies.

Maija Kappler is a reporter and editor at Healthing. You can reach her at mkappler@postmedia.com
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