Survey Finds 'Stunning' Fentanyl Surge: UW Medicine

SEATTLE — A recent survey has the University of Washington warning of a "stunning" surge in fentanyl use in the Evergreen State.

For their survey, researchers with UW Medicine interviewed nearly 1,000 people who use syringe-service program sites across the state. 42 percent of respondents said they had used fentanyl sometime in the last three months. That's more than double previous studies: in 2019, just 18 percent said they had recently used the deadly opioid.

“I've been doing drug-trends research for 20 years, and fentanyl’s growth is the biggest, fastest shift we've ever seen—and also the most lethal,” said Caleb Banta-Green, principal research scientist for UW Medicine's Addictions, Drug & Alcohol Institute.

UW's survey found that fentanyl was now more commonly abused than alcohol, benzodiazepines, cocaine and other opioid medications. That's a significant problem: As researchers explain, fentanyl is 50 to 100 times stronger than morphine. In 2020, it caused more overdoses than any other drug in Washington state.

Fentanyl has been a growing concern in Washington for several years now. Just last spring, UW Medicine published a similar report after seeing fentanyl overdose deaths more than double between 2019 and 2020. In the fall, Pierce County reported its own spike in opioid poisonings, which left 55 people dead between January and June of 2021. Health officials say many overdoses are caused by consumers who don't know what they're getting into.

"As illegal drugs are not regulated, people who buy and sell them at the street-level often don't know the content of their product," wrote Pierce County Opioid Task Force Coordinator Chelsea Amato. "They think they are buying one substance and end up with another, potentially more dangerous product."

Sometimes users cannot tell the difference between Fentanyl and other opioids, as the pills smell and taste the same, and are usually pressed to look like other prescription opioid medications. That said, the State Department of Health received several reports last year of fentanyl sold as blue pills marked with "M" and "30", which were linked to a statewide increase in overdose rates.

That said, most survey respondents didn't actually take fentanyl as a pill. UW's study found that, though more users reportedly knowingly consuming fentanyl than in year's past, most said they smoked the drug.

“This matters because the majority of people dying now from overdoses are smoking drugs," Banta-Green said. "Yet almost all of our harm-reduction services have been aimed at people who inject drugs. So we need to figure out how to recast harm-reduction programs to engage with people who smoke drugs."

Banta-Green hastened to add that more research will be necessary to determine the full scale of the issue, and the best way to prevent overdose deaths.

“This report is not the sum total of what’s going on among people using substances," Banta-Green said "Some people go back and forth between being in treatment and using drugs; it's fluid and dynamic. Providing medication at syringe-exchange sites has been incredibly fruitful. We've gotten a lot of people stabilized on treatment medications and greatly improved people’s access to naloxone (the overdose antidote).”

If you are concerned about fentanyl, here are a few safety tips from the Washington State Department of Health and Tacoma-Pierce County Health Department:

• Carry naloxone if you or a loved one are using opioids. Naloxone, commonly sold as Narcan, is an effective opioid poisoning reversal medication. Narcan can be purchased at any pharmacy without a prescription, and is often offered for free at community-based organizations. The DOH recommends carrying at least two doses.
• Test suspicious pills for fentanyl. The Tacoma Needle Exchange offers free fentanyl testing strips.
• Know the signs of overdose. They include blue, or ashy white lips, blue fingernails, struggling to breathe or no breathing, and being unresponsive to external stimuli.
• Consider addiction treatment. The Tacoma - Pierce County Health Department says medication for opioid use disorder like methadone, buprenorphine, and naltrexone are often covered by insurance and offered by community-based settings, and can help long-term recovery.