Xylazine Crisis: Why ‘Tranq’ Is Making Street Drugs Even More Dangerous

Xylazine is appearing in street drugs across the US, and it’s raising serious alarms. Nicknamed the “zombie drug,” it’s a veterinary tranquilizer that isn’t safe for humans. Even small amounts can slow your heart, drop your blood pressure, and slow breathing without warning.

Even more alarming is how fast it’s spreading. In just a few years, labs across the country have found more and more street drugs contaminated with xylazine. The biggest jumps were in the South, but it’s showing up everywhere. In one multi-city review, xylazine was almost nonexistent in overdose deaths back in 2015, under 1%. By 2020, it was involved in nearly 7% of cases.

Local testing shows even higher numbers. In Maryland, almost 8 out of 10 drug samples that contained opioids also had xylazine. And in Philadelphia, Pennsylvania recent reports found it in roughly a third of heroin or fentanyl overdose deaths.

What is Xylazine, and Why is it So Dangerous?

Xylazine is an animal tranquilizer and sedative used in veterinary medicine. For animals, it works safely under supervision. For humans, even small amounts can have profound effects. It slows the central nervous system, reduces heart rate and blood pressure, and causes extreme drowsiness.

When mixed with synthetic opioids like fentanyl, the combination is hazardous. The opioid slows breathing, and xylazine adds extra respiratory system suppression. Together, they can cause slowed breathing, drug-induced coma, or even death.

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The problem is that people using street drugs usually don’t know xylazine is present. It’s often added without warning. And unlike opioids, naloxone alone may not reverse the effects of xylazine. That’s why overdoses with xylazine are harder to treat and more deadly.

The Health Risks of Xylazine

Xylazine is not your typical street drug. It’s a veterinary tranquilizer designed to sedate large animals. That’s the first red flag, it was never meant for human bodies. When people take it, whether intentionally or unknowingly, the effects can spiral out of control quickly. Here’s what can happen:

Slowed Breathing

Xylazine slows the central nervous system, which means your breathing can become dangerously slow. Combine it with opioids like fentanyl, and the risk of life-threatening respiratory depression skyrockets. Breathing may get so slow that oxygen can’t reach your brain correctly, which can lead to a drug-induced coma or death.

Tranq Wounds

Xylazine can cause tranq wounds, deep, slow-healing ulcers at injection sites. They can appear even if the drug touches the skin without injection. These wounds are prone to severe infection, and untreated infections can become life-threatening.

Extreme Sedation (“Zombie Effect”)

Users may become extremely drowsy or move and speak very slowly, which is why people call it the “zombie drug.” In this state, it’s hard to stay safe, communicate needs, or respond in an emergency.

Polysubstance Risks

Xylazine rarely appears alone. It’s often mixed with synthetic opioids, cocaine, or other addictive drugs. Using multiple substances at once (polysubstance abuse) makes overdoses harder to treat, which greatly increases the chance of drug poisoning.

Overdose Risk and Naloxone Limitations

Even if naloxone is administered for an opioid overdose, it won’t reverse xylazine. That means someone could still experience slowed breathing, heart problems, or a drug-induced coma. Medical attention is critical, calling 911 can save a life.

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Signs of Xylazine Exposure

Here are some common signs that you need to watch out for:

Why Naloxone Isn’t Always Enough

Naloxone is a life-saving antidote for opioid overdoses. But xylazine is not an opioid, so naloxone won’t reverse its effects. A person may still experience severe sedation, slowed breathing, or heart rate collapse even after receiving naloxone.

Harm-reduction experts emphasize getting immediate medical attention. CPR, oxygen support, and rapid transport to the hospital may be required alongside naloxone.

Harm Reduction and Overdose Awareness

The safest and healthiest choice is to avoid street drugs entirely. They are unpredictable, often mixed with substances like fentanyl or xylazine, and can cause serious harm or death. If someone is struggling with substance use, professional treatment is the best way forward.

Still, we know some people continue to use. In those cases, there are a few things that can help prevent tragedy and protect lives:

1. Recognize the Risk of Fentanyl and Xylazine

Street drugs are often contaminated with dangerous additives. Fentanyl and xylazine are two of the most common, and both can cause rapid overdose. Because there’s no way to be certain what’s in a street drug, every single use carries serious risks.

2. Don’t Isolate

Overdoses are more deadly when no one is there to help. Having someone nearby who can call 911 or get medical attention can mean the difference between life and death.

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3. Watch for Overdose Warning Signs

Shallow breathing, slowed heart rate, or unresponsiveness are medical emergencies. Don’t wait! Call 911 immediately if these symptoms appear.

4. Be Prepared for Emergencies

Naloxone (Narcan) can reverse many opioid overdoses, though it won’t work on xylazine. Even so, it can save lives if opioids are involved. CPR and calling emergency services right away are also critical steps.

5. Take Health Concerns Seriously

Wounds, infections, or other complications from drug use should never be ignored. These can quickly become life-threatening without proper medical care.

6. Understand the Dangers of Unknown Ingredients

Street drugs are unpredictable and often far more dangerous than they appear. Fentanyl, xylazine, and other synthetic additives can be mixed in without warning. That means every dose is potentially life-threatening, even if it looks familiar. Treating street drugs as “unknown and unsafe” is the only realistic way to approach them.

7. Remember That Treatment Is the Safest Path

While awareness and emergency measures can reduce risks, they don’t eliminate them. The only true way to avoid overdose and long-term harm is to stop using. Professional treatment provides medical support, safety, and the tools needed to break free from addiction. Recovery is possible, and help is available.

Get Help and Treatment

If you’re struggling with xylazine or other street drugs, the safest and most effective way forward is professional treatment. Some people try to quit on their own, but with xylazine, the risks are high and the worst could happen even with small amounts.

Treatment gives you support, guidance, and safety. In a professional program, you don’t just detox. You get help for polysubstance abuse, medical care for tranq wounds, and learn strategies to avoid relapse. You also learn how to recognize and manage the dangers of addictive drugs in a way that’s impossible to do alone.

You have options: you can try to quit yourself, but professional help dramatically increases your chances of staying safe and truly recovering. Drug rehab programs like More Than Rehab specialize in xylazine addiction treatment, helping people safely detox, heal, and rebuild their lives.

If xylazine is part of your drug use, don’t wait another day. Getting treatment now could save your life. Contact More Than Rehab to start your journey toward recovery.

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Why Heroin Use Is Rising Again in Suburban Communities

Heroin is making a deadly comeback in America’s suburban communities, catching many families off guard. Once thought of as a drug confined to dark city alleyways, heroin has now seeped into cul-de-sacs and high schools, contributing to soaring opioid overdose rates.

US heroin-related overdose deaths spiked from around 3,000 in 2010 to over 15,000 by 2016. Although heroin deaths dipped in recent years (as fentanyl took center stage), new data suggest heroin use is again surging in suburbia. A 2024 report revealed a significant jump in heroin detection among fentanyl users in Western states over just a few months.

Addiction doesn’t discriminate, experts warn – no community is immune to this crisis. Parents, teens, and even white-collar professionals in wealthy suburbs are now finding themselves tangled in heroin’s web.

From Prescription Pills to a Heroin Comeback

To understand heroin’s resurgence, we must retrace its path through the opioid epidemic. For many suburban users, the journey began not in a back alley but at a doctor’s office. Throughout the 2000s, millions became addicted to prescription opioid painkillers (like OxyContin), often after legitimate medical use. As authorities cracked down on prescription abuse in the 2010s, pain pills became harder to get and more expensive.

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Many users then turned to heroin, which was cheaper and easier to come by. One study found people who misused prescription opioids were 19 times more likely to start using heroin. In short, the well-intentioned efforts to reduce pill abuse inadvertently pushed a wave of opioid-dependent individuals toward heroin.

Contamination and ‘Safer’ Use Myths

If prescription opioids set the stage, synthetic opioids like fentanyl supercharged the crisis. In recent years, fentanyl, an ultra-potent opioid, flooded drug supplies and sent overdose deaths soaring. Traffickers often lace fentanyl into heroin (and other drugs) to boost potency, fueling a deadly contamination problem.

By 2022, a staggering 80% of heroin-related overdose deaths also involved fentanyl. For users, this means playing Russian roulette: even a batch of heroin from a familiar dealer can suddenly contain a fatal dose of fentanyl without their knowledge.

Ironically, fentanyl’s ferocity has led some people to view heroin as the “safer” alternative – a dangerous misconception. There’s a growing anecdotal trend of users in suburban (and even urban) areas seeking out what they believe is “fentanyl-free” heroin, hoping it will carry a lower risk of overdose. But the reality is that truly pure heroin is hard to find.

Many who think they’re avoiding fentanyl still end up ingesting it unknowingly. And even heroin itself is highly addictive and can be deadly, fentanyl or not. As some public health experts put it, the image of the typical heroin user needs updating – it’s not just the strung-out person under a bridge, but also the teenager experimenting at a party or the professional maintaining a facade of normalcy.

There are also supply fluctuations at play. Some data suggests that when fentanyl becomes scarce or less potent, heroin use rebounds as a fallback. In 2024, for example, Western US clinics saw a sharp rise in heroin-positive drug tests, which experts linked to a temporary fentanyl shortage and dealers substituting heroin to meet demand. All these factors have combined to bring heroin back into circulation in communities that once thought the worst was over.

Hidden in Plain Sight

One of the most disturbing aspects of this suburban heroin comeback is who it’s affecting. Teenagers in well-to-do communities are experimenting with opioids, sometimes progressing from pilfered pain pills to heroin. They may know the dangers – schools have long taught “just say no” – but adolescent psychology favors reward over risk.

“Adolescents are simply more likely to take the risk if the option is available,” notes one psychologist, especially with drugs as addictive as heroin and fentanyl. In affluent areas, teens face unique pressures: high expectations, academic stress, or the simple thrill of rebellion in an otherwise comfortable life. Unfortunately, the result can be the same heartbreaking outcome seen elsewhere.

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It’s not only youth. Parents and professionals in the suburbs are also grappling with hidden addiction. Plenty of adults became hooked on opioids through legitimate prescriptions for back injuries or surgeries. When the refills stopped, some quietly shifted to heroin to stave off withdrawal. These people often maintain outward stability, holding jobs, raising families, all while battling a worsening substance use disorder in secret.

The stigma in tight-knit suburban communities can be intense; PTA moms, executives, and even healthcare workers may go to great lengths to hide their heroin or pill habit. According to addiction experts, “Addiction never impacts just one person. There’s such a deep effect it has on spouses and children and parents.” In many cases, relatives are shocked to discover the addiction only when a crisis hits: an overdose, an arrest for stealing to fund the habit, or another health emergency.

Indeed, suburban law enforcement has noted increased drug-related crime that often accompanies rising heroin use. Police and courts are encountering more cases of otherwise ordinary people involved in offenses like shoplifting, theft of family valuables, or forging checks – desperate actions to finance their addiction. Such incidents shatter the illusion that suburban neighborhoods are insulated from the drug trade.

Harm Reduction Strategies

Given the alarming spike in opioid overdoses, harm reduction strategies have become essential in urban areas. These measures aim to prevent overdose deaths and other health issues, even if someone isn’t yet able to quit using. A cornerstone of harm reduction is making naloxone (Narcan) readily available.

Naloxone is a nasal spray that can rapidly reverse an opioid overdose. Today, many suburban police and EMTs carry it, and programs train parents, teachers, and even teens to administer Narcan in an emergency. States have expanded access so community members can obtain naloxone without a prescription. This simple step has already saved countless lives by reviving people who would otherwise stop breathing from an overdose.

Communities are also pushing for fentanyl test strips and education on safer use practices. Test strips let users check drugs for fentanyl before using, alerting them to ultra-potent batches. While abstaining from drug use is the ultimate goal, public health experts recognize that tools like these meet people “where they are” and can buy time until treatment is sought. Other harm reduction efforts include syringe exchange programs (to provide clean needles and prevent the spread of diseases like hepatitis C and HIV).

Historically, suburban and rural areas have lacked these services, but the need is clear. One Connecticut study found that over half of suburban injection heroin users had no idea they’d contracted hepatitis, mainly due to a lack of local needle exchanges and education. “We need to help these people where they live and make resources available to address a growing epidemic,” urged Yale researcher Dr. Robert Heimer, noting that failing to do so is essentially “a failure of the health care system.”

Early intervention is equally critical. Families should be proactive if they notice warning signs of opioid or heroin use – for example, missing medications, secretive behavior, sudden money troubles, or drug paraphernalia. It’s a tough conversation, but talking openly with teens about the risks of opioids (prescription or otherwise) can dispel myths and encourage smart choices. If a loved one is struggling, experts recommend not waiting for “rock bottom” to act. Encourage them to seek help from reputable addiction treatment facilities.

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Many suburbs now have outpatient clinics or can connect families to nearby rehab centers that specialize in heroin overdose prevention and treatment. There are also free support groups like Nar-Anon and Al-Anon for family members, so parents and spouses can learn how best to support their loved one and themselves. As recovery advocates often remind us, people need connection. No one should fight addiction alone, and bringing the issue into the open is the first step towards healing.

Hope through Treatment and Community Action

The resurgence of heroin in suburban communities is a stark reminder that the opioid crisis is a nationwide public health battle, not confined to any one ZIP code. The good news is that awareness is growing, and with it, a determination to respond. Schools are stocking naloxone and teaching students about fentanyl. Parents are banding together to share resources and watch out for each other’s kids.

Some areas are pioneering “deflection” programs that divert those with substance abuse issues into addiction treatment instead of jail, recognizing that long-term recovery, not punishment, is the solution. And across the country, people are spreading the message that addiction is an illness, not a moral failing, which helps reduce the shame that keeps so many hiding in silence.

If you or someone you love is affected by heroin or opioid addiction in a suburban area, don’t hesitate to reach out for help. Treatment works, and early intervention can save lives. This might mean consulting with a healthcare provider about medication-assisted treatment (like buprenorphine or methadone), joining a local support network, or even considering a stay at a reputable rehab center.

More Than Rehab (MTR), for example, is one organization focused on providing evidence-based care to individuals and families facing opioid addiction, including those in suburban and rural areas. Recovery is absolutely possible – many former users and their families are living proof – but it starts with taking that brave first step.

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The Connection Between Chronic Pain, Opioid Use, & Mental Health

Chronic pain is more common and more misunderstood than many people realize. In the United States, nearly 50 million adults live with chronic pain. That’s one in five people waking up daily with discomfort that doesn’t go away.

If that’s you, you know it’s not “just pain.” It affects all aspects of your life – from sleep and energy to the ability to work, connect, and actually enjoy your life. It wears you down, physically and emotionally. And too often, the only solution offered by your doctor is a prescription drug.

For many, that prescription is an opioid. In the beginning, it helps. You might feel some relief, but over time, it stops working the same way. You may need a higher dose. You may start depending on it just to function. And slowly, without even realizing it, you're no longer managing pain – you’re managing your mind and body's dependence on the drug.

Understand Chronic Pain

Chronic pain is pain that doesn’t go away, even when doctors say you should be healed. It can show up after surgery, injury, or a health condition. Sometimes, there’s no clear reason. No test explains it. No scan shows it. And that can leave you frustrated and dismissed for months or even years.

The pain might be in your back, your neck, your joints, or deep in your nerves. It might stay in one spot or move around. Some days are better than others. But the hard days – the ones that steal your energy, focus, and joy, can pile up. It’s draining and a huge reason why most people with chronic pain also suffer from emotional issues.

Chronic Pain’s Impact on Mental Health

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When you’re in pain for a long time, your nervous system stays in constant stress. The brain keeps receiving pain signals—even when the injury has healed, or there’s no clear reason for the pain. This continuous signal disrupts how your brain regulates mood, focus, and emotion.

Studies show that long-term pain alters the structure of the brain. It affects areas like the amygdala (which processes fear and anxiety), the prefrontal cortex (responsible for decision-making), and the hippocampus (which handles memory and emotional balance). These changes can lead to symptoms of depression, anxiety, and emotional numbness. You might notice you feel more anxious than usual. Or that it’s harder to stay motivated, focus, or find joy in things you used to love.

There’s also the hormonal side. Chronic pain activates your body’s stress system—the HPA axis. This leads to an increase in cortisol, your stress hormone. Elevated cortisol over time can worsen inflammation, disrupt your sleep, and lower your mood. It also reduces your body’s ability to manage pain naturally.

That’s why emotional struggles often go hand in hand with chronic pain. Research shows that depression is up to four times more likely in people with long-term pain. Anxiety disorders are also far more common.

And then there’s the social impact. Pain can interrupt your ability to work, stay active, or maintain relationships. That isolation creates more emotional strain. Many people living with chronic pain feel like they have to prove their experience. That lack of validation can add to emotional distress.

The Link Between Pain, Opioids, and Dependence

Opioids are often prescribed for chronic pain because they work fast. They block pain signals and release dopamine, a chemical that helps you feel calm and relaxed. For a while, you might feel like yourself again. But over time, your brain adapts.

It stops responding the same way. You build tolerance, meaning you need more of the drug to get the same relief. If you’ve been on opioids for a while, you might notice the dose that once worked doesn’t help much anymore. So you might need higher doses just to take the edge off.

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But with higher doses come more side effects like constipation, brain fog, mood swings, and hormone issues. You may also notice that your pain doesn’t go away. It just gets masked for a little while. Then there’s the risk of opioid dependence, where your body starts to rely on the drug to function. If you skip a dose or try to stop, you might face withdrawal symptoms like anxiety, chills, or insomnia.

For some people, this leads to opioid misuse, even when the original goal was just to find relief. And the longer you’re on opioids, the greater the risk of accidental overdose, especially if you mix them with other medications or alcohol or if your health changes.

Research shows that 64.4% of people diagnosed with opioid use disorder (OUD) also live with chronic pain. And for most (about 61.8%), the pain comes first. Opioid use commonly begins as a treatment, but somewhere along the way, the drug ends up becoming the bigger problem. This is why long-term opioid therapy is no longer recommended as a first choice for most chronic pain. Not because your pain isn’t real. But because there are safer, more effective ways to manage it.

Stigma and Opioid Abuse

In the United States health care system, many people fear the label “drug-seeking” if they ask for stronger pain medication. Others worry they will be judged if they admit to feeling low or depressed. This stigma can prevent you from speaking openly with doctors, family, or friends. It can also keep you from finding the mental health services you need.

Stigma exists in two directions:

  1. Self-Stigma: Feeling ashamed of needing help for pain or mental health.
  2. Social Stigma: Others may label you as “addicted to painkillers” or weak if you use opioids or if you struggle with mood issues.

Breaking down stigma involves honest conversations with healthcare providers about pain management, potential opioid overdose prevention methods, and alternative therapies. It also involves acknowledging that chronic pain is real and deserves proper treatment.

Alternative Strategies for Pain Management

Chronic pain can be managed without over-relying on opioids. Approaches like physical therapy, gentle exercise, non-opioid medications, and cognitive-behavioral therapy (CBT) can reduce pain and improve your ability to cope.

Other options such as mindfulness, nerve blocks, and simple lifestyle changes can help calm the nervous system and restore a sense of control. These strategies focus on long-term relief without the risks of dependence, making them safer and more sustainable tools for daily life.

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The Role of Integrated Care

If you’re managing both chronic pain and signs of substance abuse, integrated care brings everything together. You work with a team—doctors, mental health professionals, pain specialists—who create a plan tailored to your needs. This may include medication-assisted treatment (MAT) to reduce cravings, therapy to process emotional pain, and regular check-ins to track your progress. Integrated care treats your whole self—not just your symptoms—so you can break the cycle of pain, dependence, and isolation.

Opioid Addiction Treatment at MTR

At More Than Rehab, you’ll find comprehensive, whole-person opioid addiction treatment that honors your pain and helps you heal physically and emotionally. Whether you're seeking alternatives to opioids or support with addiction recovery, our team is here to guide you. Reach out to More Than Rehab today and take your next step toward lasting relief and recovery.

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Understanding Fentanyl: Why It’s So Dangerous & How to Stay Safe

The growing reports of opioid overdose deaths are overwhelming. And the rising numbers don’t make it any easier. If you’re feeling worried—about yourself, your family, or someone close to you—you’re not alone. According to the CDC, fentanyl is now involved in about 76% of opioid overdose deaths in the United States, a statistic that underscores just how serious this crisis has become.

What makes it even more frightening is how often fentanyl is mixed into other drugs without anyone realizing it. It’s understandable to feel concerned, even helpless, in the face of these risks. But understanding fentanyl, its dangers, and how to stay safe can help you take meaningful steps to protect yourself and those you care about.

What Is Fentanyl?

Fentanyl is a synthetic opioid that can be up to 50 times stronger than heroin. Doctors sometimes prescribe it to treat severe pain, especially after surgery. It is often used in hospitals under close supervision. However, fentanyl is now found more often in illegal drug markets. People sometimes buy what they believe to be prescription opioids or other drugs, only to end up with substances laced with fentanyl.

When misused or without medical supervision, fentanyl can be very harmful. Because it is so powerful, even a minimal amount can be life-threatening. This risk becomes worse when fentanyl gets mixed with other substances like cocaine or ecstasy. Sometimes, people do not even know they are taking fentanyl. That is one reason authorities are saying "one pill can kill" as so many recent overdose deaths have been attributed to unexpected fentanyl contamination in other drugs.

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Why Is Fentanyl So Dangerous?

The main danger lies in its strength. Small doses can slow your breathing so much that your body shuts down, leading to an opioid overdose. This can happen before you even realize you are in trouble. When fentanyl is mixed with other drugs, it becomes even more unpredictable. People might think they are taking one substance but receive a much stronger opioid.

This often leads to a dangerous situation where just one pill or one dose can be enough to cause an overdose. As a result, the number of deaths from fentanyl overdoses continues to grow. Public health experts warn that using any non-prescribed pill is now a high-risk activity, especially if it might contain fentanyl.

How Fentanyl Can Appear in Other Drugs

Part of the reason fentanyl is dangerous is its invisibility. You can’t see, smell, or taste it, which means you cannot know if it’s there without testing the drug.

Drug dealers and drug cartels frequently lace substances with fentanyl because it’s inexpensive to produce and dramatically increases the potency of their products. This practice puts unsuspecting users at extreme risk. Fentanyl has been found in pills disguised as prescription opioids like oxycodone, in fake pills made to look like medications, and even mixed with drugs like cocaine and ecstasy.

How to Stay Safe and Reduce Risks

1. Avoid Drug Use Altogether

The safest option is to avoid using drugs entirely. This might sound simple, but it can be challenging if you or someone you care about struggles with substance use disorder. If that is the case, please know help is available. You do not have to face this alone.

2. Use Fentanyl Test Strips

If you or a loved one does feel at risk of encountering fentanyl, fentanyl test strips can detect whether the drug is present in a powder or a crushed pill. They are not foolproof, but they do lower the risk of an unexpected overdose. Remember, a negative result does not guarantee total safety, so caution is still necessary.

3. Recognize Overdose Signs

An overdose can happen suddenly. If you see someone who has very slow or stopped breathing, is unconscious, or has bluish lips or fingertips, treat that as an emergency and call 911 right away. You should also give naloxone (often known by the brand name Narcan) if it is available. Naloxone reverses opioid overdose by blocking the opioid’s effect on the brain, and it can save a life.

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4. Carry Narcan (Naloxone)

Naloxone kits are available at many pharmacies and community organizations. You do not need a prescription in most places. Having a kit on hand can make the difference between life and death if an overdose occurs. Public health agencies often provide Narcan at low or no cost, so you can ask about free programs in your area.

5. Harm Reduction Approaches

Some communities focus on harm reduction to lower the risk of infection, overdose, and other health issues. Harm reduction programs often offer clean syringes, naloxone training, and information about safer use practices. Their goal is to support people who use drugs and to prevent further harm. They also serve as a point of contact for people to enter drug addiction treatment programs or other forms of help.

Mental Health Care and Fentanyl Use

Many people who develop a substance use disorder are also dealing with emotional pain or stress. Mental health care can address underlying issues like anxiety, depression, or unresolved childhood trauma. Counseling or therapy helps you learn healthier ways to cope. You also gain support that can help you move away from drug use.

Remember, you do not have to handle everything on your own. A licensed therapist, psychiatrist, or counselor is there to guide and support you. They help you work on a treatment plan for your needs and challenges. This plan often includes therapy, medication, and group support.

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Finding Treatment for Substance Use Disorder

1. Drug Addiction Treatment Programs

Drug addiction treatment programs offer structured help through inpatient or outpatient settings. They often include detox services, counseling, and medication-assisted treatment. These programs give you the tools to stop drug use and maintain long-term health.

2. Support Groups

Groups like Narcotics Anonymous or other community support groups can provide a sense of connection. They let you share experiences with people who understand your challenges. They also offer encouragement to stay on track. Support from peers makes a big difference in your addiction recovery journey.

3. Family Involvement

Family members can play an essential role in recovery. They often notice changes in behavior before anyone else. When a family learns how to support a loved one and set healthy boundaries, it creates a more stable environment for healing. Encourage open, non-judgmental communication. Offer to help with finding resources or simply be there to listen.

If you or someone you care about has a substance use disorder, please remember that help is available. A treatment plan can involve drug addiction treatment programs, therapy, and support groups like Narcotics Anonymous. You also have the option of including family members who want to help. All these resources work together to keep you or your loved one safe and supported.

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Buprenorphine: A Lifeline for Opioid Addiction Recovery

Buprenorphine is the first line of treatment for opioid use disorder (OUD). It helps people with opioid addiction to safely withdraw from the drugs without the euphoria and dangerous side effects. Buprenorphine serves as a substitute for the opioid being abused, so the patient has minimal discomfort and is able to focus on their recovery. It’s prescribed as part of an evidence-based comprehensive treatment plan that includes therapy and services to heal the whole person.

Buprenorphine is also used as a pain reliever for people with acute or chronic pain. But doctors only prescribe it if they think other treatment options won’t effectively manage the pain or if other medicines aren’t suitable for your situation.

Opioid Addiction Overview

Opioid addiction is a serious public health issue. It affects more than 16 million people globally and over 2.1 million people in the US. According to the CDC, about 81,083 people in the US lost their lives due to opioid overdose deaths in 2023 alone. Substance Abuse and Mental Health Services Administration notes that most of the deaths involving opioids are driven by illicitly manufactured fentanyl.

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Opioids, whether prescribed or illicit drugs like heroin or fentanyl, can create physical dependence, making it difficult to quit. This is where buprenorphine comes in — it’s a key player in addiction treatment, helping people manage withdrawal symptoms and reduce the risk of relapse.

What Does Buprenorphine Look Like?

Buprenorphine comes in different forms, including tablets, film strips, or implants. You might hear about it under brand names like Suboxone, which is a blend of buprenorphine and naloxone. The medication is prescribed by healthcare professionals trained in addiction treatment and taken either sublingually (under the tongue), as a skin patch, or through injection.

How Does Buprenorphine Work?

Buprenorphine is a partial opioid agonist, which means it binds to the same receptors in the brain as opioids but doesn’t produce the same intense euphoria or dangerous side effects. Instead, it inhibits cravings and helps manage withdrawal symptoms. Buprenorphine has a ceiling effect. So, after a certain dose, taking more won’t increase its effects. This:

Buprenorphine for Opioid Use Disorders

Buprenorphine helps people recover from OUD. But in order for it to work, you must stop using opioids for at least 12-24 hours and be in the early stages of withdrawal. This timing is important because starting buprenorphine while opioids are still in your system can trigger acute withdrawal, which is something you want to avoid.

Once you begin the therapy and your cravings are under control, your doctor will closely monitor how your body responds. As you progress in treatment, they may adjust your dose to make sure you’re getting the right amount to manage symptoms without unnecessary side effects. One of the benefits of buprenorphine is its long-acting nature. Once you’re stabilized, you may be able to switch from daily dosing to taking it every other day, which can be more convenient.

The length of time you’ll stay on the medication depends on your individual needs. Some people require long-term or even indefinite treatment to maintain their recovery, and that’s perfectly okay. Buprenorphine helps prevent relapse, but ongoing support, whether through counseling or other forms of therapy, can further strengthen your recovery journey.

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Buprenorphine As Part of Medication-Assisted Therapy (MAT)

Buprenorphine is most effective when it’s part of a medication-assisted treatment (MAT) program. MAT blends medication with counseling and behavioral therapies to provide a whole-person approach to recovery. The Food and Drug Administration has approved buprenorphine for this purpose, and it has proven to be a highly effective, evidence-based treatment for opioid use disorder. Managing the physical aspects of addiction allows MAT to reduce relapse rates and improve long-term success.

What Are the Possible Side Effects of Buprenorphine?

Like all medications, Suboxone buprenorphine can have side effects. Common side effects are constipation, headache and nausea. Some people may experience dizziness or drowsiness, especially when starting treatment. It’s important to talk to your doctor if you notice more severe side effects like trouble breathing or allergic reactions. However, when used as prescribed, the drug is generally safe and well-tolerated.

Risks Associated with Buprenorphine

Buprenorphine also carries some risks. Misuse can still happen, especially if it’s combined with other substances like alcohol or sedatives. That’s why a doctor should closely monitor your progress through medication assisted therapy. Also, patients need to follow their doctor’s instructions carefully, as taking too much or stopping suddenly can lead to withdrawal symptoms. Despite these risks, buprenorphine remains a safe and effective treatment option when used correctly.

What Are Buprenorphine Alternatives?

While buprenorphine is an effective treatment for opioid use disorder, it’s not the only option. Methadone is another commonly used medication. It’s similar in that it helps manage withdrawal symptoms and cravings, but it’s typically provided in specialized clinics. Methadone can be a better option for people with higher levels of physical dependence, as it may be more effective in those cases.

If you’re currently on methadone and considering switching to buprenorphine, it’s important to talk to your doctor first. Switching from methadone to buprenorphine is possible, but because the two medications work differently, some patients find the transition challenging. A dose of buprenorphine works well for moderate levels of opioid dependence, but if you’ve been on a high dose of methadone, you might not experience the same level of relief. It’s important to have this conversation with your doctor to understand how switching could affect your treatment.

On the other hand, if you’re currently using buprenorphine and feel it’s not working as well as you’d like, switching to methadone may be an option. Your healthcare provider can help guide you through these decisions to find the best treatment for your needs.

MAT Treatment at More Than Rehab

At More Than Rehab, we understand that recovery is unique for everyone. Our comprehensive MAT programs, including buprenorphine treatment, are tailored to meet your needs, offering you the support and guidance necessary for lasting recovery. If you or a loved one are ready to start your journey to a healthier, opioid-free life, reach out to us today. We’re here to help every step of the way.

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Borderline Crisis: How Fentanyl is Crossing the US-Mexico Border

Synthetic opioids like fentanyl are the leading course of overdose deaths in the US. New data from the CDC’s National Center for Health Statistics shows that there were an estimated 81,083 opioid-related deaths in 2023. While this marks a slight decrease from the 84,181 deaths recorded in 2022, the numbers remain staggering and underscore the ongoing threat fentanyl poses to communities nationwide. Most of the fentanyl in the United States is smuggled across the US-Mexico border.

Our border with Mexico has become a major front in the fight against the opioid crisis. Despite efforts to tighten security, traffickers keep finding new ways to sneak the drug in. Mexican drug cartels have set up complex smuggling operations. They recruit US citizens to carry fentanyl across the border, hiding it in cars, trucks, and personal items.

How Fentanyl is Crossing the US-Mexico Border

Seizure reports show that the pounds of drugs seized at the border are trending down. But this is mostly only true for heavier, less potent drugs like marijuana. Seizures of fentanyl, which is 100 times more potent than morphine, is up significantly. In fact, it’s 480% higher at the southern border in 2023 compared to 2020.

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The US-Mexico southern border stretches approximately 1,954 miles, crossing four states: California, Arizona, New Mexico, and Texas. This long expanse includes about 26 official land ports of entry, where people, vehicles, and goods are legally allowed to cross between the two countries. These ports are crucial points for trade and travel but also serve as primary routes for smuggling fentanyl and other illicit drugs into the United States.

So, how does fentanyl get in the country?

You might be surprised to learn that most of the fentanyl coming into the US isn’t being smuggled by migrants—it’s often US citizens doing the job. Cartels recruit Americans because they can cross the border without drawing as much attention. They get paid well to hide fentanyl in cars, trucks, and even everyday items like food packages or clothes. Most of this drug trafficking happens right at official border crossings, like the busy ports of entry in San Diego and El Paso.

The Mexican cartels—mainly the Sinaloa and Jalisco New Generation cartels—have this down to a science. They use all kinds of tricks to get fentanyl past border agents. We’re talking about false compartments in cars, blending drugs with legal goods, and even hiding fentanyl pills or powder in shoes or personal items. It’s a cat-and-mouse game that’s constantly evolving, and the cartels are always finding new ways to beat the system.

Despite increased security measures, the sheer size of the border and the volume of traffic make it a challenging task for border patrol and customs agents to effectively monitor and intercept every illegal shipment that passes through.

What the US is Doing to Fight Back

The Biden Administration has been trying to crack down on this by going after the supply chain, especially the chemicals used to make fentanyl. Most of these chemicals come from China, and without them, cartels can’t produce fentanyl at the same scale.

Since 2019, China has cut down on sending fentanyl directly to the US. This is a big change noted by the DEA. However, China still plays a major role in the fentanyl crisis as it supplies the chemicals used to make fentanyl in Mexico and other Central American countries. These chemicals are shipped to Mexico, where cartels turn them into the fentanyl that floods the US.

So, the US has been pushing a foreign policy with China that will help tighten the rules on these chemicals. It’s a step in the right direction because if we can cut off the supply of these chemicals, we can slow down the production of fentanyl.

fentanyl-overdose-southern-border-foreign-policy-with-China-Mexico-drug-trafficking-federal-law-enforcement

Federal law enforcement is also working hard to break up cartel operations. They’re going after the money trails that fund these groups and are working with Mexican authorities to shut down labs where fentanyl powder is made. At the same time, US agencies are stepping up their game at the border, using more advanced tech like X-ray machines and drug detectors to spot hidden stashes of fentanyl. They’re also training customs and border protection agents to spot the tricks smugglers use.

But let’s be real—the cartels are always adapting, so it’s a constant battle. For example, fentanyl comes in many forms, and each version can be made using different chemicals. Cartels keep switching up how they make the drug, finding new chemicals that are easy to get.

It’s like a never-ending chase between cartels trying to make money and governments trying to stop them. It’s a dangerous game, and both sides are constantly trying to outsmart each other.

The Real Impact of Fentanyl

Illicit fentanyl is incredibly dangerous. It only takes a tiny amount—just two milligrams, about the size of a few grains of salt—to be deadly. That’s why fentanyl is so lethal and why it’s driving the overdose crisis in the United States. Here are some dangerous impacts of fentanyl and why it’s a public health concern:

Why Fentanyl is So Dangerous?

Fentanyl is often mixed with other drugs like cocaine, methamphetamine, and fake prescription pills. This isn’t an accident; it’s a deliberate move by cartels to make their products more potent and addictive. But it’s incredibly risky because users often don’t know fentanyl is in what they’re taking. This turns every dose into a deadly gamble.

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Fentanyl Overdose Deaths

Fentanyl remains the deadliest drug in the United States, and despite a slight drop in 2023, the crisis is far from over. For the first time since 2018, overdose deaths declined, but the numbers are still staggering. Over 100,000 Americans lost their lives to drug overdoses last year, and fentanyl was responsible for about 75,000 of those deaths.

It’s Everywhere and It’s Overwhelming

Fentanyl has flooded the streets, and it’s not just in big cities. It’s in small towns, suburbs, and communities that never thought they’d face a drug crisis like this. It’s cheap to make and easy to transport, which is why it’s turning up all over the country.

The strain on our healthcare system is enormous. Emergency rooms are overwhelmed with overdose cases, and the cost of treating these emergencies is skyrocketing. First responders use drugs like Narcan every day to save lives, but it’s just a Band-Aid on a much bigger wound.

The battle against fentanyl is tough, but it’s one we can’t afford to lose. Let’s take action now to protect our loved ones and build a safer future.

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Maximizing Texas’s Opioid Settlement: Investing in Treatment & Rehabilitation

The US has been experiencing an opioid crisis since the mid-90s. This was around the time when there was a shift in how doctors prescribed pain medication. Pharmaceutical companies downplayed the addictive potential of opioids, and doctors were encouraged to prescribe them more liberally for chronic pain. Sadly, this led to a significant increase in the number of people taking prescription opioids like Percocet and OxyContin.

As more people were exposed to opioids, rates of addiction and misuse skyrocketed. Many who became addicted to prescription drugs eventually turned to cheaper, more dangerous alternatives like heroin, further inflating overdose deaths. The rise in opioid overdose deaths paralleled the increase in opioid prescriptions, highlighting a clear link between the two. 

After the CDC survey that found over 10 million patients misused prescription opioids in 2018, it, along with states like Texas, declared an opioid epidemic and changed prescription standards. Texas and 13 other states took the drug companies to court, with both Democrat and Republican attorneys general teaming up to sue. 

In July 2021, a significant agreement was made: Johnson & Johnson and three drug distributors agreed to cough up $26 billion to settle the case. But other settlements, including with OcyContin manufacturer Purdue Pharma, are still pending. Texas is expected to get about $1.6 billion from six companies over 18 years as part of these settlement agreements.

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The Current State of Opioid Addiction in Texas

Texas is experiencing a drug poisoning epidemic. According to surveys, deaths from poisoning in the state increased by more than 75% in just five years. In 2017, the rate was 9.4 deaths per 100,000, and that nearly doubled to 15.8 deaths per 100,000 residents in 2021.

Although the prescription of opioids by doctors in Texas has reduced over the last few years, overdose deaths from illegally manufactured fentanyl continue to rise. A CDC report estimates 5,566 drug-related deaths occurred in Texas between August 2022 and August 2023. 45% of these deaths involved fentanyl.

The human cost of opioid addiction is immense. For every statistic, there’s a person and a story—a family member, a friend, or a neighbor whose life has been affected. Beyond that, the opioid epidemic is putting a strain on all levels of care. Hospitals and emergency services are overwhelmed by the number of overdose cases they handle daily.

This strain makes it harder for everyone to get the care they need. Local resources such as law enforcement and social services are also stretched thin trying to manage the wide-ranging consequences of the opioid crisis. 

The Potential Impact of Strategic Investments 

The $1.6 billion settlement presents a significant opportunity for Texas to combat the opioid crisis effectively through strategic investments. Proper allocation of these funds can profoundly impact the state's ability to support the people who are struggling with addiction, improve public health, and reduce the overall burden of the crisis.

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Let’s explore some key areas where strategic investments can make a difference:

Expansion of Treatment Facilities

There’s a need for more treatment facilities so more people can get the help they desperately need. With more money, we can build new treatment centers and improve upon the ones we already have. This means people won’t have to wait so long to get care. These centers can offer a variety of services like detox, inpatient and intensive outpatient treatments, and special treatments for mental health conditions. More facilities means increasing the number of beds, doctors, and nurses, which ultimately leads to saving more lives.

Enhancement of Recovery Support Services

The money can also go to recovery support to give people the tools they need to rebuild their lives. This includes access to counseling and therapy, which are crucial for long-term recovery. Programs that offer stable housing and job training can help people recover and stay sober.

We can also create peer support groups and mentorship programs where people who have been through recovery can offer support and advice. These services build a strong support network that can make a huge difference.

Implementation of Prevention Programs

Preventing addiction before it starts is key to tackling the opioid crisis. When we invest in prevention programs, we can educate communities about the dangers of opioid misuse and teach healthy coping strategies.

Schools, workplaces, and community centers can run educational programs to raise awareness. Early intervention programs can identify at-risk people and help them before things worsen. Strengthening prescription monitoring systems can also prevent misuse and diversion of opioids. Prevention efforts can stop the cycle of addiction before it starts, saving lives and reducing the impact of the crisis. 

Misallocation of Opioid Settlement Funds Raises Concerns

In the wake of the opioid crisis, states across the country have received significant settlement funds intended to combat addiction and support affected communities. However, there are growing concerns about how these funds are being used. Instead of directing the money towards prevention and treatment options, some states are spending it on things like new police cars and slush funds that don't directly help those struggling with substance use disorders.

Police Cars and Equipment

In several states, portions of the opioid settlement funds have been used to buy new police cars and other law enforcement equipment. While law enforcement is crucial in addressing the crisis, these expenditures don’t provide the necessary treatment or support for individuals battling addiction.

Filling Budget Gaps

Some states use the funds to cover general budget shortfalls or unrelated projects. This means the money isn’t going to addiction treatment or prevention programs, which undermines efforts to combat the opioid epidemic.

Lack of Transparency

In some instances, funds have been placed into slush funds with little oversight or accountability. Without explicit tracking, it’s hard to ensure the money is being used to help those who need it most.

The Need for Transparency and Accountability

Unless the state and local governments put the funds to good use, they won’t help those affected. The state can ensure this happens by:

  1. Establishing robust oversight mechanisms. This includes transparent reporting, regular audits, and involving community stakeholders in decision-making processes.
  2. Learning from the missteps of other states, where funds have been diverted to unrelated expenses like new police cars and slush funds, Texas must commit to using the settlement money exclusively for addressing the opioid crisis.
  3. Strategically allocating funds to areas with the highest need and potential impact. This way, Texas can maximize the benefits of the settlement, supporting recovery, reducing overdose deaths, and ultimately diminishing the overall opioid crisis in the state.
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How to Track Fund Usage in Your Community

There are several resources available to help track the allocation and use of opioid settlement funds:

News Sites

While the information might not be readily available, some platforms, like KFF Health News, have made it public after negotiations.

Government Websites

Check state and local government websites for information on fund allocation and spending. Look for sections on budget reports, public health initiatives, or opioid response plans. BrownGeer, a court-appointed firm administering the settlements, also shares the information on a public website.

Public Records Requests

You can file public records requests to obtain detailed information about funds' use. Do this through state or local government offices handling public information requests.

Community Advocacy Groups

Local advocacy groups focused on addiction and public health, such as the Texas Harm Reduction Alliance and the Texas Overdose Naloxone Initiative (TONI), can be valuable resources for information and action.

Opioid Addiction Treatment at More Than Rehab

At More Than Rehab, we’re committed to making a real impact. We offer comprehensive care, from detox and therapy to long-term support and education. Our mission is to provide a safe, supportive environment where people can recover and thrive.

With the right investments and a commitment to transparency and effectiveness, we can make a significant difference in the fight against the opioid crisis in Texas. Let’s work together to ensure these funds are used to their fullest potential, helping those in need and building healthier communities across our state.

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Dark Web Markets & the Changing Face of Narcotics Distribution

The dark web can be a helpful tool for ensuring private communication or sourcing legitimate products. But it is also a hotspot for illegal internet activity. People turn to this part of the internet to buy, sell, or exchange a variety of illicit goods and services, including narcotics. And with over 2.5 million daily dark web visitors, the digital drug trade has become a significant and concerning aspect of illicit online activities.

How the Dark Web Has Revolutionized the Narcotics Trade

The way ecommerce has changed how we do business in the same way the internet has changed the drug dealing landscape in the 21st century. Today, people can order virtually any illicit drug with a click of a button and have it delivered to their doorstep within hours or days. Buyers are attracted to crypto markets to buy narcotics due to the perceived increase in safety, variety, enhanced quality, and speed/ease of delivery. Besides, there’s no dealing with intermediaries and longer supply chains.   

The sale and marketing of illicit substances on the web can happen on different levels:

But since conducting such business on the clean web and social media platforms comes with unwanted scrutiny from the authorities, many turn to the dark web.

What is Dark Web (darknets)

Dark web concept illustrating narcotics distribution with a hacker attacking a server a focus for law enforcement

The dark web, sometimes called darknets, is a part of the internet that exists on overlay networks and requires specific software, configurations, or authorization. The dark web is intentionally hidden and is known for hosting various activities, prioritizing privacy and anonymity. To understand the dark web better, let’s look at the other layers of the internet.

Narcotics Trade on Dark Web Markets

The narcotics trade on dark web markets operates in a covert and decentralized manner, leveraging technology to facilitate illegal transactions while attempting to maintain a level of anonymity for both buyers and sellers. Here’s how the trade works:

Creation of Darknet Markets

Darknet markets are online platforms that operate on the dark web, providing a space for users to buy and sell narcotics and other drugs. These markets often operate as peer-to-peer networks, connecting buyers with sellers and dealers.

Access and Anonymity

The dark web isn't indexed by or accessible through search engines – which makes it an asset for those who buy and sell narcotics. Users access darknet markets using specialized software like Tor (The Onion Router) to conceal their IP addresses and maintain anonymity. Tor routes users' internet traffic through volunteer-operated servers, creating layers like an onion (hence the name). This allows them to browse and participate in transactions without easily revealing their real-world identities.

CryptoCurrencies (e.g., Bitcoin)

Cryptocurrencies, particularly Bitcoin, are the primary form of payment on dark web markets. Buyers and sellers use cryptocurrencies due to their pseudo-anonymous nature. Transactions made with Bitcoin are recorded on a public ledger (blockchain), but the individuals' identities are not necessarily tied to their wallet addresses. 

Cryptocurrencies add a layer of anonymity for buyers and sellers on the dark web. It makes financial transactions more difficult to trace compared to traditional payment methods – another asset for those who deal and buy drugs.

Communication and Encryption

Buyers and sellers often communicate through encrypted messaging systems within the darknet market. This adds a layer of privacy to conversations. Encryption prevents third parties, including law enforcement, from easily intercepting or deciphering messages.

Shipping and Stealth Packaging

Vendors on dark web markets often ship narcotics using discreet and stealth packaging to avoid detection during transit. Methods may include vacuum sealing, decoy packaging, or using materials that mask the scent of the substances. Sellers may also provide tracking information to buyers.

Detection and Intervention Modes

Law enforcement tackling digital drug trade through advanced drug prevention and detection intervention modes

Law enforcement agencies use the following strategies to detect and intervene in facilitated drug trade:

But despite this, law enforcement faces numerous challenges in combating digital drug trades on the dark web. These include:

Difficulty Uncovering Real-World Identities

Using anonymizing tools like Tor and encryption technologies makes it challenging for law enforcement to trace the identity and location of individuals involved in digital drug trades. Transactions and communications are shrouded in layers of privacy, making it difficult to uncover users' real-world identities.

Global Nature of the Dark Web

The dark web operates globally, and illicit activities may involve actors from different countries. Coordinating efforts across international jurisdictions poses a challenge for law enforcement agencies, as legal frameworks and resources vary widely.

Constant Adaptation of Criminal Tactics

Criminals on the dark web are quick to adapt to new technologies and law enforcement tactics. As authorities develop strategies to identify and apprehend those involved in digital drug trades, criminals respond by evolving their methods, making it a constant game of cat and mouse.

Decentralized Nature of Darknet Markets

Darknet markets are often decentralized and operate on a peer-to-peer model. Shutting down one marketplace does not necessarily eliminate the trade; new platforms may quickly emerge. This makes it challenging for law enforcement to target and dismantle these networks effectively.

Implication for Users

Although users enjoy privacy on the dark web due to its anonymity, this double-edged sword comes with several user risks and implications as discussed below:

Risk of Scams and Fraud

The lack of regulation on online platforms for drug trade opens users to the risk of scams and fraud. Sellers may misrepresent products, fail to deliver, or engage in other fraudulent activities, leading to financial losses for buyers.

Health and Safety Risks

Users may unknowingly purchase substances with unpredictable compositions, harmful additives, or incorrect dosages. This poses serious health risks, including the potential for overdose, poisoning, or other adverse reactions.

Vulnerability to Exploitation

Users engaging in internet-facilitated drug trade may be vulnerable to exploitation by malicious actors. Scammers, hackers, or violent individuals might take advantage of users' activities for personal gain, leading to financial or personal harm.

Difficulty in Quitting

The ease of access and perceived anonymity provided by online platforms may make it challenging for users to quit or seek help for potential addiction issues. The discreet nature of online transactions may delay or hinder individuals from accessing the necessary support and treatment.

That said, if you ever thought of purchasing drugs on the crypto markets, know that law enforcement is fully aware of what’s happening. Many buyers have had DEA agents show up at their doorsteps instead of the drug package they were expecting.

Purchasing narcotics online places you at risk of federal charges. Add that to the fact you may not know all the ingredients that are in the drugs you’re ordering from an anonymous dealer. It’s all too risky. If you’re struggling with addiction, it’s best to seek addiction help right away. 

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Synthetic Opioids: The Invisible Epidemic

The 2022 provisional data showed that over 68% of the reported 107,081 drug overdose deaths in the US involved synthetic opioids other than methadone. According to the CDC, illicitly manufactured fentanyl was the primary driver of these deaths, accounting for nearly 73,654 of all overdose deaths. Fentanyl deaths have increased every year since 2012. In addition, fentanyl analogs like carfentanil, furanylfentanyl, and acetylfentanyl are being detected more in overdose deaths.

Not since the HIV/AIDs crisis has the US faced a lethal and devastating public health issue as the current opioid crisis. More people die each year of drug overdoses than died in the entirety of the Korean War, Vietnam War, or any armed conflict since WWII.

What are Synthetic Opioids?

Synthetic opioids are a class of powerful and man-made drugs designed to replicate the effects of natural opioids, such as morphine and heroin. These substances are chemically synthesized in laboratories, and they differ significantly from natural opioids due to their artificial origins and, most notably, their potency.

Drug Potency and Overdose Risk

The potency of synthetic opioids is a defining and devastating characteristic. Fentanyl, for instance, is estimated to be between 50 to 100 times more potent than morphine. Carfentanil is estimated to be 10,000 times stronger than morphine. Such extreme potency means that only a minuscule amount of the drug is sufficient to produce a powerful effect. This, in turn, significantly amplifies the risk of overdose.

Fentanyl is not a newcomer to the opioid scene, as it has legitimate medical uses for pain management. However, the illicit production and distribution of this drug have exacerbated the opioid crisis significantly. The clandestine production of fentanyl, often mixed with other drugs like heroin or cocaine, poses an enormous risk to users who may unknowingly ingest a lethal dose. 

The unpredictability of synthetic opioids further compounds the dangers. Street drugs laced with these substances may not be uniform in composition, leading to variability in strength and effects. This makes it difficult for users to gauge the risk accurately, and even experienced individuals can inadvertently consume a lethal dose.

Understanding the Opioid Epidemic: When Did It All Start?

Understanding the opioid epidemic with synthetic opioids substance abuse and drug potency showing a bottle of prescription drugs and hydrocodone pills

The opioid overdose epidemic in the United States can be divided into three distinct waves, each marked by different factors and substances involved.

The First Wave (1990s)

The first wave of the opioid overdose epidemic began in the 1990s with the increased prescribing of opioids, particularly prescription painkillers. During this period, there was a surge in the prescription of opioids, including natural and semi-synthetic opioids like oxycodone and hydrocodone, as well as methadone.

Overdose deaths involving these prescription opioids began to increase during this time, with a notable rise since at least 1999. This wave was primarily driven by the overprescribing of opioids for pain management.

The Second Wave (2010)

The second wave started around 2010 and was marked by rapid increases in overdose deaths involving heroin. This shift was partially a consequence of the first wave. As the medical community and authorities began to recognize the overprescribing of prescription opioids, efforts were made to reduce their availability, which led some individuals to turn to heroin as a cheaper and more accessible alternative.

This wave was characterized by a surge in the use of heroin and its associated overdose deaths.

Third Wave (2013)

The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, especially illicitly manufactured fentanyl. Illicit fentanyl, which is much more potent than heroin and prescription opioids, became a primary driver of overdose deaths.

The market for illicitly manufactured fentanyl evolved, and it started to appear not only on its own but also in combination with other drugs, such as heroin, counterfeit pills, and cocaine. This made drug use riskier as users often didn't know what substances were in the drugs they were consuming.

This wave was marked by the rise of synthetic opioids, particularly illicit fentanyl, and their association with a substantial number of overdose deaths.

Challenges in Detection and Regulation

Synthetic opioids substance abuse and drug potency issues represented by fentanyl syringes anesthetics and muscle relaxers highlighting the opioid epidemic and narcotic misuse crisis

There are numerous origins and types of opioids in the market, which makes it hard for the authorities to detect, let alone regulate, these drugs. Let’s explore the reasons behind the detection challenges and regulation difficulties surrounding opioids. 

Evolving Chemical Structures

Illicit manufacturers of synthetic opioids continually alter the chemical structures of these drugs to evade legal restrictions. This "cat and mouse" game with law enforcement makes it difficult to keep up with the constantly changing landscape of these substances.

Online Sales and Dark Web Marketplaces

The internet has become a major distribution platform for synthetic opioids. Dark web marketplaces and online sales have made these drugs accessible to a global audience, rendering traditional law enforcement and border control methods less effective.

Lack of Regulatory Oversight

The lack of regulatory oversight on the production and distribution of synthetic opioids contributes to their proliferation. Many of these drugs are manufactured in unregulated facilities, making it nearly impossible to ensure quality control or safety.

Analog Substances

The existence of analog substances compounds the difficulty of regulation. Even when specific synthetic opioids are banned, analogs with minor chemical variations can emerge, circumventing legal restrictions.

The Need for Increased Awareness

Behind the statistics and headlines are real people, families, and communities affected by the synthetic opioid crisis. Lives are shattered, and the social and economic costs are immense. The opioid epidemic has created a public health crisis of unprecedented proportions.

There is a need to increase public awareness about the dangers of synthetic opioids. Educational campaigns can inform individuals about the risks associated with these drugs, making them more cautious and informed when confronted with them.

Harm reduction strategies and the distribution of naloxone (a life-saving opioid overdose antidote) are vital steps in reducing the harm caused by synthetic drugs. Safe injection sites also provide a controlled environment for users to minimize risks and seek support.

Above all, preventive measures like prescriber education, monitoring prescription practices, and improving access to addiction treatment can go a long way in combating the synthetic opioid crisis.

Rehabilitation and Treatment Options

The opioid epidemic has exacted a heavy toll on individuals and communities. While efforts to raise drug awareness, prevent overdose, and regulate these potent substances are critical, they must be accompanied by robust rehabilitation and treatment options to help those already affected.

Substance abuse is a medical condition, and treatment and rehabilitation options are essential. Rehab programs can provide the necessary support for individuals struggling with synthetic opioid addiction. But it’s equally important for the stakeholders to reduce barriers to treatment, such as cost or location. This will improve the likelihood of individuals seeking and continuing treatment. 

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The War on Drugs: More Harm than Good?

Drug offenses are the number one reason for arrest in the US. According to sources, over 1.16 million arrests are made for drug law violations each year. Sadly, these arrests disproportionately affect Black, Latinx, and Indigenous people.

Five decades after President Richard Nixon declared drug abuse "public enemy number one" and allocated significant resources to combat it, about 83% of Americans believe that the policy has been a failure. In one poll:

The campaign led to the creation of the Drug Enforcement Administration (DEA), a US federal law enforcement agency responsible for enforcing controlled substances laws and regulations. The drug enforcement agency works to prevent the diversion of prescription medications, combat drug-related crime, and regulate the legal production and distribution of controlled substances.

More Harm than Good?

Illegal drug production depicting the consequences of the war on drugs including mass incarceration and drug related violence

The question of whether the War on Drugs initiative has done more harm than good is a subject of ongoing debate. The perspectives on this issue can vary widely, and the assessment of its impact depends on one's viewpoint and the specific aspects being considered.

Proponents argue that:

However, a majority of Americans believe that it’s a failed initiative. If one considers the historical beginnings, the things that were supposed improve – people stopping using drugs, communities getting back together, getting drugs off the street, and everyone being safe – didn’t happen.

Although there was a sharp decline in illicit drug use in the earlier years, the drug problem is increasing in the country and at an alarming rate. According to SAMHSA, the number of people 12 years or older using illicit drugs shot to 13% in 2019, almost reaching its peak from four decades ago. If the initiative was meant to reduce drug use and prevent drug-related deaths, it has not made much progress. If anything, it has played a part in:

Increased Incarceration Rates

The massive increase in incarceration rates, particularly for non-violent drug offenses, is one of the most compelling arguments against the War on Drugs. While proponents argue that incarcerating drug offenders serves as a deterrent, the reality is that it has led to an unprecedented surge in the US prison population.

This has placed a considerable burden on the criminal justice system and fueled concerns about fairness and racial disparities. Incarceration also harms people. It blocks them from support and can even get in the way of finding a place to live, a job, or an education.

More Drug Overdose Deaths

Again, there’s the issue of overdose cases rising. The latest federal data shows that there were over 107,081 reported drug deaths in 2022, up from 106,699 in 2021. Opioids like fentanyl were the biggest contributor to these surging overdose cases.

The opioid epidemic is mostly a public health crisis and not of criminality. The cost of incarcerating people abusing these drugs instead of getting them help outweighs the potential deterrent impacts of criminalization.

Drug-Related Violence

Mexican armed forces in northeast Mexico illustrating the war on drugs mass incarceration and drug related violence issues

Paradoxically, the War on Drugs has contributed to an increase in drug-related violence. The prohibitionist approach, which makes drugs illegal, has created a lucrative black market for illegal drugs. This, in turn, has led to competition among drug cartels and gangs, resulting in violent conflicts over control of the drug trade.

Moreover, the "tough on crime" stance has often led to confrontations between law enforcement and drug offenders, which can turn violent. Overall, the policy has not succeeded in reducing the violence associated with the drug trade.

Societal Impact

The War on Drugs has had profound societal and domestic consequences. Families have been torn apart by the incarceration of loved ones, especially in cases of non-violent drug offenses. It has led to the stigmatization of individuals with addiction issues, making it harder for them to seek treatment and reintegrate into society.

The focus on punitive measures has overshadowed efforts to address the root causes of drug addiction, such as poverty, lack of education, and lack of access to healthcare. As a result, it has not effectively reduced drug addiction rates.

Expenditure and Resource Allocation

The federal government’s budget for drug use prevention and control was a little over $ 1 billion in 1981. But this number increased to $34 billion by 2020. When adjusted to inflation, that translates to $1,090%, and the number keeps increasing by the year.

The allocation of significant resources to the War on Drugs has raised concerns about whether this is the most cost-effective approach to addressing drug-related issues. Some argue that these resources could be better spent on prevention, treatment, and harm reduction strategies that address the public health aspects of drug use rather than a purely punitive approach.

Other Impacts

But the policy impact is not just limited to mass incarceration, deaths, and violence. Those from low-income are denied public assistance and food stamps for past drug convictions. States like Florida and Texas suspend driver’s licenses for drug offenses that are not related to driving, and many other policies deny voting rights, child custody, loans, employment, and financial help to people with criminal records. In 2019, drug offenses came second as the most common reason for deportation, only after illegal entry.

As drug use becomes increasingly problematic in the US, we must rethink our approach and admit that mass incarceration isn’t working. We need to invest in alternative approaches like support services for those who want or need them.

This includes providing access to addiction treatment, harm reduction strategies, peer support, and recovery programs. Instead of criminalizing drug users, this approach aims to address the root causes of addiction and help individuals overcome their substance abuse issues. More Than Rehab offers addiction rehabilitation services to help those struggling to regain control of their lives.

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