Loma Linda Psychiatrist On The Dangers And Rise Of Fentanyl

Oct 23, 2019

Deaths from the drug fentanyl have spiked over the last few years. KVCR’s Benjamin Purper speaks with a Loma Linda psychiatrist about the growing trend of fentanyl deaths and what can be done to address it.

Dr. David Puder is a psychiatrist at Loma Linda University Health. He says fentanyl is an opiate, like heroin.

Puder: “So unlike heroin, fentanyl is a lot faster acting. So usually if you have a heroin overdose it will take about 30 minutes to get to that sort of critical level. Whereas fentanyl can take two minutes. The second reason it's probably killing more people is because it is vastly cheaper than heroin and it is 100 times stronger than heroin. And so it's a whole lot harder to dose the correct amount or an amount that would be an amount that would be a safe amount. And so often people don't know how much they're getting, and are you really going to trust a drug dealer to dose something where literally if you look at a penny, the words, you know, of the year on the penny, if you just cover that with a little bit of sand, that's the amount that you can overdose on fentanyl.”

Puder also says other drugs sold on the street are being laced with fentanyl.

Puder: “Yeah, it's a whole lot cheaper to put something like fentanyl in these substances than the actual substance itself. So a lot of heroin nowadays is actually like sold as black tar heroin but it really has fentanyl. And there's been a lot of deaths of famous people with this substance as well, so it's a big issue. Like just to give you an idea of how big it is, in 2012 there was only 1,600 deaths of fentanyl, and in 2016 there was 18,000 deaths of fentanyl in the U.S.”

Puder says he sees patients suffering from fentanyl addiction all the time.

Puder: “I was just talking to a patient this week, and I was asking him, you know, why are people, do people know that this is in other drugs, right? I'm trying to educate and to tell people like hey, be careful. And he says actually people when they hear someone dies from a fentanyl overdose, there's a lot of people who will seek after the drug dealer to try to get some of that because it's going to be a killer high. He literally said, it's going to be a killer high. And so there's this demand from serious users of opiates to have something that feels like that first time that they were on heroin. And then you have the innocent people who are maybe just at a party, not thinking that they're using anything but what they thought maybe a couple years ago was just cocaine. And then all of a sudden it's laced with fentanyl and they're just not ready for it, and so they can die literally within minutes.”  

Puder says the question of how to address fentanyl deaths is complicated.

Puder: “I see it as a big problem and I see it continuing to be an even bigger problem in the years to come because of how easily it's transported, you're not talking about one big shipment of this stuff, you're talking about potentially tens of thousands of little shipments being sent over through the mail system, and it's very very difficult to detect it, there is a huge epidemic of opiates, you know we've kind of had three waves and fentanyl's the third wave, the first wave was prescription opiates that increased, and the second wave was heroin, and the third wave is fentanyl. And we are going to have this issue, it's going to continue to be a big public health crisis. The amount of deaths by opiates has overtaken the amount of deaths by motor vehicle accidents just in the last couple years. And so, you know, I think that that is a very complex question, how are we going to combat this.”

Puder says if you or your family member or friend is going through an addiction to fentanyl or other drugs, you should seek professional help.

Puder: “I would say one of the best courses of action is to get professional help and to get into a detox and go through with like a day treatment program for a month or even two months. There are programs that are like, live-in programs where you go there to live. They're mixed quality. And so you kind of have to do your research, you have to figure out, what is the quality of this program, not just the marketing of the program.”

You can hear more of Dr. Puder’s work on his podcast, the Psychiatry and Psychotherapy Podcast.