Part of our Substance Abuse Annual meeting was a presentation by Daniel W. Neill, Assistant Special Agent in Charge – Las Vegas District Office of the DEA.  He shed much light on a number of drug related issues, but I chose to focus this on the most recent and unfortunately the deadliest epidemic in the substance abuse world.

The United States is 5% of the world population

  • 99% of Hydrocodone is consumed by US – An Opioid
  • 85% of Oxycodone is consumed by US –An Opioid
  • 80% of Heroin Abuser start with Opioids
  • 143 drug overdoses occur per day
  • 63% of those deaths are pharmaceutical opioids or heroin related


Historically, it has been used to treat advanced cancer pain

  • 50 times more potent than heroin
  • 100 times more potent than morphine
  • Most overdose and deaths are linked to illegally made Fentanyl
  • According to the CDC, the number of reported law enforcement encounters testing positive for Fentanyl was less than 1,000 until 2014, when it jumped to approximately 5,000. Subsequently, it continues to spike from approximately 14,000 in 2015

The effects on the body and the overdose effects are similar to the other opioids, morphine, hydrocodone, oxycodone, hydromorphone, methadone, and heroin

Effects on the body

  • Relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression

Overdose effects

  • Stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of poisoning

What is going on? 

Cracking down on the over-prescription of opioid pain killers and shutting down its illegal use has caused users to migrate to Heroin.  By cutting the Heroin with Fentanyl, the yield can be increased more than 50 fold while not losing its effect.  “Cutting” means adding another substance to the powder in order to make it go further.

It is now being manufactured in China and shipped through Mexico with the Cartels, along with Heroin.  It is very deadly in very, very small doses.


What to look for and what to do

  • Exposure – Ingested or inhaled or absorbed through skin or eyes
  • Symptoms – Respiratory depression, drowsiness, sedation, disorientation, pinpoint pupils and clammy skin
  • Immediate Action – Move to fresh air, wash exposed areas immediately with soap and water
  • Medical Intervention – Seek medical attention, monitor victim, be prepared to administer naloxone.  For more info on naloxone, visit this NIDA site.    – NIDA – Naxolone

Some other interesting stats can be found at the CDC site  –  CDC