A new report shows that overdose deaths among adolescents have more than doubled since the start of the COVID-19 pandemic. In large part, this is due to the rise of synthetic opioids such as fentanyl, which have become cheap fillers for illicit drugs. Fentanyl is approximately 100 times more powerful than morphine and 50 times more powerful than heroin. This creates a dangerous situation for any person, but particularly for young people who may have little drug tolerance or experience, let alone the tools to determine whether a pill is safe.
Some people might recall the prescription drug scare of 1982 when a number of Tylenol capsules were laced with poison, causing seven deaths. What followed was a massive nationwide recall of Tylenol pills, urgent public health messages, and a redesign of pill and bottle technology to prevent tampering. Although the perpetrator was never caught, police deduced that someone had laced the pills with poison and returned them to the shelves before they were sold to the public.
What would it look like to treat our current overdose crisis more like a poison control problem? How would we store or distribute pills and what would we tell people about them? Certainly, we would make sure young people knew the appearance of a drug is not an indicator of quality; it’s easy to make a pill that looks like something else. We might even have more tolerance for laws that prioritize the detection and elimination of poisonous pills.
Beyond this, there are actions you can take to reduce the risk that you or your loved ones will experience a drug-related poisoning.
First, throw out unused or excess medication. The vast majority of people who misuse opioid pills get them from a friend or relative, either by getting them for free, buying them, or taking them without asking. If there isn’t a take-back program in your area, the FDA gives instructions for disposing of unused prescription drugs and publishes a list of medications that are safe to flush down the toilet. Even if you trust the people that live in your house, you might not trust every person who has access to these medications in a given year. Don’t assume your child’s friends aren’t peeking into your medicine cabinet.
Second, secure any large bottles of medication. Most people who own guns wisely keep them secured in a safe, but twice as many people die each year from an overdose, compared to gun deaths. People can do the same with medications, especially those that are intended as sleep aids or to reduce pain. If you take a medication regularly, take what you need for the week, and lock away the rest.
Third, order naloxone nasal spray and keep it on hand. Naloxone (sometimes called Narcan) can reverse the effects of an opioid overdose. In Texas, you can obtain Narcan without a personal prescription from most pharmacies with your normal insurance copay, or by visiting https://www.morenarcanplease.com.
Finally, you can advocate for laws that match this new reality. For instance, Texas should repeal antiquated laws that criminalize fentanyl test strips and syringe services programs, which were passed decades ago before poison pills were scattered throughout our communities. The White House’s Office of National Drug Control Policy now endorses these approaches, but Texas is way behind. Test strips can tell people whether there is fentanyl in a pill. Syringe service programs can screen people who are using drugs and connect them to life-saving treatment.
Thirty years ago, the average person who overdosed had a relatively long history of drug use. Today, it is increasingly likely to be a 14-year-old who buys an unknown substance on Snapchat. The overdose landscape has changed and so our tools must be used to navigate this new landscape.
Walters is Regents Professor at the University of North Texas Health Science Center.