Alabama doctors warn most fentanyl overdoses result from unintentional ingestion as deaths rise

Doctors across Alabama are warning residents that fentanyl, a synthetic opioid that is between 50 and 100 times more potent than morphine, is causing a significant number of fatal overdoses in rural and urban parts of the state.

Alabama overdose deaths rose by at least 27% from January 2021 to January 2022, according to estimations from the CDC. Fentanyl overdose deaths alone increased 136% in Alabama from 2020 to 2021, according to a report from the Gulf Coast High Intensity Drug Trafficking Areas program.

In Montgomery County alone, there were around 40 overdose deaths last year, and earlier this year, Montgomery County District Attorney Daryl Bailey said the county was seeing fentanyl overdoses almost weekly.

Doctors across the state say the problem continues to worsen.

“When it comes to treating addiction, I don't necessarily think we get a lot of effectiveness in trying to scare people. However, fentanyl is being cut into everything,” Birmingham Recovery Center director Ian Henyon said. “When they are manufacturing these fake pharmaceuticals, they aren’t doing it with an eye towards quality, so you might get more fentanyl in one particular pill than another, which makes it even more dangerous.”

Related:More than 107,000 Americans died from overdoses last year. This drug is behind most deaths.

'Rainbow fentanyl' and Narcan in schoolsWhat you need to know about illicit fentanyl

Recently, "rainbow fentanyl," brightly-colored opioid pills made to look like candy, has become an increasing concern among law enforcement agencies throughout the country as well. Major busts have been reported in Arizona, New York and Washington, D.C., and experts on an Alabama Medical Association panel on Wednesday said rainbow fentanyl is in circulation in Alabama.

“It’s not lost on me that it's here during the holiday season. It’s being smuggled also in candy bags,” said Richard Tucker, former U.S. Drug Enforcement Administration special agent and Drug Education Consulting Group consultant.

Tucker said the use of candy packaging, like bags of Skittles or boxes of Nerds, is a tactic for those selling the pills to smuggle it discreetly. He doesn’t think young people are being targeted to think the pills are candy.

“These folks don't want to poison folks. They want somebody to buy something from them,” Tucker said.

In hospital settings, fentanyl is used to treat severe pain and for advanced-stage cancer patients, but when used it is manufactured illegally, the Alabama Medical Association says two milligrams, or the amount that could fit on the tip of a pen, can be lethal.

Fentanyl can be found in any drug purchased illegally, including heroin, cocaine, and in some instances, marijuana.

As drug users are exposed to fentanyl, they may begin seeking it out, but Jefferson County Department of Public Health official Dr. Darlene Traffanstedt said that is not the main problem facing Alabama right now.

“Most of the people that are overdosing on fentanyl are not trying to get high on fentanyl. That is not their goal,” Traffanstedt said. “They're taking something else and the fentanyl is contained within it.”

Jefferson County has seen a 233% increase in fentanyl-related deaths in the last two years, according to Traffanstedt. So far this year, at least 283 people in Jefferson County have died because of overdoses.

Dr. Julia Boothe, a rural family physician and President of the Medical Association of the State of Alabama, moderated the association’s panel on Wednesday.

“As Alabama is experiencing this surge in fentanyl overdose deaths, we felt that it was important to discuss the dangers of illicit fentanyl, treatment options and more,” Boothe said.

The Jefferson County Department of Health partnered with the state to offer free Naloxone, a medication that can reverse opioid overdose, and free fentanyl test strips to anyone in Alabama. Visit the Jefferson County Department of Health to complete a 10-20 minute training and receive a Naloxone kit and test strips in the mail.

The Alabama Department of Mental Health and Recovery Organization of Support Specialists also offers a 24/7 helpline at 1-844-307-1760 to provide services to individuals in Alabama who struggle with addiction and need support and to families and friends in need of more information.

Hadley Hitson covers the rural South for the Montgomery Advertiser and Report for America. She can be reached at hhitson@gannett.com. To support her work, subscribe to the Advertiser or donate to Report for America.

This article originally appeared on Montgomery Advertiser: 'Rainbow fentanyl' and laced drugs contribute to rising overdoses