Fentanyl-laced illicit drugs: Warnings stepped up in NH 'no safe experience' campaign

ROCHESTER — Those who work in recovery say overdose cases are on the rise, and that the drugs in circulation are more dangerous than ever.

A new public awareness campaign in New Hampshire launched recently, warning there is "no safe experience" when consuming any drugs that have not been prescribed by a medical provider. At a press conference on Jan. 12, Gov. Chris Sununu said the campaign will focus on educating youth, young adults and families of the dangers and prevalence of fentanyl in counterfeit pills and illicit drugs.

According to the Drug Enforcement Administration, more than 50.6 million fentanyl-laced, fake prescription pills and more than 10,000 pounds of fentanyl powder were seized in 2022, representing more than 379 million potentially deadly doses.

“The bottom line is that fentanyl is now in all different types of substances, whether that be cocaine, methamphetamine, fake pills, or vape cartridges — assume it is in anything and everything," Sununu said in a press release. “There is no safe experience with substances, unless they are prescribed by a provider, and taken only as directed by the person they are prescribed to. Our campaign will be laser focused on this critical message to help save lives."

Recovery leaders respond to rise in overdose rates

Those who work in recovery services say they are not surprised by the rising overdose rates.

Asked about a report that there was a "bad batch" of fentanyl circulating in the Sanford, Maine, area that might be reaching the Seacoast, SOS Recovery Director John Burns replied by asking rhetorically if there is ever a "good batch."

"I am always confused by that term, bad batch," he said. "There are no good ones. And yes, we are seeing increased overdose cases for a number of reasons. Fentanyl is an unregulated substance, with impurities and with different substances being mixed in."

“Fentanyl is 50 times more powerful than heroin and 100 times stronger than morphine and a two-milligram dose is enough to be lethal,” New Hampshire State Police Col. Nathan Noyes said at the recent governor's press conference. “That’s the same as a few grains of salt. The intentional and accidental mixing of fentanyl is also becoming more commonly discovered in cocaine, marijuana and even made to look like candy. That’s why there is no safe experience when it comes to experimenting with drugs or taking something that is not prescribed to you.”

Burns said SOS Recovery is seeing a lot of Xylazine (basically a large animal tranquilizer) making its way into street fentanyl, also benzodiazapenes.

Health care professionals should be cautious of possible Xylazine inclusion in fentanyl, heroin, and other illicit drug overdoses, as naloxone may not be able to reverse its effects, the FDA said in a recent press release.

"I have heard that there is a slight spike in OD rates but have nothing objective to go off," said Peter Fifield program director at The Doorway at Wentworth-Douglass Hospital, which is part of the state's treatment network.  "I know the state just released an official statement regarding a warning of Xylazine in the local batches of opioids (fentanyl and/or heroin) and this is causing more overdose because it is not reversable by Narcan."

"Xylazine produces a deeper sleep, which further depresses the respiratory system," he said. "We still can use Naloxone, but are encouraging emergency responders to use rescue breathing because the combination of drugs further depresses the respiratory system. Rescue breathing, checking pulse and chest compressions if needed, can be required to try and save a life. It's a slower reversal process, so just Narcan may not be enough."

Lauren McGinley, executive director of the New Hampshire Harm Reduction Coalition, said the way people use drugs has dramatically changed.

"Bad batch alerts used to be routine," she said. "It would be high fentanyl content, but now, it's that and so much more. It is completely dangerous, but we have to recognize that people are using, will use and we need to find ways to eliminate the stigma and recognize this as the disease it is. We have lost too many good people."

Regular users are always at risk, but the danger is equally high for the weekend user, said McGinley. "A cocaine use might not be what you think you are getting for that recreational use. One time is all it takes."

What can users do to be safer? Experts offer resources and advice

Burns said drug users should never use alone. And the people they are with should have doses of Nalaxone and know what to do if things go wrong.

"Inject smaller doses, test shots," said Burns. "Use a quarter of what you would use normally and wait and see how you react before continuing. Go slower than ever before because we want to keep you alive."

"We can no longer say, 'Just don't do it,'" said McGinley. "I advocate test shots, too. I tell people go low and go slow. You can always add more but you cannot take any out. Have two doses of Narcan, a breathing mask and friends who know how to help. Behavior matters."

If no one can be with you when you use, there is a nationwide hotline - Never Use Alone (1-800-484-3731).

"There is no judgment, no preaching, and it is anonymous," said McGinley. "The person you call will get your location and they will stay with for about 30 minutes. You are only required to respond to them. If there is no response, they will send emergency services to you."

According to DEA Laboratory testing results in 2022, six out of 10 fentanyl-laced, fake prescription pills contained a potentially lethal dose of fentanyl, an increase from four out of 10 in 2021. These pills are made to look identical to real prescription medications – including OxyContin, Percocet, Xanax and Adderall – but only contain filler and fentanyl and are often deadly.

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Fentanyl test strips are handed out by New Hampshire Harm Reduction, SOS and many other agencies. The test strips will detect fentanyl in any drug, heroin, cocaine or others. It will not detect Xylazine or other substances mixed with drugs today.

"People who inject are at the highest risk," said Burns. "We are suggesting people sniff or smoke the substance instead. It will not eliminate the risk, but it can reduce it. These are unregulated drug supplies. Whatever we can do to encourage people to be safe, we will.

McGinley said people must be aware of who they are buying from, and testing the drugs is crucial.

"Test every substance out there," she said. "It takes two minutes. We give the kits out at our needle exchanges but also work with local partners not connected with that who can reach other populations."

This article originally appeared on Fosters Daily Democrat: NH, Maine: Fentanyl laced drugs are on rise, officials warn users