One pill can kill: OSU working to counteract fentanyl overdoses

Feb. 3—Sixty percent of fentanyl-laced fake prescription pills contain a potentially lethal dose, Drug Enforcement Administration laboratory testing revealed.

That is why Oklahoma State University's National Center for Wellness & Recovery launched the "One Pill Can Kill" campaign — to educate young adults and parents in Oklahoma about the rise of deaths related directly to fentanyl poisoning.

The Oklahoma State Department of Health said the fentanyl overdose death rate has more than doubled in the 2020s compared to the 2010s, and the synthetic drug is now involved in nearly half of all opioid-related deaths.

NCWR CEO Don Kyle said fentanyl is the deadliest drug as it is 100 times more potent than morphine, and international cartels are mass-producing fake pills and deceiving Americans into believing them as legitimate prescription pills. These fentanyl-laced pills are essentially identical to authentic opioids such as Oxycontin, Percocet, Vicodin, Xanax and Adderall and are sold through social media and e-commerce platforms.

"On college campuses, one of the concerns there is specifically related to Adderall, which can be purchased online, and oftentimes, students might share Adderall with each other if there's a test, or they need to focus or study," Kyle said. "Because of that reason, Adderall is targeted by the cartels to get it out there as a counterfeit."

But why?

The Centers for Disease Control and Prevention estimated almost two-thirds of the nearly 108,000 drug overdose deaths in 2022 were caused by synthetic opioids, mostly fentanyl.

Why would a drug cartel intentionally lace its product with a substance that kills its own customers? Dead people can't re-up, after all.

Kyle said no one knows for sure. The cartels don't exactly share their information. But there are a few leading theories.

"It's a way to addict your customers," Kyle said. "There's also a business competition . . . and so putting fentanyl into some of things, they could argue, gives you a much better high or a different high, so your product is much better than your competitor's."

A third theory is a belief that fentanyl is easier to traffic.

"Because the potency of fentanyl is so high . . . you don't really need a lot to press into a tablet — just a few milligrams. It's a very small amount," Kyle said. "And so it's a lot easier to evade law enforcement because you don't have a tractor-trailer full of fentanyl to provide products to an awful lot of people. You just need a little bit, so it's a lot easier to hide."

Still, the number of pills the DEA has seized has soared from 2.2 million in 2019 to 50.6 million in 2022.

The laboratory testing showed an average of 2.3 milligrams of fentanyl are in each pill. Two milligrams is considered lethal, and smaller amounts can still be deadly.

Kyle said Oklahoma is especially vulnerable to trafficking because its capital is at the crossroads of interstate highways going in all directions.

"Those highways through Oklahoma are known to be major routes of trafficking," Kyle said. "These counterfeit tablets are trafficked through, as well as other illegal drugs such as methamphetamine."

The NCWR is doing more than just handing out flyers and posting on social media to help battle the opioid epidemic.

It is conducting research and development on identifying new molecules for managing pain that are not opioids, which would give physicians more options for prescriptions.

Another project relating to this are molecules that work similar to Narcan — used to counteract opioid overdoses — but are stronger and have a longer duration.

"Narcan can be effective, but oftentimes it takes multiple injections to reverse a fentanyl overdose, and first responders may not always have more than one or two available ... and the duration of fentanyl in the bloodstream is several hours longer," Kyle said. "We're looking at designing and synthesizing new molecules that can compete with fentanyl."