Navigating Active Addiction During the Fentanyl Overdose Epidemic
**Please read with awareness that this post is directly related to opioid drug overdoses and could be triggering for some individuals.** The hard fact is not all drug addicts are ready to quit using drugs. With the epidemic of opioid deaths in the past few years, it is important to talk about integrity and drug dealing. According to the National Center of Health Statistics, there were 105,752 deaths related to fentanyl and other synthetic opioid in the United States from October 2021 to May 2022 (McPhillips, 2022, para. 2). That means almost 106,000 people senselessly died from just opioids in the United States alone in the past eight months. This is absolutely not OK.
Even though hundreds of thousands are dying from overdoses, a lot of people are still going to use street drugs. This is a reality. As an addictions therapist, I am now having a direct and compassionate conversation with my clients who are still actively using drugs about whether or not they trust their drug dealer. I would assume this topic makes a lot of people uncomfortable, including therapists, but it needs to be discussed. We, as a society, need to face facts and have these hard conversations. We need to support, educate, and love the active addict because they probably have lost the ability to effectively do those things for themselves.
Do not get me wrong, your drug dealer is not your friend! Let me say that again. No matter how honorable they might seem, your drug dealer is not your friend. Their goal is to sell drugs and lots of them. When they call to check on you and “see how your doing”, the likelihood is that they don’t really care; they have product (drugs) and they want to sell them to you. There are sporadic situations where a drug dealer is your friend first and your drug dealer second, but this is not usually the case. I do know an individual who was recently triggered to relapse on methamphetamine. In a moment of panic, he called his drug dealer, who he also considered a friend. The drug dealing friend said he wasn’t going to contribute to this individual’s relapse and asked how he could help him stay sober. THAT is a friend.
The conversation with my clients, and others struggling with active drug use, surrounds whether or not they trust their drug dealer. I don’t mean whether or not they trust this person entirely, but do they trust the product they are selling is legit. Street drugs are “cut” (mixed) with tons of crazy and horrible things. Laundry detergent, laxatives, rat poison, and baking soda, to name a few. In theory, none of these substances are lethal and this has been going on for decades. The days of much purer “biker meth” speed and white powder heroin are long gone and have been replaced by mixtures of chemicals to keep the addict supplied and the drug dealer rich. One of these chemicals is unfortunately now fentanyl.
Fentanyl obviously kills people, and many people are knowingly using it to get high. Fentanyl is usually cheaper and is reportedly over fifty times more potent than heroin; it is also now readily available, which is a driving force in increased use. (Fox, 2018, para. 10). But thousands of people dying are from drugs laced (mixed) with fentanyl; they don’t even know they are consuming it and it can be hiding in any drug bought off the street. Fentanyl has been found in many street drugs, like cocaine, heroin and methamphetamine; yes, it has even been found in marijuana (Partnership to End Addiction, 2019, para. 2). I recently heard about a teenage girl in my community who bought marijuana from someone she didn’t know. She probably thought she was going to get a “weed buzz” and have a good time; she was found dead minutes after smoking from an opioid overdose. This is just one tragic example of people using drugs without knowing what is really in them.
We have also all heard about many people who have been responsibly or irresponsibly prescribed opioids, such as Percocet or oxycodone, for legitimate physical pain who ended up addicted to them. When their supply from prescriptions is no longer available, they can turn to buying prescription pills “off the street”. With the high potency of fentanyl, and its everchanging chemical compounds, these pills often contain a much higher concentration of opioids. It has also been found in benzodiazepine (e.g., Xanax, Valium, Klonopin). It should be noted that any opioid mixed with any benzodiazepine can be a very lethal combination.
This comes back to, “do you trust your drug dealer”? Do you know where they get their product? Does your drug dealer know where their dealer gets their product? And so on and so forth. This question MUST be asked in the drug world; it just has to be asked.
The word “integrity” is not often used in conjunction with the words “drug dealer”. Drug dealers have dedicated their lives, at least part of it, to actively destroying others for their own monetary gain. They come in all shapes and sizes. Whether it’s a dealer on the street corner, a “meetup” phone call, or stopping by their place on the way home, when you choose to “score” drugs off the street, you are playing Russian Roulette with your life. In actuality, you cannot EVER actually trust your drug dealer. Some drug dealers do have a level of integrity when it comes to knowing their product. They are “pretty sure” it’s not laced with anything they don’t know about. Baby laxatives? Maybe. But they are convinced there is nothing that is going to kill their clients. These are the drug dealers you want to buy from if you are going to continue to use.
And yet, some people are choosing to use fentanyl knowing its lethal effects. Some addicts specifically seek out dealers who sold product to someone who has died from using it. Yes, there is a mentality of some drug addicts to use the same drugs that have killed other people because they think they are tougher, stronger, and invincible. They want the rush and they are sure they can handle it. They know they are toying with death and they do not care. This is completely terrifying, yet I can also empathize with their struggle.
Active addiction is rough. I would know. I heavily used drugs and alcohol for over a decade trying to escape reality. I found the depths of despair and finally the universe pushed me with sufficient reason to seek a life of recovery. Addiction is a comprehensive disease; it affects the body, the mind, and the spirit. I often say opiates will steal your soul. There is just something a little different about how these drugs seem to “zombify” a person; this means they end up walking around as a shell of their former selves. Opioids are highly physically addictive and when the body has developed a dependence on these substances, a person will go into withdrawal when they don’t use them. This is a never-ending cycle of physical agony and mental desperation. Using opioid obviously doesn’t fix anything; it actually continues to make things worse and worse. But for a brief moment their body and brain stop struggling because the drug has temporarily “fixed” their pain. The addict is no longer seeking the rush of a high; they are simply seeking a moment of relief. And this is why they are desperately searching to “score” their next “fix”. And if the person is actively abusing opioids, this circles back to “do they trust their drug dealer?
This is not a comfortable conversation to have with a client, let alone a child, parent, friend, or coworker. Yet, it is a conversation we need to have. We also need talk with drug dealers about the trust they do or do not have in their product. I have no intention of “referring” people to drug dealers, but people are going to use and sell drugs. The more we can continue to have real conversations about these hard issues, the more we can shift the trend of opioid deaths. This has to stop.
If you are actively using drugs or love someone who is using, I encourage you to reach out to me or another therapist for support. You can also check out the “resources” page on this website. It is full of organizations that are dedicated to supporting you in your recovery journey. I know that things may seem hopeless. They are not. Millions of people who once felt the despair of addiction and have found a life of recovery. There are still the ups and downs. Yet, we are able to face them sober and with skills, instead of temporarily drowning them out. We become brave and we grow.
This post is dedicated to the many people that have died from a drug overdose who I personally know and love, as well as the hundreds of thousands I do not know. It is also dedicated to their loved ones. When someone dies from an overdose, their pain has stopped. The pain of those who loved them will unfortunately continue for a lifetime. Addiction DOES NOT have to lead to death.
References
Fox, M. (2018, December 4). Why would anyone cut heroin with fentanyl? It’s cheap, these researchers say. National Broadcasting Company [NBC]. Why would anyone cut heroin with fentanyl? It's cheap, these researchers say (nbcnews.com)
McPhillips, D. (2022, May 16). US drug overdose deaths reach other record high from fentanyl surge. Cable News Network [CNN]. US drug overdose deaths reach another record high as deaths from fentarge - CNN
Partnership to End Drug Addiction (2019, June). Substances lace with fentanyl. How to protect your loved ones. Substances Laced with Fentanyl: How to Protect Loved Ones - Partnership to End Addiction (drugfree.org)