Tag: fentanyl

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Naloxone, Fentanyl Test Strips Now Free from Health Department

Photo by Pharmacy Images on Unsplash

Kits to help prevent and stop opioid overdoses are free in Shelby County until supplies run out. 

The Shelby County Health Department (SCHD) is distributing the kits at select sites (see below) on a first-come, first-served basis. The kits contain two doses of nasal-spray naloxone (known as Narcan by its brand name), 10 fentanyl test strips, and instructions for each. 

SCHD Health Officer Dr. Michelle Taylor said the kits are being distributed “to save lives.”

“From 2018 to 2020, overdoses killed more people in Shelby County than automobile accidents,” Taylor said in a statement. 

The program is a partnership with the Tennessee Department of Health (TDH), which says naloxone is “a proven tool in the battle against drug abuse and overdose death.” 

“When too much of an opioid medication is taken, [the opioid] can slow breathing to a dangerously low rate,” reads the TDH web page on naloxone training. “When breathing slows too much, overdose death can occur. Naloxone can reverse this potentially fatal situation by allowing the person to breathe normally again.”

The state says naloxone is not “dangerous medicine.” But state law does require proper training to give the drug and be covered against civil lawsuits. In 2014, the Tennessee General Assembly passed a Good Samaritan Law that give civil immunity to those administering the drug to someone they “reasonably believe” to be overdosing on an opioid. 

To get the required training, the state offers an interactive online course here and a read-through version of the class here.  

After the review, trainees must pass an online quiz available here. Once complete, trainees can then add their name to a printable certificate found here. 

Regional Overdose Prevention Specialists (ROPS) offices are located throughout the state of Tennessee. They are the point of contact for most opioid overdose training and the distribution of naloxone. 

The state says more than 450,000 units of naloxone have been distributed through ROPS from October 2017 to March 2023. In that time, state officials have documented at least 60,000 lives saved with naloxone, a number that’s likely higher “because of stigma and other factors.” 

State Sen. London Lamar (D-Memphis) wanted to make naloxone even more widely available in this year’s legislative session. Her bill would have mandated that some bars (selling more than $500,000 worth of alcoholic beverages per year) keep naloxone on premises as a condition of keeping their liquor-by-the-drink license. 

The legislation was similar to New York City’s “Narcan Behind Every Bar” campaign. But Lamar’s bill was never fully reviewed and stalled in the committee system.  

Fentanyl test strips were illegal in Tennessee until last year. Possession of such strips were a Class A misdemeanor and distribution was a Class E felony. But lawmakers made them legal to fight opioid overdoses when Gov. Bill Lee signed a bill into law in March 2022.

To use the strips, small amounts of drugs are mixed with water. The strips are dipped into the solution for 15 seconds. Then, the strips produce colored bars to signal whether or not the sample contains fentanyl or if the test is inconclusive. 

In 2018, researchers found that some community groups across the country began to distribute fentanyl test strips. At the time, they found that most (81 percent) drug users who got the strips, used them. Some (43 percent) changed their drug-use behavior because of the strips and most (77 percent) said they were more aware of overdose safety by having the strips. 

Those kits with naloxone and the fentanyl test strips are available from 8 a.m. to 4:30 p.m. at 

• SCHD headquarters

 814 Jefferson Avenue

• Cawthon Public Health Clinic

1000 Haynes, 38114

• Hickory Hill Public Health Clinic

6590 Kirby Center Cove, 38118

• Millington Public Health Clinic

8225 Highway 51 North, 38053

• Shelby Crossing Public Health Clinic

6170 Macon Road, 38133

• Southland Mall Public Health Clinic

1287 Southland Mall, 38116

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Xylazine-Related Drug Deaths on the Rise in Tennessee

Photo: Luchschen | Dreamstime.com
Shelby County Health Department

Overdose deaths involving an emerging drug called xylazine have climbed in Tennessee, according to the latest state data, and while a new law outlaws the drug here (for illicit purposes), officials are searching for ways to battle the drug. 

Xylazine is a non-opioid tranquilizer used by veterinarians, usually to sedate horses or cattle. Its street name is “tranq” or “tranq dope.” In legislation this year, the Tennessee General Assembly called xylazine the “Drug of the Living Dead.” That might be because that, according to the U.S. Drug Enforcement Agency (DEA), those injecting the drug can develop severe wounds, including necrosis, the rotting of human tissue.

The powerful sedative is most often mixed with other drugs, especially fentanyl, but also with heroin and cocaine. A 2022 DEA report said the drug was first seen used as an adulterant in drugs from Puerto Rico but has become widespread. 

Xylazine is not listed as a controlled substance in the U.S., like cannabis or LSD, and is “readily available” to buy on the internet, the DEA said, in prices ranging from $6 to $20 per kilogram. 

“At this low price, its use as an adulterant may increase the profit for illicit drug traffickers, as its psychoactive effects allow them to reduce the amount of fentanyl or heroin used in a mixture,” reads the report. “It may also attract customers looking for a longer high since xylazine is described as having many of the same effects for users as opioids, but with a longer-lasting effect than fentanyl alone.”

Alarm bells began to ring on xylazine after the DEA report last year and newer reports that began to track the drug’s appearance in screens from overdose cases, especially fentanyl. More than half (66 percent) of the 107,735 drug poisonings from August 2021 to August 2022 were caused by fentanyl, according to the U.S. Centers for Diseases Control and Prevention (CDC). 

“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said DEA Admisntrator Anne Milgram. “DEA has seized xylazine and fentanyl mixtures in 48 of 50 States. The DEA Laboratory System is reporting that in 2022 approximately 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA contained xylazine.”

In Tennessee, 56 drug overdose deaths involved xylazine in 2020, according to the Tennessee Department of Health (TDH). That number jumped to 94 in 2021, the state said. In all of these deaths, xylazine was found mixed with other drugs, mostly fentanyl, methamphetamine, Delta-9 THC, cocaine, and Xanax, TDH said. 

Tennessee Department of Health

The Shelby County Health Department does not break down suspected overdose deaths by drug type, an official said, so, it’s unknown how many drug deaths here involved opioids, fentanyl, or xylazine. However, as of July 22nd, 239 had died of suspected drug overdoses Shelby County. Forty-five percent of those were Black males and the most common age was 28. 

The latest state data show 549 drug overdose deaths in Shelby County in 2021, the highest of any Tennessee county that year. DEA data found xylazine rose in all four quadrants of the U.S. but saw the  highest rise (193 percent) in the South.

Earlier this year, state lawmakers added xylazine to the state’s Schedule III, placing it alongside steroids, ketamine, and some other depressants. This made possession of the drug a Class Class A misdemeanor, which could come with jail time of up to 11 months and 29 days and a $2,500 fine. 

In April, the Biden Adminstration used a brand new designation for fentanyl mixed with xylazine, labeling it “an emerging threat to the United States.” 

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Drug Overdose Deaths Rose in Tennessee Last Year Amidst Falling National Trend

CREDIT: Justin Fox Burks

Justin Fox Burks

Drug overdose deaths rose to a record high in Tennessee in 2018, according to new statistics released by the Centers for Disease Controls (CDC), while the numbers were down nationally.

There were 1,837 drug overdose deaths recorded in Tennessee last year, 3 percent more than in 2017. However, such deaths were down 5.1 percent across the country, marking the first decline of overdoses in 25 years.

The figures were discussed recently on an episode of Tennessee Court Talk, a podcast from the Tennessee Supreme Court and the Administrative Office of the Courts. The episode featured Special Agent Tommy Farmer from the Tennessee Bureau of Investigation (TBI) Dangerous Drug Task Force and Dr. Robert Pack, professor of community and behavior health at East Tennessee State University (ETSU).

Farmer, from the TBI, said he wasn’t surprised to see the increase in overdose deaths but hoped the state would “plateau off.” He said the rise is thanks to a transition to illegal drugs from prescription medications.
[pullquote-1] “There’s no doubt it has to do with fentanyl and heroin and the availability of them,” Farmer said.

Pack, the doctor from ETSU, said he didn’t expect a dramatic decrease in the figures here but was pleased to see the shift in the figures nationally. He said headway on reducing overdose deaths in Tennessee won’t be made unless changes are made closer to the source of the problem.

“We have to get upstream as far as we can to stop the cycle of addiction that is occurring in these (communities),” Pack said. “If we can’t stop it, then all we can do is repeat it.”

One way to do that, Pack said, would be to influence kids to be more resistant to drugs.

While much more work needs to be done, Pack and Farmer said gains have been made in Tennessee, particularly addressing the opioid crisis. Pack said more agencies are better reporting overdose deaths now than ever before, which could be one reason for the 2018 spike.

“We’ve said for a long time that the numbers were grossly underreported,” Farmer said. “There’s a lot more out there than we’re actually seeing. I do believe this number indicates that we’re doing a better job of getting good information.”

Overdose deaths are higher in big cities, Farmer said, but that doesn’t always mean the deceased lived in them. Large cities serve as a source of drugs for dealers, so drugs are cheaper there. Also, people want to be closer to the source of their drugs, so they’ll travel to it. When they get the drugs, they don’t wait to take them home, he said, “they’re getting the drugs and overdosing at that location.”

Pack said Tennessee now has better access to care and drugs to help those addicted than ever before.

Fentanyl, a synthetic opioid pain reliever usually prescribed to cancer patience, is on the rise in Tennessee, Farmer said. The drug is powerful, he said. One thing that means is that it’s shipped in smaller units (like the size of two sugar packs), making it harder for law enforcement to detect.

DEA

The opioid fentanyl can be 100 times more potent than morphine.

The drug is being mixed with methamphetamine or heroin. It’s smuggled to Tennessee largely from suppliers in China or Mexico, Farmer said. For users, “it gives them an incredibly powerful high,” Pack said.

What fentanyl gets mixed with largely depends on what is popular in different areas of the state, Farmer said. In Memphis, that’s heroin, where “there’s always been a steady availability” of the drug, he said. Oxycontin is popular in Oak Ridge and Percocet is favored in Nashville.
[pullquote-2] But dealers will blend their drugs with just about anything, Farmer said, if they fear customer complaints. He said TBI agents have found drug operations outfitted with blenders bought from Walmart or Walgreens producing drugs that are not at all what the dealer said they were selling.

“We’ve seen crazy concoctions, made from anything they can get their hands on, from aspirin to ibuprofen to vitamin B12,” Farmer said. “It doesn’t matter as long as it gets them high. The potency of fentanyl is so powerful in microscopic amounts that it doesn’t take much at all.”

Meth returns

Meth is returning to Tennessee “with a vengeance,” Farmer said. The TBI lab is on track to get more submissions of meth than ever before.

“We’ll probably see more than even back in the heyday and at the height of our meth epidemic when the state of Tennessee had the dubious distinction of being No. 1 in the country, the meth capital of the country,” Farmer said.

Laws here have made it harder to get the ingredients to make meth and seizures of meth labs have decreased here by about 86 percent, Farmer said. But what remains is an “insatiable appetite for stimulants in our state” and a steady supply of meth from Mexican drug cartels.

Pack said methadone clinics are seeing a rise in patients screening positive for meth.

“We can’t just deal with this on the treatment side,” Pack said. “We have got to get upstream and deal with whatever it is that is driving people to seek (meth) to fix their pain, their physical or emotional pain with something other than coping or other effective strategies.”