TN Court News: For far too many Americans, the opioid epidemic has become an all too familiar tragedy. Friends, colleagues, and family members across the country have had their lives hijacked or lost due to these powerful drugs. While all opioids are dangerous if abused, one drug in recent years has proven to be in a lethal class of its own. With grim efficiency, even small amounts of fentanyl can and do kill.
In an effort to protect one of our most impressionable populations from this drug, the Tennessee District Attorneys General Conference recently launched an educational campaign directed at teenagers called Fentanyl: The Deadliest High. The Conference and individual district attorneys are using a mixture of social media and school outreach to let middle and high schoolers know about the unique dangers of fentanyl.
“Why we’re doing this now is because fentanyl is what’s killing people,” Guy Jones, executive director of the TNDAGC, said.
The numbers affirm this. In just the past decade, fentanyl and its analogues have contributed to a sharp rise in overdose deaths. Nationally, according to the Drug Enforcement Administration, fatal overdoses associated with illicit fentanyl and fentanyl analogues have jumped from 2,666 in 2011 to 31,335 in 2018.
In Tennessee, the story is just as troubling. In the past few years, fentanyl has surpassed heroin as the leading cause of fatal overdoses in the state. From 2014 to 2018 the number of fatal overdoses from fentanyl per year jumped from 69 to 742, according to the Tennessee Department of Health’s 2020 Annual Overdose Report.
Even within that time frame, the danger is accelerating quickly. For instance, just from 2017 to 2018 drug overdose deaths involving fentanyl rose 48 percent, with 47 out of Tennessee’s 95 counties showing an uptick in fentanyl-related deaths. As of October 9, the Metro Public Health Department in Nashville reported that drug overdoses in Davidson County had already surpassed the number of deaths for all of 2019. Fentanyl was found in nearly 80 percent of fatal drug overdoses where toxicology reports have been completed.
Tommy Farmer, the special agent in charge of the Tennessee Bureau of Investigation’s Dangerous Drugs Task Force, is on the leading edge of the fight against fentanyl, and has likewise seen how it has become more and more widespread in the state.
“The overdoses speak for themselves and those continue to increase,” he said. “We are significantly above where we were last year.”
Special Agent Farmer said that the primary danger comes from the very nature of the drug, which can be 100 times more powerful than morphine and 50 times more powerful than heroin.
“You could be an experienced drug user and just a few grains of fentanyl the size of grains of salt are more than enough to overdose you,” Special Agent Farmer said. “It’s so unforgiving.”
The fatal difference can be seen in the bodies of those fentanyl users who first responders find after an overdose.
“We’re finding that most folks who are overdosing on fentanyl- based products, whether known or unknown, still have a needle in their arm when we find them,” he said. “It’s causing such a fast reaction.”
Many users know that respiratory depression or even failure is a possible side effect of an opioid overdose. Some users keep Narcan on hand for that reason, thinking that they will be able to use it if they begin to have trouble breathing. Narcan is not a guarantee of survival, though, especially when fentanyl is involved.
This is because fentanyl can cause not just a respiratory depression where a user may slowly get tired and drift off, but to what Special Agent Farmer called a “chest lock,” where users suddenly find themselves unable to breathe.
“They can’t grasp how strong this drug is,” he said. “I don’t care how strong you are or how good. You can’t handle this one.”
That staggering potency of fentanyl has made it a popular choice for drug dealers to mix in with other drugs to increase their effect.
“We’re finding a lot of illicit drugs like heroin and even cocaine that have been adulterated with fentanyl because it’s so incredibly powerful in microscopic amounts,” he said.
This highlights one of the main risks of buying and using any illicit drugs: buyers don’t really know what they are getting.
Special Agent Farmer said almost all people would scoff at the idea of buying a drug like aspirin from someone on the street who said he manufactured it at home. Every day, though, countless people purchase illicit drugs that they know little about from dealers.
“These are drugs that are not made in any normal setting,” he said. “They don’t come from a reputable pharmaceutical company with known standards, oversight, or quality control. It’s irrational to think that you could do an illicit drug that’s made in some type of clandestine setting and know what the outcome is going to be.”
Given the incredible danger that the drug poses, Executive Director Jones said it was only natural to warn teens about it.
“In our research, we discovered a lack of education around the dangers and prevalence of fentanyl and opioids in general,” Executive Director Jones said. “Our youth are our future. It is with that in mind that we work to inform them on the realities of addiction and overdose. We want this effort to be the start of the end of fentanyl and deadly drug abuse in Tennessee, and we must work together to make this goal a reality.”
As part of the campaign, attorneys general throughout the state have issued public statements, shared information on social media, and taken other steps to get the message across.
“We are seeing far too many cases of people dying from drug overdoses, and fentanyl is now the leading cause,” Sumner County District Attorney General Ray Whitley told Gallatin News. “Tennessee’s District Attorneys are committed to getting the word out to everyone as to how exceptionally dangerous this drug really is.”
“It is our responsibility as District Attorneys to fight against the rise of this terrible drug, and we will do everything we possibly can to make sure it does not claim our communities, our friends or our children,” 4th Judicial District Attorney General Jimmy Dunn said in a statement to Grainger Today. “It is important to educate our youth on making smarter decisions, while also putting a stop to those who are putting the deadly drugs on our streets.”
The office of 23rd District Attorney General Ray Crouch decided to further the campaign’s goals in a unique way. In September, his office sponsored a public screening of the film Toy Story 4 in an Ashland City public park. Attendees were handed “educational materials demonstrating the lethal consequences of using fentanyl,” Attorney General Crouch said in an email to The Exchange.
The danger of fentanyl and other deadly opioids is something about which Rutherford County Juvenile Court Judge Donna Scott Davenport is well aware. According to the TBI’s 2020 Prominent Drugs Heatmap, Rutherford County has had the highest number of crime lab samples test positive for fentanyl so far this year.
While Judge Davenport said that marijuana is still the drug of choice for juveniles she sees in delinquent cases, parental opioid use has played a large role in many of her dependency and neglect cases.
“The addiction is just so huge, “she said. “We can go a little while without food or water, but what we’re seeing is these parents absolutely cannot go without having their opiates.”
Judge Davenport says that parents who are dependent on opioids often find themselves unable to perform basic duties. It is as if their lives have been taken over by their addiction.
“They can’t function,” she said. “They’re not in touch with reality at all. They pass out, placing themselves and their children in danger when they’re with them.”
Judge Davenport was recently one of 13 judges in the state selected to take part in the Project ECHO training project, which educates judges on issues including the physiology of addiction, evidence-based programming interventions, and medication-assisted treatment. She said that the training so far has been “phenomenal,” really delving into the dynamics that underlay chemical dependencies.
From her experience as a judge, she has found that oftentimes drug use is coupled with mental health issues. In turn, these mental health issues can stem from any number of adverse childhood experiences, or ACEs.
“I think that mostly the children that I see use drugs because they’re easing the pain of something else,” she said. “A lot of that is unaddressed mental health issues and depression. These children may be struggling with school, struggling with living in a hotel or motel week-to-week. All of that contributes to their trauma. They escape from it, and they escape using drugs and alcohol.”
Special Agent Farmer wants teens who find themselves struggling with issues like this to know that drug use is not the escape they may think it is. It is its own prison, and one that can have unpredictable consequences for their lives and well-being.
Many kids choose to take drugs because they have friends or acquaintances that take them and seem to suffer no major negative consequences. It is important to realize, though, that drugs can affect different people differently.
This can be for any number of reasons related to upbringing and genetics. Special Agent Farmer shared the statistic that a family history of drug dependency can play up to a 40 to 60 percent role in a person’s vulnerability to addiction. Because many people do not know whether, for instance, one of their grandparents ever struggled with a substance use disorder, this can leave them in the dark about their chances of becoming addicted to drugs or alcohol.
“It’s not a matter of I’m stronger than him or he’s stronger than me, it’s going to depend on some factors that you can’t control,” Special Agent Farmer said.
In practical terms, this means that two high school friends could both be prescribed the same drugs for a sports injury, and one would have a greater chance of addiction because of an inherited genetic disposition to dependency.
Another reason it is so essential to keep teens from trying opioids like fentanyl is because the long-term psychological and physiological ramifications can be more drastic the earlier someone starts using.
“We are trying to delay drug use for as long as possible,” Special Agent Farmer said. “The longer we can delay drug use the better off we are and the greater the chances are that the drug use may be a temporary lapse.”
The TNDAGC campaign comes, of course, in the midst of the COVID-19 pandemic, which is shaping up to be a worrying time for fentanyl use. While the TBI and other agencies have had great success in cutting back on prescription opioid abuse in the state, the trade in illicit drugs continues to grow. TBI records show that the number of crime lab tests showing positive results from fentanyl are skyrocketing, roughly doubling every year since 2013. This year the agency expects to see approximately 2,930 positive crime lab results for fentanyl.
It is Executive Director Jones’ hope that the TNDAGC campaign can make a dent in that growth and guide teenagers to a happier and healthier future.
“If we save a life then the whole effort is worth it,” he said.