EDITOR'S NOTE: This is the second installment of a multipart series on opioids, considered to be the fastest-growing abused substance in Garland County by local health officials.
Commonly prescribed opioids like hydrocodone have the potential to lead to illegal substance abuse, according to Quapaw House Director Casey Bright and Hot Springs Police Chief Jason Stachey.
Bright said recently that oxycodone, hydrocodone, morphine and fentanyl are the most commonly abused opioids in Garland County. Fentanyl, which was originally manufactured as a reliever of extreme pain, is 50 times more potent than heroin.
Though it can be prescribed for pain by doctors, fentanyl is also manufactured as a street drug and sold illicitly. In a presentation at the Prescription Drug Summit Nov. 9 at the Hot Springs Convention Center, Stan Jones, a Drug Enforcement Agency special agent from Nashville, said fentanyl has a return investment of $20 on the penny for its manufacturers.
Jones said illicit fentanyl pills are branded with Rx lettering to give them a genuine appearance.
"As long as there's that profit margin, there's gonna be people that are gonna make that kind of profit, and as long as we have the disease of addiction that we have, we have the perfect storm," Jones said in his presentation.
With addicts, Bright said synthetic opioids are often taken with illegal substances and can lead to the use of more dangerous opioids.
'A place that's illegal'
Stachey says his officers have seen users transition from prescription opioids to illegal drugs.
"From what they've received from their physicians, they will move onto heroin," Stachey said. "That's what we've seen."
"With opiates, it's a road that leads them to a place that's illegal," Bright said.
On July 2, The Sentinel-Record reported the emergence of the synthetic opioid carfentanil in Arkansas. Carfentanil, an analog of fentanyl that was originally manufactured for the purpose of tranquilizing elephants and other large mammals, is 100 times more powerful than fentanyl. In his presentation, Jones said an amount of carfentanil "that can fit in President Lincoln's ear on a penny" can kill a human being.
Bright cited carfentanil for one in-state overdose in 2017. The user was treated at the University of Arkansas for Medical Sciences in Little Rock.
LifeNet Hot Springs General Manager Jason Gartner said the amount of Narcan, a substance used for treating opioid overdoses, that his team has administered in certain instances in 2017 has been consistent with carfentanil use.
In the field, Gartner said the administration of Narcan has sometimes proven ineffective, even if all of the user's signs point to opioid abuse.
"It's not uncommon for patients to take more than one drug if they're overdosing," he said. "Narcan only reverses opioids. So if they've taken other non-opioid drugs, the Narcan doesn't do anything for that."
'The gamut'
The stories Gartner has heard from his first responders regarding opioid abuse reach into every area of the abuser's life.
"Some of the headline, catchy stuff, is people are dying, and that is certainly true. But it's so much more than that," Gartner said.
He said his teams have often responded to incidents that are not exclusive to substance abusers to find the subject of the incident is displaying signs of opioid use. His team has also responded to traumatic opioid withdrawal episodes similar to those that Bright mentioned.
"From an analyst's perspective, how it's showing up for us is everything from moving vehicle accidents to simply not feeling well to overdoses," he said. "It's the gamut."
Gartner said it is not uncommon for his teams to respond to multiple calls in reference to different situations involving the same opioid abuser.
"The primary complaint might not be, 'I'm taking opioids,'" Gartner said. "That's just part of the story that's interwoven in why we're interacting with them."
Bright called opioid abuse "a sore subject" among the Garland County population, noting it is evident at his speaking engagements.
"When I tell them, 'Your real problem is prescription drugs in general, opiates, benzos and alcohol,' They go, 'Well, what about methamphetamine?'" he said. "You have people in that room who are using a high number of prescription drugs."
Local on 11/15/2017