Cocaine overdoses on the rise with fentanyl combo flooding the market

By Dr. Ananya Mandal, MDOct 24 2018

According to the figures from Centre for Disease Prevention and Control (CDC) there has been a sharp up-rise in the cocaine overdose over the last two years. The Drug Enforcement Administration (DEA) has also said there has been an inflow of Columbian cocaine into the United States.

The report from CDC states that over the last 12 months alone there have been 14,205 deaths due to cocaine overdose across America. Cocaine that is widely available, the agency said is contaminated and mixed with fentanyl – a synthetic opioid. This combination is likely to lead to more serious overdoses.

The CDC states that the media attention being on opioid abuse, cocaine use has risen over the past few months. The increase seen over the last one year is a 22 percent rise from the year before, the agency report states. The report adds that there is a decline in opioid overdose deaths by 2.7 percent from 2017 on the other hand (46,655 deaths last year compared to 47,944 in 2017). Daniel Ciccarone, a professor at the University of California at San Francisco called this a waning of the heroin cycle. The new report adds that with addition of fentanyl to cocaine, it is not yet free from opioids.

According to the National Institute on Drug Abuse (NIDA) the number of Americans using cocaine has remained stable over the last 10 years with present numbers being 4.7 million Americans over the age of 12 years using cocaine. Further 38 million Americans have used cocaine at some point in time says the agency.

In 2017 the DEA seized a batch of cocaine on the East Coast and noted that at least 7 percent of the batch contained fentanyl. This is a six percent rise from previous year, the agency says. Cocaine is a CNS stimulant that acts via the dopamine receptors while fentanyl is a CNS depressant that acts by depressing the CNS. Combination of the two can provide both the high as well as the euphoric effects say experts making it a lucrative one. On similar principles cocaine and heroin too have been combined. Fentanyl being at least fifty times more potent than heroin makes it a more potent combination especially in a person who has not abused heroin or other opioids before.

The DEA has warned that there has been an influx of cocaine from Colombia to the US. The CDC says that fentanyl could be the reason for the rise in overdose deaths and not cocaine and heroin alone. The CDC in a statement said fentanyl is, “likely driving the increases in deaths involving cocaine, as there is a lack of awareness of the potency or even knowledge of fentanyl contamination.” The CDC director’s own son had nearly died of an overdose of cocaine laced with fentanyl according to reports.

This March $4.6 billion was allocated for fighting the opioid use epidemic. Recently a report came from the Government Accountability Office (GAO) citing the steps taken by the government to fight this menace. Department of Health and Human Services has been urged to speed up the approval and rapid implementation of the opioid-epidemic related actions and plans. HHS Secretary Alex Azar recently announced that the drop in opioid use has been due to the efforts put behind it by both the state and federal governments. He said, “The seemingly relentless trend of rising overdose deaths seems to be finally bending in the right direction.” CDC Director Robert Redfield however was more sceptical when he said, “We’ll see how that works out as we finalize the numbers.”