The Apocalyptic Shift from Heroin to Fentanyl OD Deaths


Plus: New guidelines on how much drinking is too much; and, yes, the dangers of binge-watching

By William Wagner

The recent news that there were more than 100,000 overdose deaths in the one-year period ending with April 2021—the first time the six-figure OD mark had ever been crossed in the U.S. over 12 months—has shaken the addiction treatment field. And new research adds to the evidence that the main culprit is the synthetic opioid fentanyl.

We also shine a light on a new set of alcohol consumption guidelines from Australia, and the notion of binge-watching as an addiction.

From the OHIO Alliance for Population Health:
The Third Opioid Wave

Ohio has been one of the opioid epidemic’s hotspots, so research out of the state warrants a close look. The OHIO Alliance for Population Health—a collective of healthcare experts led by Ohio University—tracks and analyzes drug trends in the state. New research from the Alliance shows a marked increase in overdose deaths related to fentanyl. The Centers for Disease Control and Prevention (CDC) calls fentanyl the third wave since the beginning of the opioid epidemic in the 1990s, the first being prescription drugs and the second being heroin.

[T]hat there was an overdose problem was not a surprise at all. I would say, to a degree, fentanyl caught us not completely off guard, but it was a little surprising how bad it’s gotten now.”

—Joe Gay, OHIO Alliance for Population Health

“For a little more than a decade, there has been a significant problem with opioids and overdoses,” Joe Gay, PhD, a staff member with the Alliance, said in a news release about the research. “So, that there was an overdose problem was not a surprise at all. I would say, to a degree, fentanyl caught us not completely off guard, but it was a little surprising how bad it’s gotten now.”

From 1999 to 2020, according to the Alliance report, the number of overdoses per year in Ohio went from 327 to 5,018. The Alliance attributes much of that jump to fentanyl, saying that it was seven times deadlier than heroin and the stimulant cocaine. Some victims have OD’d on fentanyl unknowingly. Gay says drugs such as heroin, meth and cocaine increasingly have been cut with fentanyl. The Alliance’s statistics and insights seem to reflect what’s happening elsewhere in the country.

From the Medical Journal of Australia:
New Alcohol Consumption Guidelines

Australia’s National Health and Medical Research Council (NHMRC) has revised its recommendations regarding alcohol use. In a study published in the Medical Journal of Australia, the body lowered the maximum number of “standard” alcoholic beverages Australians should consume in a week from 14 to 10.

The authors of the study based their revised recommendations on a four-year review of data. “Evidence on alcohol and health has evolved considerably since the last update of the NHMRC guidelines in 2009,” the study reads. “Evidence linking alcohol to cancer risk has strengthened, particularly at lower levels of consumption. … For example, the risk of breast cancer in women increases by 12% per additional standard drink … per day.”

The authors note that their recommendations line up with what’s happening in other countries: “Consistent with this changing evidence, internationally recommended limits to reduce risk from alcohol consumption have been decreasing steadily, including recent downward revisions in the United Kingdom, the Netherlands and France.”

From Frontiers in Psychiatry:
Binge-Watching as an Addiction

Binge-watching TV shows has become something of a pastime, especially during the pandemic. But according to research published in Frontiers in Psychiatry, this seemingly innocent form of addiction isn’t so benign after all. It can result in poor eating choices, anti-social behavior and subpar work or academic output. “Binge-watching is a highly common activity among young adults,” the authors write. “This behaviour is not only used for entertainment purposes but also shares several symptoms of certain behavioural addictions, such as Gaming Disorder or Internet Gaming Disorder.”

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