What is fentanyl and how does it impact Native communities?
Fentanyl is a synthetic opioid like morphine but is 50 to 100 times more potent. Its impact on indigenous communities is reason for concern. There are two types of fentanyl: medical grade, which is prescribed by a doctor, and illegally manufactured, which is produced and distributed through drug markets. Pharmaceutically, medical professionals developed fentanyl as a pain management treatment. Because of its potency and spike in drug markets, it has created a dramatic overdose crisis for adults and young adults.
How is fentanyl used?
Typically, fentanyl is used like morphine to treat patients with severe pain or, for example, after surgery. Physicians can prescribe fentanyl as a shot, patch or tablet. Fentanyl works by binding to the body's opioid receptors in various brain parts that control pain and other emotions. However, because of its potency, the use of fentanyl can lead to addiction at a much higher rate than other drugs.
The National Institute on Drug Abuse (NIDA) reports symptoms of fentanyl use as including:
Muscle and bone pain.
Sleep problems.
Diarrhea and vomiting.
Cold flashes with goosebumps.
Uncontrollable leg movements.
Severe cravings.
What are signs of overdose?
Due to the potency of fentanyl, the possibility of overdose is high. If a person who doesn't typically take drugs takes fentanyl, they can underestimate the dose of the opioids they are taking, which could result in an overdose.
Moreover, those who take drugs or access them illegally through drug markets might take fentanyl unintentionally and overdose. This is especially acute for young adults who can access drugs through social media or other methods and find themselves on the brink of death. According to the CDC, the median monthly overdose deaths among those 10-19 years old increased 109 percent from July–December 2019 to July–December 2021.
According to NIDA, signs of a fentanyl overdose include:
Small, constricted "pinpoint" pupils.
Falling asleep or losing consciousness.
Slow, weak, or no breathing.
Choking or gurgling sounds.
Limp body.
Cold and/or clammy skin.
Discolored skin (especially in lips and nails).
How does fentanyl connect to Native communities?
In the 90s, drug companies began flooding many Indigenous towns with pain pills. In 2022, the CDC reported that the American Indian and Alaska Native populations had the highest drug overdose death rates in 2020 and 2021 — 42.5 and 56.6 deaths per 100,000 persons. As of 2021, the highest rates of overdose with fentanyl were among Native American and Alaskan Native teens.
With indigenous communities where a tribe might have 800 people, losing 20 to overdose in a year has tragic ramifications. In one example, according to Pew Research and the Cherokee Nation's record-keeping information, tribes across Oklahoma lost at least 350 citizens between 2003 and 2014, meaning Oklahoma's Cherokee tribes lost people at a rate higher than the state average.
To retain Native communities and champion a brighter tomorrow for Native youth, understanding the risk associated with opioids, especially fentanyl, is crucial. According to SAMHSA, even when prescribed a medication by a physician, “[a]lways follow the instructions you receive with your medication. Ask your practitioner or pharmacist if you have questions or are unsure of how to take your medication.” Another significant way to combat the fentanyl crisis is through naloxone, a medication that can temporarily reverse an opioid overdose and save lives. In many states, naloxone is widely available. To learn more visit SAMHSA.
Resources: