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Experts discuss fentanyl’s role in overdose deaths, share prevention plans

An emergency entrance to a hospital is pictured. Overdose deaths among young people have been rising for years, specifically those related to fentanyl. (Daily Bruin file photo)

By Vivian Stein

Feb. 1, 2025 7:33 p.m.

California had over 7,000 opioid-related overdose deaths in 2022. Nearly 87% of them were linked to fentanyl.

Overdose deaths among young people have been rising for years, said Joseph Friedman, a resident physician and substance abuse researcher at UC San Diego. The rise is tied to fentanyl, a powerful synthetic opioid which has increasingly been used to modify other drugs in the United States, he added.

“In terms of overdose death rate overall, the U.S. is an extreme global outlier,” Friedman said. “We are – depending on the numbers you look at – several orders of magnitude above the global average, and we are at least twice as affected as the countries right after us.”

When fentanyl first emerged in the U.S., it was largely used as a replacement for or supplement to heroin, primarily impacting existing heroin users, Friedman said. He added that, now, it has also appeared in counterfeit pills, which disproportionately impacts younger generations, as they are more likely to report using prescription medications such as Adderall or Xanax.

Drugs associated with bar or club scenes are also at risk of containing fentanyl, Friedman added. A 2023 study found that 12-15% of stimulant samples sent to a drug-checking service contained fentanyl, he said.

Friedman added that whether someone obtains drugs from a stranger or a friend, they should consider that the substance may not be safe.

“The most important thing is that you really can’t trust any pill that you didn’t get yourself from a pharmacy,” he said.

Friedman also said expanding access to naloxone – an antidote for opioid overdoses – is a safe, evidence-based strategy to help prevent fentanyl deaths. He added that educating people about Good Samaritan laws, which protect people from legal consequences if they seek medical assistance during a suspected overdose, and distributing more fentanyl test strips are also important ways to combat the growing crisis.

While using fentanyl test strips is helpful, a negative result does not guarantee a drug’s safety, Friedman said, adding that other harmful substances, including opioids not detectable by the strips, could still be present in drugs such as cocaine.

“This is a really particularly dangerous time to experiment with drugs,” he said.

Beyond increased access to naloxone and test strips, educational websites about drug use, such as Facts Fight Fentanyl, are vital in combating the crisis, said Jessica Hwang, the public awareness section chief for the Substance and Addiction Prevention Branch at the California Department of Public Health.

Encouraging college students to know how to access naloxone on campus, such as through UCLA’s Narcan Distribution Project, is especially important, she added.

“Everyone can play a role in combating the opioid crisis in California,” Hwang said. “By carrying naloxone, knowing about fentanyl and knowing the signs of an opioid overdose and how to respond, you can do your part to save a life and really help to reduce overdose deaths within California.”

Chelsea Shover, an assistant professor in the David Geffen School of Medicine, said naloxone should be widely available to all college students.

“The issue with fentanyl and strong synthetic opioids is that they’re so strong that even small differences in dose or purity can make a difference between having overdosed and not – life and death,” Shover said.

Prevention strategies vary depending on whether someone uses opioids regularly and has a high tolerance or if they are experimenting for the first time, Shover said.

While fentanyl sometimes appears in “party drugs” such as cocaine or ecstasy, a vast majority of fentanyl overdose victims knowingly use fentanyl, unaware of its unregulated potency, she added.

“There’s also this misconception that fentanyl is just showing up in other drugs all the time,” Shover said.

At the national level, much of fentanyl-stimulant mixing is intentional, driven by long-term addictions, Friedman added. On college campuses, however, unintentional exposure during experimentation is more common, he said.

The drug market is rapidly evolving and today’s drugs carry greater dangers than a decade ago, with substances often varying widely in content and risk even when from the same source, Friedman added. He said while drug abstinence is the safest strategy to avoid an overdose, for those who choose to experiment with drugs, proper education on evolving risks and harm reduction is essential.

While college has always been a time for experimentation, the rise of counterfeit fentanyl pills has made drug use significantly more dangerous, Shover said. She added that in years prior, taking a pill with unknown origins might lead to a bad night, but now it could be fatal due to the presence of fentanyl.

“Counterfeit pills have this very strong opioid now,” Shover said. “That kind of experimentation that’s just always been built into that age and setting can be really, really dangerous.”

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Vivian Stein
Stein is a News staff writer and an Arts and Copy contributor. She is a second-year anthropology student from Thousand Oaks, California.
Stein is a News staff writer and an Arts and Copy contributor. She is a second-year anthropology student from Thousand Oaks, California.
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