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One pill can kill: Understanding the risks of fentanyl

As overdose deaths skyrocket, an addiction medicine specialist explains the drug’s dangers and urges community members to learn what they can do to save lives.

In March 2022, 2 Portland, Oregon, high school students died within 24 hours of each other after overdosing on fentanyl in the form of counterfeit pills.

The deaths are part of a substantial increase in overdose deaths from nonprescription fentanyl, said Sarah Leitz, MD, chief of addiction medicine for Kaiser Permanente in Portland. There were 237 fentanyl-related deaths in Oregon during the first half of 2021, up from 230 in all of 2020, according to the state medical examiner.

Nationally, overdose deaths among adolescents more than doubled from 2010 to 2021, according to a study published in JAMA, and rose another 20% in the first 6 months of 2021. Synthetic opioids like fentanyl are the primary driver of these deaths.

Dr. Leitz believes the spike in fentanyl deaths is the result of several factors. The drug is potent, addictive, and easy to smuggle. The stress and isolation of the past 2 years may also play a role.

“Substance use in general has increased and become more severe during the COVID-19 pandemic,” she said.

Dr. Leitz answered questions about reducing the risk of fentanyl overdose — and what to do when overdose happens.

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