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The risk of counterfeit fentanyl poisonings a serious threat among not just youth, but all ages and demographics

PHOTO COURTESY OF CLEAR ALLIANCE - Graphic demonstrating where fentanyl is being foundIn 2021, Oregon saw 53 Fentanyl poisonings in ages 18-24.

That is a sobering and frightening statistic, and due to the seriousness of this issue, the Oregon-Idaho High Intensity Drug Trafficking Area (HIDTA) is sounding the alarm in a recent community threat bulletin. In addition, the Drug Enforcement Administration (DEA) reports that 40% of all counterfeit pills in circulation contain fatal amounts of fentanyl. Counterfeit pills (also known as fake pills) kill an estimated 5,000 young people annually.

"It's the modern-day version of Russian roulette," commented Sergeant Kent Vander Kamp of the Central Oregon Drug Enforcement (CODE) team.

Fentanyl is a very strong synthetic opioid. Opioids are often used as painkillers. Although fentanyl is made and used pharmaceutically, it is also produced illegally in Mexico and trafficked into the United States, usually as powder or pills. A very small amount can cause someone to overdose and die. According to the HIDTA, in 2021, Oregon saw 11 fentanyl-related fatal poisonings in ages 0-17 years of age and 53 in ages 18-24.

Fentanyl was originally approved by the Federal Drug Administration for use as an analgesic and an anesthetic. It was developed in 1959 and introduced in the 1960s as an intravenous anesthetic. According to the DEA, most of the counterfeit pills are produced in other countries; mainly China, Mexico, and India. However, an increasing number of pills laced with fentanyl are being produced in the U.S.

They are usually produced in substandard conditions, labeled incorrectly, and may include dangerous, unapproved substances. There are no quality control mechanisms in the illicit labs producing counterfeit pills to ensure dosing is not lethal. DEA officials report that at least 2 milligrams of fentanyl is considered a deadly dose.

"The dosage is extraordinarily high, and usually that is what creates the overdose reaction, just the potency and volume of fentanyl in some of these tablets," commented Vander Kamp.

He also supervises CODE, which is a regional team supported by HIDTA and DEA. Their task force services Crook, Deschutes, and Jefferson counties, but they are also part of a statewide HIDTA. It is his second time working with the team, and he previously worked as a detective and a patrol sergeant. He has seen fentanyl come into the Central Oregon area as a patrol sergeant and supervising the drug team.

"I would say the speed of growth in the area has been staggering, to say the very least. It has been very interesting to see the sourcing of it and how it has changed the face of our drug enforcement — and then you have Measure 110 on top of it, which has muddied the waters to say the least, for Oregon."

PHOTO COURTESY OF UNITED STATES DEA - Authentic Oxycodone shown left, and counterfeit pill is shown on right.Vander Kamp indicated that the drugs they encounter that are being trafficked include methamphetamine, heroin, cocaine and fentanyl. He added that most of the drugs are sourced from Mexico, and they have seen a large influx in the region in the past year. The fentanyl forms that they have seen include powder, liquid, or in a fake tablet form. The counterfeit tablets they encounter are fake Xanax, fake Oxycodone and fake Vicodin.

He added that opioids in general are a problem, but fentanyl is a synthetic substance. There are 20 to 30 different versions, and all are synthetic and produced in mass quantities in labs. Emergency responders and law enforcement who use the drug Narcan, which is used to reverse the effects of Opioid overdoes, find that it is not working with the potent counterfeit fentanyl pills.

"They are finding that fentanyl (pills) are so potent and strong that it takes two, three, four shots of Narcan before patients will revive. That is narrowing the window of survival even more," Vander Kamp stressed.

He went on to say, "We are seeing a very wide range of victims; we are seeing everything from school age children who are experimenting with random pills, to older people who are looking for cheap alternatives to pain medications and are uninsured or don't have access to medication."

He cautioned people who are on Instagram, Snapchat, or other social media apps. There are often advertisements for pills on these platforms, but people need to understand they are most likely counterfeit pills. It is common for people to obtain the fake pills through mail from these advertisements as well.

"Now they are distributing through social media and on the street. It is completely unregulated, and the product that is being pushed are pills that can cause death — they are not pharmaceutical grade. That is where the disconnect is, the community still does not realize that, yes, it looks like a commercially-made prescription tablet, but it is not. It just takes one pill, and the odds of you surviving are slim," Vander Kamp said emphatically.

Vander Kamp also voiced his concern that the current health curriculum in many school districts is behind and does not address this significant threat to youth. He added that there is a lack of education available for teens, who may be dealing with stress and anxiety. He encounters many teens who already take medications for ADHD or anxiety but have never heard of counterfeit pills.

"That is where CLEAR Alliance comes in. Vander Kamp serves as a volunteer Board Director for CLEAR Alliance, an educational non-profit organization in Prineville that stays current on drug trends to provide evidence-based prevention education curriculums and awareness campaigns geared for youth, parents, schools, driver education programs, and other public-source organizations that serve these populations. "It is easy to say we are enforcing the rules and the laws, but if we are not doing anything to get on the front end, then we will always be on the back end" Vander Kamp said. He added that the last numbers released by Oregon Health Authority (OHA) in 2021 indicated that Oregon drug deaths were happening twice as fast compared to United States for all drugs - and fentanyl deaths in Oregon are happening four times faster than the U.S. average.

Mandi Puckett, Executive Director for CLEAR Alliance also stressed the importance of educating schools, parents, and students.

"In the seven years of CLEAR Alliance being in existence, the most common response we hear from youth, parents, school staff, and community members is 'I didn't know that' or "I had no idea,'" said Puckett. "We are the agency that works to educate the public in as close to real time as we can. Once we have the evidence, we let people know what our public service partners are encountering on the front lines. We don't want any lives lost because the data is behind" she said.

Puckett added that CLEAR Alliance teaches youth to be critical thinkers and gives them preventative tools, such as refusal skills, to protect themselves. CLEAR Alliance has been partnering with public and private schools in Central Oregon for nearly seven years to gather input from students, parents, and school staff to assess what they know and don't know about substance abuse and impaired driving - and then builds curriculums and awareness campaigns that are catered specifically to address the needs. The education is then expanded statewide and is now reaching other states, such as Iowa and Virginia. CLEAR Alliance is now developing a Counterfeit Pill Education Course (CPEC) that they are piloting in local schools throughout the coming year that will be available statewide for teens, parents, schools, and public-service partners in 2023.

The issue is not only a grave concern in Central Oregon, but in all parts of the state and the country. Oregon State Representative Janelle Bynum, House District 51, serves the communities of East Portland, Damascus, Gresham, Boring, North Clackamas and Happy Valley. She recently learned about the dangers of counterfeit fentanyl through an article in the Oregonian where two students at McDaniel High School died. "I didn't know, and it was particularly moving for me that these parents had lost their children," she said of the impact that the article had on her.

Bynum added that she has four children of her own, and she felt vulnerable because she didn't know that these drugs were even out there.

"I felt particularly moved by the fact that we saw a lot of kids during COVID struggle with mental health. As a mom, my heart sank when I read about the stories of those families losing their children."

She recently sponsored a town hall that focused on community safety. She believes that the topic of fentanyl and public safety and the lives of our loved ones is where they should be focusing their community resources.

"What I really thought was important was for law enforcement to tell people, 'You might be hearing about these things that are sensational in the news, but here is what you should really be looking at."

Another couple who lost their son to accidental fentanyl poisoning has used their family's story to get awareness out to other schools and families. Jen and Jon Epstein lost their son, Cal, in 2020. He was in college and died of fentanyl poisoning.

"He reached for a fake pill, and we will never know exactly why. After he died, we were blindsided, and we had never heard of fentanyl, and we had never really known what was going on," the couple said of their son's death.

Jen added that they heard of some drugs being sold on the internet, but not how accessible they really were. They approached their local school district in Beaverton to share their family's story. Unfortunately, the district had already lost four students to fentanyl-related deaths. They conducted a town hall to have a community conversation, where the Epstein's spoke about their experience. Law enforcement agencies were present, as well as the health department to address mental health issues.

"We recognized that if we didn't know what was going, there was a lot of people in our community who likely didn't know what was going on either."

More than 6,000 people attended the virtual town hall and it was viewed close to 50,000 times. The Epstein's also reached out to another family who had lost their child to fentanyl and who had started a non-profit called Song for Charlie. The non-profit started a social media campaign in August to reach youth about the dangers of fentanyl. The Epstein's now work for Song for Charlie.

"As of now, we have reached 60 million views so far, so we know our message is getting out there," they said of the recent campaign.

"This could happen to anyone, and parents should not exclude themselves from the opioid epidemic, based on prior knowledge," said Jon. "That is because the opioid epidemic has evolved, and unlike a few years ago, it is now completely filled with synthetics — fentanyl mainly — which are unlimited and cheap."

PHOTO COURTESY OF DEA - Authentic OXY shown left; counterfeit fentanyl shown right.From the counterfeit and the deception aspect, Jon emphasized that the opioid epidemic is not what it used to look like. It isn't just about heroin and prescription pills but the synthetic pills, which are everywhere and being packaged into counterfeit pills.

"Kids can get them easily through social media. Any kid who has a phone in their pocket can get these drugs delivered to them within minutes," emphasized Jen. "Literally, it is as easy as ordering a pizza, so parents need to know that the drug dealers are preying on anyone who is willing to buy, which means youth as well."

She went on to say that the use of pills to solve problems to make you feel better has become normalized in our culture, so there isn't as much stigma around the use of pills.

"Song for Charlie is not the prevention experts," emphasized Jon. "Song for Charlie is sounding the alarm to raise awareness so that kids and families don't have to go through what we went through with the loss of our son." Song for Charlie is partnering with CLEAR Alliance and will be featured as guest presenters in the Counterfeit Pills Education Course (CPEC). Jen pointed out that there are more youth who are victims of fatal fentanyl overdoses because they did not understand the risks.

"People only know what they know. We believe most people will make the choice to not use these pills if they just have the information in hand. Lives can be saved with this education."

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