Fentanyl kills in 45 seconds

Los Angeles LGBT Center Addiction Recovery specialist Mike Rizzo tests a Fentanyl test strip. (Photo courtesy Rizzo)

Last month, the Palm Springs LGBT community experienced a surge of fear after two people were shot at the Toucans Tiki Lounge, a popular gay nightclub. Instantly thoughts went to the Pulse Nightclub massacre in Orlando, Fla., on June 12, 2016. Nerves calmed when the facts emerged, with Palm Springs Police Lt. William Hutchinson telling the Los Angeles Blade that the shooting is not being investigated as a hate crime.

That terrorist attack on the Pulse Nightclub left a psychic mark with LGBT people now being more vigilant, sometimes curtailing freedom for the sake of safety. But there are also moments and events where the old gay liberation culture clamors to let it all hang out, let gay Pride and freedom ring and party until the spirit says please, no more.

One such event is the annual White Party in Palm Springs, this April 26-29 celebrating its 30^th anniversary of unbridled gay hedonism. But there may be a silent killer stalking the White Party for which the organizers and partygoers are unprepared —Fentanyl and Carfentinal, about which the Drug Enforcement Agency just issued a dire warning after three deaths in San Diego. 

Fentanyl is usually linked with the nation’s ongoing opioid epidemic, which kills 130 Americans every day, according to the Centers for Disease Control and Prevention and for which opioid manufacturers are facing over 1,700 federal lawsuits, according to ABC News. Federal prosecutors are also looking at pharmaceutical executives and companies’ failure to properly report “thousands of suspicious orders of oxycodone, fentanyl and other controlled substances” to the DEA.

But the casual drug user attending the White Party or any other social gathering might not equate fentanyl in oxycodone with fentanyl in crystal meth, cocaine or other non-prescription drugs popular in the LGBT community. And that makes these new powder-forms even deadlier because one’s guard is down.

Mike Rizzo, manager of Addiction Recovery Services at the Los Angeles LGBT Center, only became aware of the deadly encroaching crisis last year when an employee died of an accidental overdose of Fentanyl that was “cut” into the cocaine he was using.

“This beloved employee was not an addict,” Rizzo told the Los Angeles Blade. “He and a few of his buddies where celebrating a friend’s birthday. There were four of them that used that night—three of them died. The fourth individual woke up at 6 a.m., thought his friends were asleep, went home and felt sick. That prompted him to go the ER, which probably saved his life.”

When he read about the Center employee’s passing on Facebook, Rizzo says, “I was in shock. I immediately ran to the office and started to do some research and found that Fentanyl was being cut with meth, cocaine and ecstasy. It has been a problem on the East Coast and it’s just now hitting the West Coast. This is very concerning for me.”

The more research Rizzo did, the more afraid he became.

“Pride was right around the corner. What was going to happen to casual users who would choose to celebrate Pride with a bump of meth or cocaine? An unsuspecting individual may lose their life because they wanted to have a good time,” Rizzo says. “Just because someone chooses to party doesn’t mean they should lose their life.”

Rizzo says there are five points to know about Fentanyl:

1. Fentanyl can be 100 times more potent than heroin;
2. Individuals may not know that what they are about to use may contain Fentanyl;
3. The intervention rate for a heroin overdose is 1-3 hours; the intervention for a Fentanyl overdose is 45 seconds;
4. The normal dose of Narcan may not be enough to prevent an overdose from Fentanyl, more may be needed;
5. Of the meth samples tested in San Francisco, 78 percent tested positive for Fentanyl and 68 percent of the cocaine samples also tested positive for Fentanyl.

“One of the scariest parts of this,” Rizzo says, “is that people who are using meth or cocaine think they are using a stimulant and will not have the tools they need, like Narcan,” a nasal spray or Naloxone, an injectable (needle) solution.

Fentanyl is a cheap, apparently relatively easy to make synthetic drug that has become popular among drug dealers because it’s also highly addictive, as well as deadly when not dosed properly as in a legitimate prescription. Fentanyl can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.

One example is the high-profile case of singer Demi Lovato, who was rushed to Cedars Sinai Medical Center last July after she was found unresponsive in her Hollywood Hills home. LACFD paramedics administered Narcan to the then 25-year-old pop star, reviving her prior to transport. It was believed at the time that she had ODed on oxy that may have been laced with Fentanyl.

As a drug 80 to 100 times more potent than heroin, Fentanyl may be classified as a weapon of mass destruction. “Fentanyl’s high toxicity and increasing availability are attractive to threat actors seeking non-conventional materials for a chemical weapons attack,” Assistant Secretary James F. McDonnell, Department of Homeland Security, wrote in a Feb. 22, 2019 internal memo to senior DHS and Defense Department officials asking them to consider classifying Fentanyl as a weapon of mass destruction.

Fentanyl test strip (image from dancesafe.org)

In Nov. 2018, DEA Acting Administrator Uttam Dhillon announced results of the National Drug Threat Assessment that outlined the threats posed to the U.S. by domestic and international drug trafficking and the abuse of illicit drugs.

“Of all opioids, the abuse of illicit fentanyl and other synthetic opioids has led to the greatest number of deaths in the United States,” the report said. “Fentanyl is increasingly available in the form of counterfeit prescription pills marketed for illicit street sales, and also sold by traffickers on its own, without the presence of other drugs.”

On March 29, the editorial board of the Los Angeles Times took aim at the Trump administration’s diverting billions of dollars away from the opioid crisis.

“In 2017, the most recent year for which we have good data, more than 70,000 Americans died from drug overdoses,” The Times wrote. “Nearly 50,000 of those deaths involved opioids. New government data released this month show that a key driver of the overdose deaths in the last few years has been the spread of fentanyl, a synthetic opioid that has been mixed in with heroin and other illicit drugs. Extraordinarily potent, fentanyl is killing unwitting users in rapidly growing numbers.”

This prompted the West Hollywood City Council to vote on April 15 to proactively engage in “harm reduction” by making available Fentanyl test strips available to combat the problem. 

“It’s important to target the casual user, as well as the addicts,” West Hollywood City Councilmember John Duran tells the Los Angeles Blade. “In the 1980s, I was legal counsel to Clean Needles Now, part of the efforts by ACT UP/LA to help in the prevention of spreading HIV.”

Harm Reduction is “a much needed step in to addressing these deaths caused by Fentanyl-related overdoses,” he added.

“We are doing this because WeHo is a hub for the LGBTQ community. This is a real public health emergency that has significant impact on the 40% of our population who are LGBT,” he said.

“People who are using—whether at a party or an event like the upcoming White Party or hook-ups on Grindr or other social events. They’re not expecting to use and then die,” Duran says. “We need to inform people as to the real dangers. They need to understand that even their casual party use can be lethal.”

Rizzo concurs. “With a 45-second intervention rate, the only defense is to test the product before you use it.”

Fentanyl Test Strips are available in every Center department and in all satellite locations, including Center WEHO. The City of WeHo recently gave the Center a grant for more test strips and this year the Center will do outreach at every Pride event. “We would like people to stock up before they attend these events and have them available for themselves or for friends who may choose to party,” Rizzo says. “If you do choose to party…party safer.”

Even deadlier than Fentanyl is carfentanil, one hit of the drug the size of a speck of dust can kill, the DEA reports.

“The DEA in San Diego County has issued an alert after three people have suffered documented fatal overdoses from a new form of the drug Fentanyl know as carfentanil,” CBS13 in Sacramento reported April 16. “It would only take 2 mg of the drug to cause a deadly overdose. Meanwhile, it would only take .02 mg of carfentanil to have the same fatal results.”

This synthetic drug is so fast-acting it not only attacks the brain stem to interrupt breathing but also rapidly closes the esophagus so even Narcon might fail to act in time.

The bottom line: freedom-loving gay partiers these days must become as vigilant about their drugs as they are about scoping out the exits at a crowded gay bar.

For more information about Fentanyl and the addiction services offered at the Center, please call 323-993-7448.