The U.S. Drug Enforcement Agency (DEA) has issued a nationwide alert about the dangers of fentanyl and related compounds (fentanyl analogues). Fentanyl, an opioid that is 50-100 times more powerful than morphine, is both abused on its own and commonly added to heroin to increase its potency. Fentanyl and fentanyl-laced heroin have been a concern for over a decade and have caused numerous overdose deaths among injection drug users in several U.S. cities.
Health officials in Indiana have announced a fast-spreading outbreak of new HIV cases in the southeastern portion of the state that are linked to injection drug abuse of the powerful prescription opioid painkiller Opana. Injecting drugs and sharing injection equipment is one of the main routes of transmitting HIV. Also, a few new HIV cases in southeastern Indiana were transmitted sexually.
“Krokodil,” a toxic homemade opioid that has been used as a cheap heroin substitute in poor rural areas of Russia, has recently been featured in news reports alleging its appearance in parts of the United States. The CEWG is investigating, although the DEA has not yet confirmed any krokodil in this country.
One of the fastest-spreading recorded U.S. outbreaks of HIV since the inception of the epidemic is now occurring in southeastern Indiana, and it is being driven by injection drug use—specifically, abuse of the opioid painkiller Opana (oxymorphone). Sadly, this outbreak was preventable, given all that we know about HIV and its links to opioid addiction, yet adequate treatment resources and public health safeguards were not in place. Following the discovery of 11 new HIV cases in Indiana’s rural Scott County in January, positive tests have been reported almost daily, and health investigators are actively locating and testing people who may have shared needles or had sex with those infected.