Though they know that nearly all heroin is laced with the dangerous synthetic opioid fentanyl, many Baltimore users aren't prepared to prevent or treat fentanyl-related overdoses, a new study finds.
Baltimore has a thriving heroin trade and 1,000 opioid overdose deaths a year.
The study, by researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore, included 316 people who admitted recent illicit opioid use. All had heard of fentanyl and about 56 percent suspect most or all of Baltimore's heroin is laced with it.
Nearly 75 percent said they were "quite a bit" or "very worried" about acquaintances overdosing on fentanyl, which is 30 to 50 times more potent by weight than heroin. Fentanyl and related synthetic opioids are the leading cause of drug overdose deaths in the United States -- more than 70,000 in 2017 alone.
Nearly 66 percent of study participants said they had been prescribed or received the opioid overdose medication naloxone (Narcan), but almost as many (65 percent) said they never or rarely had it on hand when taking drugs.
Just 12.5 percent of the 210 injection drug users said they had often or always had naloxone available when shooting up with others. More than half said they usually or always injected alone, so no one would be there to administer naloxone if they overdosed.
The findings underscore the need for programs that encourage users not to inject alone, to carry naloxone, and to use it appropriately to treat overdoses, said the authors of the study published recently in the journal Substance Use & Misuse.
"In many parts of the country, fentanyl is now the major cause of all the death and despair arising from the opioid epidemic, and we have to reduce the barriers that prevent users from being prepared to treat fentanyl overdoses," lead author Carl Latkin said in a Hopkins' news release.
Latkin is vice chairman of the Department of Health, Behavior and Society at the Bloomberg School.
The U.S. National Institute on Drug Abuse has more about fentanyl.