As fentanyl threats rise in the country, so does UNC research

Delesha Carpenter lost two friends to drug overdoses within the span of two weeks. That experience seven years ago transitioned her research focus from asthma to reducing opioid overdoses. 

Decades into the opioid epidemic, experts like Carpenter are concerned about the increased prevalence of fentanyl-laced products.  

Fentanyl is an extremely potent opioid drug, with quantities as small as 2 milligrams being lethal depending on a person’s size and tolerance. Although the drug is not usually used by itself, fentanyl can be mixed with other controlled substances such as cocaine, increasing the chance of an overdose. 

Carpenter, an associate professor at the Eshelman School of Pharmacy, is using funding from the National Institutes of Health to create maps detailing Naloxone availability across North Carolina. 

Naloxone, also called Narcan, is a drug that can revert the effects of an opioid overdose. In late March, the medication was approved for over-the-counter use by the U.S. Food and Drug Administration. Carpenter said she hopes her data can look into statewide racial and geographic disparities related to opioid deaths. 

She said pharmacists are one of the most accessible health professionals in the country and that individuals can stop by with any questions at any time. 

“Making sure that pharmacists are equipped to provide tools like Naloxone and fentanyl test strips — that's what I work on: to train pharmacists to be prepared offering these services especially in rural areas," Carpenter said. 

Her work is in line with her belief in harm reduction, a set of strategies designed to help drug users engage in less risky drug behaviors. 

Skylar Harrigfeld, co-director of the UNC's Student Pharmacists Opioid Misuse Prevention (StOMP) Task Force, said harm reduction is an important practice for those using opioids. She said the StOMP Task Force has been working closely with the North Carolina Harm Reduction Coalition to make free Naloxone kits distributed to other drug users. 

“It's not that people are choosing to take fentanyl,” Harrigfeld said. “It's that they're taking other drugs that are laced with fentanyl and don't know it. That has been horrible for people who use drugs and people with opioid misuse disorders because it's very potent and leads to death much quicker than other opioids.”

Harrigfeld said college students are generally more likely to experiment with drugs compared to other demographics. But she said solely telling people not to use drugs is not effective. Instead, methods like harm reduction give users safer ways to take drugs and provide avenues to get help.

Earlier this month, the Biden administration declared fentanyl laced with xylazine, a novel animal tranquilizer and non-opioid, an “emerging threat” in the United States. Between 2020 and 2021, forensic laboratory identification of xylazine rose by 193 percent in the South.

Colin Miller, the community liaison for the UNC Opioid Data Lab, said xylazine is making it much more difficult to successfully reverse opioid overdoses. Although Naloxone can reverse the opioid component of an overdose, Miller said xylazine can leave users unconscious and lead to people administering more Naloxone than necessary.

Miller said he has been working together with local programs to detect drugs laced with substances like xylazine. To stay safe, Miller believes drug users should get their drugs tested at a lab. 

“The person who turns in the sample at whatever syringe service program or health department gets a number so they can remain anonymous,” Miller said. “This number follows that sample to the lab and then we post it on the website under that number. The person can just go on the streetsafe.supply website, type in the number they got and see what's actually in their drugs.”

Miller said there are also tell-tale signs on whether xylazine is present in drug products. He said xylazine usage can not only leave users with dry mouths but also cause wounds to heal more like a burn rather than a traditional abscess. He said there is also much training needed to tackle these issues. 

“We need to definitely disseminate and figure out our best practices for these xylazine wounds that we're seeing,” Miller said. 

Overall, Carpenter believes there is a stigma against people who use drugs, something which leads to the devaluation of users’ lives. 

“Most of the resistance that you see is based on stigma and not feeling like supporting these populations,” she said. “I think that's the underlying thing that's going on. We need to work on stigma reduction.”

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