The fourth wave of opioids swamps Montana with meth-fentanyl cocktail
A lethal dose of heroin compared to a lethal dose of fentanyl (Photo New Hampshire State Crime Lab).
The current drug epidemic of fentanyl being mixed with other substances has been called “the fourth wave.”
And if you use that metaphor, then Montana is getting pummeled by tsunami.
New real-time drug testing reports show that even though the state lagged behind others initially when it came to the trend, its effects in the Treasure State are now among the worst in the nation.
Simply put, few methamphetamine users and opioid addicts are using the substances individually — now, they’re often found together, and Montana is far eclipsing the national average of “polysubstance use,” meaning drug testing is more often than not detecting positive results for a mixture of drugs, instead of just one.
New data, released through the Millennium Health Signals Report, and presented by Kelly Olson at a meeting of clinical laboratories and medical providers in Billings on Thursday, showed the devastating and harrowing results of statewide drug use.
Nationally, just more than 60% of drug testing for methamphetamine indicates a mixture of fentanyl as well. But in Montana, that number is shy of 75%.
Millennium Health is a national laboratory that specializes in drug testing and monitoring illicit drug use. It produces the Millennium Health Signals Report from which these statistics come, along with the United States Department of Health and Human Services.
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That is challenging health care providers and law enforcement because many of the users may be think they’re getting a single drug, like fentanyl, a synthetic opioid, or methamphetamine, but really getting both. It’s a modern twist on the “speedball” drug phenomenon, where a stimulant and depressant are used together.
But today’s fentanyl-methamphetamine cocktail is much different than a “speedball” of a few decades ago. Today, the purity of both drugs is remarkably more concentrated and more dangerous. Not only that, but the ways in which drug cartels manufacture the substances makes them smaller, more concentrated, more potent — and thus, more addictive.
“These drugs grab the brain and hold it hostage,” said Olson, with the Millennium Health.
Furthermore, Montana has seen a decrease in fentanyl when combined with prescription opioids and heroin use in the past decade, but a 247% rise in methamphetamine-fentanyl and near 5,000% increase in cocaine-fentanyl, largely due to the fact that in 2013, there wasn’t much cocaine detected in Montana, while it’s now recorded in about 4% of all drug screenings. Meanwhile, meth use with fentanyl during that same time period has gone from 21% to 73%.
Dr. Kelly Olson of Millenium Health speaks to a group of clinical laboratory staff at a conference in Billings on April 11, 2024 (Photo by Darrell Ehrlick of the Daily Montanan).
Montana also remains higher than the national average in positive drug tests of fentanyl and alcohol, likely attributed to the Treasure State’s propensity for drinking in general.
What makes the statistics so troubling, Olson said, is the lethality of drugs together. Because they are more potent and more pure, they’re also more deadly. Between 1998 and 1999, there were around 5,000 annual deaths from opioids. By 2021, that number had jumped to 106,000, largely because of fentanyl, according to the report. In 2010, Olson said, less than 1% of overdose deaths from opioids had stimulants detected. In 2021, that number had jumped to 32%.
Olson said the powerful combination of the drugs apparently help balance each other, creating a potent high. Unlike opioids alone, which cause lower energy and even sleepiness, the amphetamine helps users stay more alert for longer, which “gives the drug legs.”
Since 2008, emergency room visits for overdosing have increased by six times, and between 2015 and 2019, psychiatric hospitalizations due to overdose or drug use had nearly doubled.
“In many cases, trying equals dying,” she said. “Folks are being surprised by what they get. They think they’re just getting fentanyl. For others, the combination is insurmountable.”
The problem is especially pernicious in the West, where states have been battling against methamphetamine for what seems like forever. Cartels, Olson said, are becoming more sophisticated, avoiding larger cities where their activity can be traced, and spreading out into smaller communities. The number of fentanyl-only drug tests has dropped to just 7%, meaning most of the street drugs are combinations, with cartels looking to improve and enhance the product. However, some of the synthetic opioids that are being “cooked” are more than 10,000 times more potent than the morphine.
“If you look at the stats, Montana is being hit hard — harder than most — with fentanyl and methamphetamine,” Olson said.
The post The fourth wave of opioids swamps Montana with meth-fentanyl cocktail appeared first on Daily Montanan.
