Last spring in the Santa Clarita Valley, eight people overdosed within a 72-hour span. All of the people involved were between the ages of 19 and 26, just standing on the cusp of adulthood. A year earlier, 27 people overdosed within the span of four hours in Huntington, West Virginia, a city of only 48,000 people. A few months later, six people died of overdoses in a single Vancouver neighborhood over the course of eight hours. While years ago these incidents may have been shocking, today they are so common that they are no sooner reported than lost in a swelling sea of overdose stories brought on largely by the introduction of fentanyl in the drug supply.
In Philadelphia, Art Gutierrez knows he’s in danger of the same fate. “It’s a new epidemic,” says Gutierrez , who makes his morning heroin run as religiously as some people get their morning coffee fix at Starbucks. “If you catch a pure bag of fentanyl, that Narcan ain’t bringing you back.” He’s right, and the danger is growing. Fentanyl-related overdose deaths rose almost 600% between 2014 and 2016 in America’s 24 largest cities. Of course, fentanyl isn’t the only overdose culprit; while fentanyl raises the stakes, you can overdose on everything from a clean, white pill you purchased at a pharmacy to a bag of heroin purchased on a street corner. In fact, heroin and prescription opioid-related overdose deaths have both sharply risen in recent years, accounting for 15,400 and 14,400 deaths respectively in 2016. But despite their alarming increases, the meteoric rise of fentanyl means it now outpaces them both, causing 20,100 deaths last year.
While individual overdose deaths rarely receive much publicity, their collective magnitude is now undeniable, sending politicians, public health officials, and addiction specialists scrambling to find answers. It has also led to the words “opioid” and “opiate” making regular appearances in headlines, policy papers, and political speeches, words that not only describe particular types of drugs but carry with them the specter of a particular type of danger. But what is the difference between opioids and opiates, and do these differences impact the surge of addiction and overdose we are now seeing? For the loved ones of people struggling with addiction to these substances, they are more than academic questions. The answers can help you better understand your loved one’s experience and the danger they are in—as well as how you can help them.