HJNO Jul/Aug 2022

DRUG ADDICTION A US HEALTHCARE JOURNALS SERIES Drug Addiction There seem to be times in our lives when the earth shifts — when a one-time, perhaps enjoyable dalliance can now ... actually kill you. AIDS might come to mind for those of us who watched the early carnage and communal fear associated with lives taken too young by an unknown killer. We only knew that having sex could be fatal. Societal adjustments had to be made, and researchers scrambled to solve the new threat. What was once mostly benign was now potentially deadly, and, initially, there was no test to know. Fentanyl has now entered the scene and caused its own shift. This drug is so powerful in such amazingly small amounts that it has entered the unregulated, underground drug scene as an easy, cheap alternative for a quick high. Many street drugs of choice once considered “safe” are being laced with fentanyl and causing unanticipated deadly results. Do these drug lacers intentionally create street drugs that will kill a user? The answer is probably “no.” Why would a businessman intentionally kill his client base? But what was once a casual decision — an escape for the unsuspecting — can now lead to consequences the user never saw coming. Between the opioid and now fentanyl crises, there have been many fingers pointed. We asked one of our own, a prescriber of both in the middle of the fray, to share his thoughts on these drugs. He balances their good while being aware that patients sometimes divert these drugs with deadly consequences. The story is just unfolding … but buyer beware. 10 JUL / AUG 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS