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Fentanyl's Potency Creates Hurdle in Fighting Opioid Overdoses

NASHVILLE, Tenn. (WKRN) - Overdose deaths are skyrocketing across the country from synthetic opioids.

According to the Centers for Disease and Control and Prevention, much of the overdoses stem from illicitly-manufactured fentanyl, a synthetic opioid health experts call dangerously potent.

A woman, News 2 is naming Sarah out of confidentiality, knows this all too well.

What began as a way to treat pain after a visit to the dentist, evolved into a 25-year addiction to opioids.

Some of that, Sarah said, was laced with illicit fentanyl.

News 2 was there on a big day on her road to recovery.

After almost 25 days in rehab at The Next Door in West Nashville, Sarah packed up her past.

"I feel much better emotionally, physically," said Sarah. "I don't want to get up ever again and have to do some type of drug to make myself feel better or get off sick."

Sarah's departure from the recovery center means she's preparing for the next big test in beating her opioid addiction.

"Mainly I want to see my son get off the bus and squeeze him real tight," she said. "The temptations are out there so I am a little nervous about that, but I also think I'm in the perfect spot or set up for success from here on out. It's just me and my will power."

For recovering opioid addicts like Sarah, the test lies in overcoming the need for the high that comes with drugs like heroin - the danger, lying in the unknown.

"The bottom is ultimately dying and that's what's going on right now is the fentanyl being mixed with stuff and if you don't end up dying, you're pretty darn close to it," said Sarah.

"Fentanyl is a synthetic opioid, so it's in the same family of morphine and heroin and demerol and all the opioids," said Dr. Michael Ferri at The Next Door. "What makes it sort of unique is that it's incredibly potent."

Dr. Ferri said the danger comes from how quickly fentanyl can get to the brain to give users that high.

"It turns out that fentanyl and its derivatives are one of the most potent molecules to bind the opioid receptor, which is responsible for anesthesia and pain, but also for respiratory depression which is what can kill people," said Dr. Ferri.

That bind is so tight, it can make it hard for life-saving Narcan to reverse an overdose.

"Fentanyl binds much, much more tightly. It's much more potent and it's more sticky at that receptor site," said Dr. Ferri. "So a dose of Narcan may not be enough to push off that fentanyl."

For comparison, fentanyl is roughly 100-times more potent than morphine, a naturally-occurring opioid.

Just a couple of grains of fentanyl would be enough to kill the average person.

The potency has drug dealers cashing in.

"People are cutting the heroin with the fentanyl just to make it stretch," said Sarah.

"At a certain point, buying Oxy, things like that off the street becomes too expensive," said Dr. Ferri. "And that's where the fentanyl comes in. The drug dealers can cut that fentanyl to make it cheaper for them to make it a more potent product."

Sarah said she's had close calls with fentanyl-laced heroin.

"Luckily, I've been fortunate you know," said Sarah. "But yeah, that's the bad part is nobody knows what's in there and I know overdoses are on the rise, because I've lost several friends to it."

But Sarah said she's determined not to let that happen - for herself, her family, and especially her son.

"I'm looking forward to being a much happier mom and I was an involved mom before, but I want to be a more involved mom," said Sarah.

Sarah added this is her second effort to get clean and hopes it'll be her last.

She said she'll be continuing her recovery with four days a week of intensive outpatient treatment at The Next Door.

News 2 is investigating the impact of fentanyl across Middle Tennessee. We have special reports all day Thursday in every newscast. You can also join in on the discussion during a live town hall meeting airing at 6:30 p.m. on News 2.

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