Local health care providers have received reports of street drugs in Cordova containing the potent opioid fentanyl, according to an announcement by the city. Additionally, the Cordova Police Department has received third-party reports of drugs containing fentanyl, department officials said. However, the presence of fentanyl in Cordova has not been confirmed.
Authorities are working with the state to provide access to resources like Narcan, Cordova Community Medical Center Medical Director Dr. Hannah Sanders told Cordova City Council at a June 16 meeting. Narcan is a brand name for naloxone, a medication used to treat narcotic overdoses. Kits including Narcan nasal sprays and fentanyl-detecting test strips, provided by nongovernmental organization Project HOPE, are available for free at CCMC and Ilanka Community Health Center.
Additionally, Ilanka Community Health Center operates a medication-assisted treatment, or MAT, program to aid individuals recovering from opioid use disorder. MAT programs use a combination of medication and therapy to treat dependence on substances like opioids or alcohol. The program operated by Ilanka Community Health Center uses Suboxone and naltrexone, medications that reduce the euphoric effects of opioids and lessen cravings.
“[MAT] is considered the gold standard for addressing opioid addiction,” said Susie Powell, behavioral health coordinator for Ilanka Community Health Center.
MAT programs have been shown to decrease illicit opiate use and other criminal activity among people with substance use disorders, and to improve birth outcomes among women who have substance use disorders and are pregnant, according to data from the Substance Abuse and Mental Health Services Administration.
Ilanka Community Health Center also hosts Ilanka Recovery Circle, a substance use support group that meets weekly.
Though local treatment programs are available, public stigma can deter individuals with substance use disorders from seeking treatment, Powell said.
“We all have our struggles,” Powell said. “We’re all susceptible to this… Nobody wakes up in the morning and decides, ‘I think I’ll get addicted to opioids today! I think that sounds like a great idea!’ Of course not. It’s a very painful experience, and I think what people need is compassion to help them move toward treatment.”
Further response to the local effects of the opioid crisis is being organized by the city’s task force on substance abuse issues. This task force includes representatives from the police department, CCMC, Ilanka Community Health Center, the Alaska Court System, and the Native Village of Eyak Tribal Court.
Councilman Tom Bailer said that some blame for the crisis falls on physicians who over-prescribe opioid medications. Bailer described being given excessive amounts of opioid pain relievers following surgeries in Cordova.
“I specifically said, ‘Please don’t give me a large prescription,’ but yet they always give me a prescription of 40 or 50 OxyContin, and usually like two will do it,” Bailer said. “It’s been consistent with the doctors over the years — we had doctors in Cordova that over-prescribed, so I think a lot of it falls in the professionals’ court too, not to put so many drugs out on the street.”
In past years, young people were able to obtain dozens of opioid pills from local health care providers by claiming to have back pain, Bailer said.
Wasilla doc illegally distributed fentanyl
Elsewhere in Alaska, health care professionals have been implicated in the illegal distribution of fentanyl. June 16, a Wasilla doctor pleaded guilty to illegally dispensing and distributing controlled substances, including fentanyl, to patients in his medical practice. David Chisholm, 64, illegally prescribed thousands of pills including fentanyl, oxycodone, methadone and other addictive controlled substances, according to court documents.
An undercover investigation showed that Chisholm routinely distributed these controlled substances without administering a medical exam, according to a Department of Justice release. The investigation also found that Chisholm’s prescription of these controlled substances was a significant contributing factor in the accidental deaths of five patients. Chisholm has yet to be sentenced, and faces penalties of up to 20 years’ imprisonment, three years’ supervised release, and a fine of up to $1 million. Chisholm’s plea agreement requires that he surrender his Alaska State medical license.
“Dr. Chisholm’s irresponsible prescribing habits are an abuse of his medical license and endangered our citizens while continuing to fuel the opioid epidemic that is a clear and present danger to our nation’s health and security,” said Frank A. Tarentino III, Drug Enforcement Administration special agent in charge, in a release. “Physicians like Dr. Chisholm who used his position to traffic opioids is really a drug trafficker with a prescription pad and he must be held responsible for his reckless prescribing practices.”
What is fentanyl?
Fentanyl is an opioid about 50 times more potent than heroin. Typically prescribed as a pain reliever, fentanyl commonly appears mixed with heroin, cocaine and other street drugs, or molded into counterfeit medication tablets. People addicted to fentanyl who stop using the drug may experience severe withdrawal symptoms beginning as early as a few hours after the last time the drug was taken, according to a report by the National Institutes of Health.
Fentanyl poses a high risk of accidental overdose because it is so much more potent than a drug like heroin. A heroin user may miscalculate the size of a dose of heroin if he or she does not realize that it has been laced with fentanyl.
The U.S. opioid crisis began in the late 1990s when health care providers began to prescribe opioid pain relievers at greater rates, assured by pharmaceutical companies that these medications were not highly addictive. Since then, nearly 500,000 people in the U.S. have died from overdoses involving opioids, according to Centers for Disease Control and Prevention statistics. Overdose deaths involving synthetic opioids, such as fentanyl, have risen particularly sharply in recent years, increasing more than tenfold from 2013-2019. Roughly 21-29% of patients prescribed opioids for chronic pain misuse them, according to National Institute on Drug Abuse data.
Alaska reports a moderate drug overdose death rate compared to other states. In 2019, 132 Alaskans died of drug overdoses, according to CDC data. This would make Alaska the state with the 31st-highest drug overdose death rate. Alaska physicians have also been relatively moderate in prescribing opioids: in 2018, Alaska providers wrote 44.9 opioid prescriptions for every 100 persons, compared to 51.4 prescriptions nationally, NIDA reported. However, from 1999-2019, American Indian and Alaska Native people in Alaska died of drug-related causes at a roughly 27% higher rate than that of the state’s general population, according to CDC data.