Fentanyl has rapidly replaced heroin as the dominant opioid in Alaska's drug supply over the past few years. This shift has significant implications for public health and safety, especially among street drug users.
Data from law enforcement, nonprofit organizations and drug users themselves all indicate that fentanyl has almost entirely eclipsed heroin in the state. In 2023, Alaska law enforcement agencies seized 83 kilograms of fentanyl compared to just 9 kilograms of heroin.
The rise of fentanyl is accompanied by decreasing prices and increasing risks. Fentanyl, which is up to 50 times stronger than heroin, is often sold in the form of counterfeit pills that resemble pharmaceutical oxycodone products. These pills are available for as little as $0.70 in Colorado and sell for $10 to $15 on the Kenai Peninsula, reaching prices of up to $100 in remote communities.
The abundance of cheap, potent fentanyl has led to a decline in intravenous drug use, as users are less willing to "poke" due to the unpredictable dosage. Instead, many are turning to smoking or vaporizing the drugs, which carries a lower risk of overdose. However, this shift has not eliminated the threat, as polysubstance use involving opioids and stimulants like methamphetamine is increasingly common in Alaska.
The surge in fentanyl has also driven a dramatic increase in overdose deaths in the state. In 2018, just 9 overdose deaths were attributed to fentanyl, but by 2022 that number had risen to 151. To address this crisis, the distribution of the overdose-reversing medication naloxone (Narcan) has increased tenfold, with the state providing nearly 45,000 kits in the past year.
To combat this crisis, effective prevention measures are essential, including increased public awareness, expanded naloxone distribution, routine screening for substance use, and integrated treatment approaches. Strengthening data collection and advocating for policies addressing the root causes of addiction will also be crucial in mitigating the impact of fentanyl on public health.
