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Fentanyl and the Opioid Epidemic: A Review of Volume 4, Episode 2 of “Patriot Act”

This week on Patriot Act with Hasan Minhaj, Minhaj introduced one of the most serious topics I’ve seen him cover: the opioid epidemic. Recognizing that last week’s episode was based on a more lively matter compared to this week’s, Minhaj jokes, “…if we get through this, next week, I’m gonna do the whole episode while jumping on a trampoline.” The opioid epidemic is the worst drug related crisis in the United States, however, the rate at which overdoses occur decreased last year for the first time since 1990. This means that some of the actions Americans are taking, including treatment and public awareness, are actually working. “Isn’t it so weird to hear genuinely good news? It’s like when you see your favorite celebrity trending on Twitter and you’re like ‘Oh, my God please don’t tell me he just got #MeToo-ed.. Oh, he just died, thank God…”. There is something other than reactions, though, that is aiding to decrease overdoses. It’s a drug called naloxone, which has been called the “miracle drug” by pediatrician Jennifer Plumb. Naloxone can be used to revive victims of overdose even after they’re already deceased and it is expected to become a billion dollar business within a year. Although this episode was based on such a grim topic, Minhaj was able to relay the information to the audience with ease.


The first wave of the opioid epidemic was when doctors overprescribed patients incredibly addictive painkillers, such as Oxycontin and the second was when patients turned to heroin. Now, a third wave is being discovered because of a drug called fentanyl. Fentanyl is fifty times stronger than heroin and even just a pinch of it is dangerous. Minhaj created a visual for the audiences to understand this better; he displayed a photo of a penny with fentanyl covering just the beard on Abraham Lincoln’s portrait. He then tells the audience that that was enough fentanyl to kill an elephant. It has killed 95 thousand people- young, old, poor, rich, famous, you name it- it doesn’t matter who you are. Prince, Mac Miller and Tom Petty all had fentanyl in their systems when they passed. Minhaj personally knows people who didn’t take fentanyl on purpose but died because of it. The opioid crisis, Minhaj says, cannot be beaten until fentanyl is gone.

On one hand, fentanyl can be found in pharmacies and on the other, in drug deals. In the streets, fentanyl has dangerous, much more alluring names, which include china girl, apache, TNT, jackpot, dance fever, goodfella, murder eight and many more. Minhaj laughs at these names and asks, “Why does it sound like Vin Diesel came up with all those titles?”. Many times, heroin is laced with fentanyl and Minhaj cited a news source that shadowed a drug dealer who stated that “There are very few people who make pure heroin these days.” Heroin from Mexico is almost always laced, usually with a mix of miscellaneous drugs and a little bit of fentanyl. It sounds confusing that a drug dealer would willingly give buyers a drug that could easily kill them, but Minhaj explains that it’s because that mix of drugs can be worth $1.5 million and all of the ingredients are incredibly attainable on the dark web. “It’s like selling bottled water at the airport,” Minhaj explains. In the city of Huntington, 26 people overdosed on fentanyl laced heroin by victims who didn’t know that they weren’t taking pure heroin.

Fentanyl has horrifying effects in the realm of prescription drugs too. There are two important uses for the drug: it is supposed to be used as a painkiller for cancer patients and for patients in surgery. However, doctors have prescribed fentanyl to patients who didn’t need it. When Dr. Paul Janssen created synthetic fentanyl in the 1980’s, it was the most powerful opioid created at the time and when his patent on it ended, fentanyl literally became a “free for all”. Therefore, the FDA attempted to regulate it with The Transmucosal Immediate Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS), which is a program that is supposed to be making patients aware of the risks of the treatments they get. However, the FDA outsourced fentanyl to McKesson, one of the largest drug distributors and McKesson didn’t deny the drug to anyone because of the profitability. In addition to the weakness of this program, the mandatory test for doctors to be able to prescribe it is a simple, multiple choice, open notebook exam with only eleven questions. Minhaj compares this to the mandatory class that venders have to take to sell churros in Times Square, which is eight hours long. 

Minhaj then dives into the lawsuits caused by the distribution of fentanyl. Johnson and Johnson was sued by Oklahoma’s attorney general because they exaggerated on the benefits of fentanyl and undermined how addictive it was. “Johnson and Johnson, yeah… the family company. I know that’s jarring; it’s like hearing Pantene makes atom bombs,” he jokes. There were 6,100 deaths in Oklahoma alone due to fentanyl. Cephalon, a biopharmaceutical company sells fentanyl in several forms, mostly pills and pushed it on people who didn’t need it. Insys Therapeutics, another pharmaceutical company, trained its sales representatives to push fentanyl on patients and make it seem like the doctors specifically wanted them to receive it. Sometimes they were even told to claim the patient had cancer to ensure they would be given the drug. For example, a young woman named Sarah Fuller had chronic neck and back pain from car accidents and was prescribed fentanyl by Insys Therapeutics. A little over a year after she began taking the drug, she was found dead on her bedroom floor. When interviewed, her parents were asked “What killed your daughter?”. Her mother answered, “Well, technically fentanyl, but a drug company who couldn’t care less about a human life.” 

Now, Insys and Cephalon are attempting to sell naloxone. As Minhaj stated earlier in the episode, naloxone can revive overdose victims- but can it revive these companies? People can get hooked on fentanyl because of prescriptions, but it turns into an illegal game because of the addiction. There will never not be something to become addicted to, because now Dsuvia, which is ten times stronger than fentanyl and up to a thousand times stronger than morphine, has been approved by the FDA. Minhaj ends the episode by looking at the camera and saying, “…guess what, pharmaceutical companies? This crisis is on you.” His final words were the perfect way to end an episode about a topic that needs to be talked about.

Patriot Act with Hasan Minhaj is released every Sunday on Netflix and YouTube.

Featured Image via Youtube.

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Hey! My name is Jilleen Barrett and I'm from Long Island, New York. I attend college in New York City. I love to travel, read, and write- mostly reviews! Check out my reviews of "Patriot Act with Hasan Minhaj," and "You".

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    Anita Turner

    August 15, 2019 at 4:03 am

    The episode of The Patriot Act, “Fentanyl” really struck a massive cord within me. Back in 2006, I was seeing my primary care physician, after suffering from lower back pain for several years. My doctor had previously been prescribing me just 1 to 2 7.5mg hydrocodone tablets per day, for only 3 or so months. After relating to my doctor that I was getting little to no relief, he insisted that I start using the fentanyl patch labeled “Duragesic.” I was leery, scared, & insisted over & over that I didn’t want to use it, but knowing next to nothing about it, & after his refusal to prescribe me anything else, & his claim that the patch was “safer” than the hydrocodone I had been using, I felt I had no other option but to try it & was prescribed the 25ml patch & started using it. It helped, in fact, a LOT! No pain whatsoever. But it ended up coming with a HUGE physical & psychological price to pay.
    After 1 month I went back to my doctor, telling him that every 2 days or so I felt as if I was dying. He immediately raised the patch dosage to 50ml. 1 month later, same thing, so was raised to 75ml. It continued to get worse & worse. I lost 25 lbs in 3 months & was down to 110 lbs & nothing but skin & bones & grey skin. I told him I was convinced I was dying, & it was at this point that he told me that I had “issues” & while I sat there in his office crying my heart out, begging him to help me, telling him I knew I was going to die, he told me to leave his office & never come back, & told his nurse to call the police to escort me out. She refused, & I left.
    I felt I was a goner, dying, going into severe withdrawals every 2 days. After 2 weeks, my mother called him back, & after several calls, convinced him to see me again. I made yet another visit back to his office, where I threw the whole bag of over 3 months worth of patches on the floor & finally convinced him to start tapering me down.
    The tapering was a seemingly endless nightmare. I couldn’t eat, couldn’t sleep, I hallucinated for weeks on end, had extreme cold chills, extreme restless leg & arm syndrome, & was convinced my life was over. After 4 months of tapering, I finally started feeling a bit better, & went to see my doctor one last time, who literally told me I looked like shit, & that I had almost died, & was very lucky that I hadn’t.
    It was the worst thing I have ever experienced in my whole life, & something I would never, ever wish on anyone, not even my worst enemy.
    I simply feel the need that someone, anyone, possibly everyone who sees this specific doctor, should know that he did this to me. The pain & suffering it caused is unexplainable, & I feel that there’s nothing worse that any doctor could possibly do to a person.

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