One of the scariest things about the opioid epidemic for public health workers, police and users is the makeup of the opioids themselves is constantly changing. Pills that are sold illegally don’t come with a list of ingredients that can be believed. Without clear identification, it’s hard to treat overdoses and prosecute dealers. In some states, as certain kinds of synthetic opioids are banned, manufacturers of drugs are finding slightly different variants of a synthetic opioid that is then manufactured and is technically legal, reporter Max Blau of Stat News tells NPR. Some of these are lab formulations that were created in the 1960s and 1970s that never made it out into the world. People working in, homemade labs have been able to find them and create slightly different opioids that are legal only because there’s never been a reason not to make them illegal.
In Baltimore, when there is a uptick in drug abuse that is higher than usual, the fire department alerts the public health commissioner, who believes that instead of waiting months or even a year for final data to come out on the public health side, she can send workers to a neighborhood or a block where overdoses are happening and train residents on how to use the antidote Naloxone or have health workers on hand in case there are more overdoses on the way.