by Rebecca Grapevine
The Georgia Department of Public Health discussed increasing fentanyl overdose deaths, COVID rates, and a mysterious hepatitis outbreak among children at its May meeting.
Fentanyl-involved overdose deaths in Georgia increased 218 percent from 2019 to 2021, said epidemiologist Dr. Laura Edison. That drastic increase represents 1,248 deaths in a two-year-period.
Fentanyl, a synthetic opioid, is particularly dangerous because it is 100 times more potent than morphine and because it is often mixed with non-opioid street drugs, said Edison.
Drug users may not know that their drugs are laced with fentanyl and just “one pill is enough to kill,” Edison emphasized.
Fentanyl has flooded American streets in the past few years. The Atlanta-Carolina High Intensity Drug Taskforce Agency seized a staggering 70,843 doses of fentanyl in 2021, compared to just 3,415 doses seized by the same agency in 2020, said Edison.
That’s about a twenty-fold increase. Such seizures are “just the tip of the iceberg” of the amount of the drug actually on Georgia streets, Edison said.
Almost all fentanyl-involved deaths in Georgia involve another drug as well. These include fentanyl-laced cocaine, amphetamines, and benzodiazepines like Xanax.
“No part of the state is being spared from this,” Edison said. “While we’re seeing the highest counts of overdoses in urban areas, the rates of opioid overdoses tend to be higher in non-urban areas.”
Along with public education efforts, “we need to get naloxone into more hands,” Edison said. Naloxone (brand name Narcan) is an easy-to-administer drug that can rapidly reverse the effects of an opioid overdose, preventing deaths.
Naloxone is available to anyone in Georgia without a prescription under a standing order from 2019, Public Health Commissioner Dr. Kathleen Toomey pointed out.
However, “angry consumers” have recently called the agency complaining about the high cost of the drug, said Toomey.
Naloxone prices at retail pharmacies can range from $47 to $161 in Georgia, according to drug price comparison website GoodRx.
Toomey said some of the $636 million coming to the state from an opioid lawsuit settlement with large pharmaceutical companies could help fund getting Naloxone “into the hands of individuals.”
Fentanyl test strips are another harm reduction measure that “have been shown to be effective in preventing overdoses and altering drug taking behaviors,” said Edison, the DPH epidemiologist. The test strips allow drug users and dealers to test their drugs for fentanyl.
A bill the General Assembly passed this year would remove Georgia’s legal prohibition on fentanyl test strips. That bill is awaiting Gov. Brian Kemp’s signature.
It’s not yet clear how the state will ensure the strips are widely distributed once the bill is signed. That could be another effort funded by the opioid lawsuit settlement funds, Edison said.
State Epidemiologist Dr. Cherie Drenzek updated the board about the mysterious cases of pediatric hepatitis first identified in previously healthy children in Alabama last fall and now being found across the country and the world.
Drenzek emphasized that though the cases of pediatric hepatitis are serious, they are also very rare.
So far, 109 children with the previously unknown form of hepatitis have been identified in the United States, including “several” in Georgia.
None of the children had been vaccinated for COVID, so the outbreak is not driven by the vaccine, as some have speculated. Nor are the cases related to COVID, according to a statement from the federal Centers for Disease Control and Prevention.
Drenzek said one hypothesis scientists are exploring is whether the hepatitis is caused by the common – and usually mild – adenovirus type 41. About half of the children with hepatitis tested positive for the adenovirus, said Drenzek.
“The CDC is casting a very wide net to try identify affected patients and ask very detailed questions about a number of potential exposures,” Drenzek said.
COVID numbers are also on the rise in Georgia, with about a 65% increase in reported cases over the last two weeks, Drenzek said. This is in line with national trends.
A new subvariant (BA.2.12.1) is “highly transmissible” and makes up around 40 percent of all circulating COVID-19 virus in the United States, Drenzek explained.
She emphasized that COVID numbers are “still at relatively low levels” compared to prior surges and described the current increase as “a slow, steady wave.”