Breaking the grip of fentanyl
Greg Dolysnki is on the road to recovery. He has been in a methadone and recovery program for two months.
There is no sensation like it. The wave of euphoria. The warmth that crawls out from your core into your fingers and toes. The calm sense that everything is right.
“You feel like all your problems have just melted away. You don’t have a problem in the world,” says Greg Dolynski of St. Catharines, a recovering opioid user. “At least that is what it’s like while you are on it.”
The artificial bliss created by opioids is ephemeral. The descent back to reality is a plunge into a personal hell.
Withdrawal comes quickly and without mercy, says Dolynski. Your body shakes and sweats. Fatigue is crippling, but you can’t sleep. The violent diarrhea is only matched by the force of the uncontrollable vomiting.
“It feels like you are dying,” says Dolynski. “That’s why you can’t just quit. You can’t just go cold turkey because the withdrawal symptoms are so bad.”
It’s how the drug takes control of a user. He doesn’t just crave the hot rapture of the opioid high, his body needs it. Without the drug, the addict’s body goes into a debilitating free-fall.
Dolynski, 29, says that is why kicking opioids is so challenging. It’s not just a matter of will. If the withdrawal symptoms are not managed, an addict will never cross the Rubicon to recovery.
“It’s why I am taking methadone,” says Dolynski, now on his second month taking the drug which prevents the withdrawal symptoms but doesn’t produce an opioid high. “It’s been great so far. I’m working. I can manage what I have to manage.”
Dolynski tried to break his dependance on opioids before on his own, but it didn’t work. The withdrawal was too much to manage, he says, and he wasn’t ready to quit.
“You have to want to recover for the right reasons. If you don’t, you won’t make it. If you do, then you can.”
For Dolynski, the reality of the local illicit opioid market provided all the motivation he needed.
That reality is fentanyl, a frighteningly powerful opioid that has infected nearly every level of the illegal drug market. Cheap and easily accessible, it is being cut into an entire spectrum of drugs that includes cocaine and heroin.
Fentanyl is 80 to 100 times more powerful than morphine. It has been found to be fatal, depending on the health of a user and whatever else they may have taken, in a dose as small as five nanograms per 100 millitres of blood. (A nanogram is a billionth of a gram.)
Some users take fentanyl directly, injecting it like heroin. Others will chew or suck on fentanyl patches originally created as pain medication. Still others will mix fentanyl with another opioid such as morphine or heroin into a powerful “hot shot” to provide a devastating high.
Like all opioids, an overdose can cause severe respiratory problems to a point where the user will stop breathing.
Dolynski knows first hand what the drug can do.
“Things are bad,” he says. “I’ve used naloxone three times on friends who overdosed. Fentanyl is everywhere.”
He also knows what it feels like to take fentanyl. Like many opioid users, he took it by accident.
“I thought it was heroin but as soon as it hit me I knew it was something else,” Dolysnki says. “It was fentanyl.”
The high came on faster than it did from other drugs and was vastly more visceral.
The impact was well beyond the sensation of taking Percoset, the first opioid he used. Mild compared to fentanyl, it still provided enough of that euphoric high that Dolysnki started taking more.
In time, however, Percoset wasn’t enough.
“I developed a tolerance for it,” he says. “I wasn’t getting that same kind of high anymore. So I started taking oxycontin. The only time I would take a Percoset after that was if I couldn’t get oxy, and that was just to keep me from going through withdrawal.”
Oxycodone, in turn, stopped having the punch it once did. Dolysnki graduated to heroin.
His world became consumed by opioid use. He took it because he wanted to. He took it because he needed to.
Fentanyl, however, was a game-changer.
The powerful drug is used as “filler” to extend a dealer’s drug supply, or is simply sold as something else. It is not uncommon for a batch of heroin to actually be pure fentanyl. Users can no longer reliably know the drug they pump into their veins is what they think it is.
That inconsistency can exist even within a single purchase of heroin, says NRP Det. Sgt. Todd Waselovich.
“You might get a batch of heroin, for example, and the first bit a person takes is just heroin. But if it is has been cut with fentanyl and the mix is uneven, maybe the next hit is mostly fentanyl and their body cannot handle it and it causes an overdose.”
Fentanyl’s invasion of street drugs hasn’t gone unnoticed by users. At the harm-reduction program Streetworks in St. Catharines, requests for kits of naloxone — the drug that acts as an antidote to an opioid overdose — has risen sharply. The number of opioid overdoses reported by police in Niagara, as with police across Ontario and the rest of the country, is also rising. Hospital emergency rooms, including at Niagara Health System, have seen a steady increase in the number of drug overdoses.
Dolysnki said users are well aware of the potential risk of an overdose, but are so hopelessly dependent on opioids, they roll the dice anyway.
In the span of a few months, Dolynski had to use naloxone to save three friends from overdoses. Given the pervasiveness of fentanyl, it was only a matter of time before he took some without knowing about it.
Dolynski didn’t want someone to save his life with naloxone. He didn’t want an accidental overdose to be his end. Rolling the dice with his life wasn’t an option anymore.
That’s the thing about addiction recovery, Dolynski says. The user has to want to do it for themselves. If they do it for the approval of other people, he says, they are bound to fail.
Two months ago, Dolynski started a methadone program and began his road to recovery. He attends counselling regularly and lives with some supportive friends who understand his past and want to help him build a future.
“I just want what anyone wants. To live my life. Go to work. Normal things,” he says. “I know it is not easy. I cannot say I won’t ever have a bad day or a relapse. But I know what I want for my life now.”