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CDC: More alternative opioids identified in Knox County amid rising overdose cases

Officials said they have identified more cases involving para-fluorofentanyl and benzimidazole-opioids in overdose cases.

KNOXVILLE, Tenn. — Health leaders said drug overdose deaths across the U.S. increased by around 28% during 2020-2021 and around a third of those deaths involved opioids. In Knox County, they said they identified cases involving two alternative types of opioids.

The first is called para-fluorofentanyl, which was created as part of research efforts in the 1960s. It has since been called "China-white" according to a report from the Centers for Disease Control and Prevention and was classified as a Schedule I substance in 1986.

They said para-fluorofentanyl was found in heroin packets, counterfeit pills and has been found in autopsy findings. It was first found in East Tennessee in toxicology results from drug overdose victims in November 2020.

The second kind of alternative opioid is a class of them called 'benzimidazole opioids.' These kinds of drugs were discovered through research for new kinds of painkillers in the 1950s. Specifically, the CDC said it found metonitazene more often in the U.S.

It was first found in East Tennessee in January 2021, in combination with fentanyl and para-fluorofentanyl.

From November 2020 through August 2021, the Knox County Regional Forensic Center reported 770 accidental drug overdose deaths, according to the CDC. They said 562 of those cases involved fentanyl, and 192 of those cases did not involve other substances.

They also said 48 of those cases involved para-fluorofentanyl, while 26 involved metonitazene.

The CDC said while the opioid compounds were different, emergency treatments for the alternative kinds of opioids were the same. They said Naloxone could still be used to reverse overdoses involving these kinds of compounds, but said additional doses may be needed if alternative opioids are present.

"For these powerful synthetic drugs that are being laced, sometimes they have to do three, four, five doses," said Karen Pershing, the Metro Drug Coalition executive director.

She said the potency of synthetic drugs like metonitazene can be linked to more deaths in East Tennessee. 

"People wake up and because they are doing something illegal in many cases they're afraid to seek medical care so they'll refuse to be transported to the hospital," Pershing said. "You may think you're buying cocaine or heroin, but it's not pure. It's mixed and laced with these other very dangerous drugs."

She said anyone who needs help either stopping substance use or immediate emergency help in an overdose-related situation should call for help. Most medical professionals will not arrest users and most police look to arrest drug dealers, she said.

She also said the Metro Drug Coalition is preparing to open a new facility where they can better organize care for people in need. Jason Goodman is the director of recovery training, and he said he understands situations that users may face because he used illegal drugs for several years before stopping.

"They poured into my life, so what I'm doing every day, what I am doing here with MDC is trying to give back to somebody else," he said.

The MDC is establishing Knoxville’s first recovery community center — The Gateway. 

The MDC has secured grant funding to cover operations for the next 3 years and says it is exciting to share how well their recovery coaching model is working with participants so far.

Construction is underway at the new location, 530 West Fifth Ave in Knoxville. 

For more information, click here.