Rapper Bull the Bastard, who became famous in High School Rapper 2, was sentenced to four years in prison for taking illegal drugs this February. He appeared on the KBS documentary Prescribing Drugs in December 2021 and appealed to the public about the risks of the drug fentanyl. In response, the Sungkyun Times (SKT) will introduce the dangers of the narcotic painkiller fentanyl, the current drug abuse severity, and measures to prevent its spread in Korea.
Introduction to Fentanyl
-What Is Fentanyl?
Fentanyl is a synthetic laboratory-made opioid that is approved by the Food and Drug Administration (FDA) of America for use as an anesthetic and analgesic (pain relief). Fentanyl was first developed in 1959 by Dr. Paul Janssen, founder of Janssen Pharmaceuticals, and was approved for medical use in 1968. It was initially used as an intravenous anesthetic called Sublimaze and was the most powerful painkiller ever discovered. Fentanyl was released as a cloned drug after Janssen’s patent expired in 1981 and became available to any pharmaceutical company. Fentanyl doses can be taken through injection, sprays, oral medications, and patches - the most widely used method. Unlike pills or injections, fentanyl patches can be easily prescribed by a doctor. By applying the patch to the skin, fentanyl passes to the body and lasts up to 72 hours after application.
-Two Faces of Fentanyl
Fentanyl is originally a pain reliever that acts on the central nervous system to suppress pain transmission, leading to analgesic effects. Because of its quick absorption, its effect comes 100 times faster than morphine and heroin. Thus, fentanyl is used for terminal cancer patients, amputation patients, and analgesic injections for mothers during childbirth. People who take fentanyl and are not in extreme pain can experience pleasure and exaltation from the drug. However, side effects after the ecstasy can be severe, resulting in symptoms such as extreme constipation, vomiting, and hypoxia (lack of oxygen in tissues). Moreover, there are many cases of fentanyl addicts whose teeth have melted from stomach acids due to repeated vomiting. Also, when fentanyl is repeatedly taken, hypoxia destroys the brain and corrupts the signals that transmit around the body – causing the muscles and joints to move arbitrarily like Huntington’s disease. Unfortunately, while a lethal dosage of heroin for an average male is 30mg, fentanyl is just 3mg, proving how deadly the drug can be.
What Is the Fentanyl Situation in Korea?
-Medical Loophole
The most serious issue regarding the fentanyl problem in Korea is that non-patients can easily, and legally obtain the drug from hospitals. In fact, according to a report submitted by the Ministry of Food and Drug Safety to Assemblyman Kang Ki-yoon, the number of prescriptions for fentanyl increased from 891,434 in 2018 to 1,488,325 in 2020, which is a 67% increase over three years. Yang Myung-jae, a specialist at Open St. Mary Hospital, said, “I heard from my colleagues that teenagers who ask for fentanyl prescription are becoming more common these days.” The underlying cause behind hospitals becoming fentanyl suppliers is due to doctors’ inconsiderate prescriptions. The problem is that there are doctors who prescribe fentanyl patches irresponsibly without an accurate diagnosis and proper explanations regarding the risks. To illustrate, in 2021, a producer at KBS visited a hospital introduced by fentanyl addicts to acquire the drug as part of an investigative program. There, it was shown that the doctor immediately prescribed fentanyl without any concerns or doubt. In addition, narcotic painkillers such as fentanyl are non-subsidized psychotropic drugs; therefore it is difficult for doctors to take legal responsibility if they wrongly prescribe them. This current situation creates a blind spot in fentanyl’s circulation management.
-Youths in Fentanyl’s Deadly Hands
In addition to the problem that fentanyl can be easily obtained, adolescents are also exposed to fentanyl. According to the National Police Agency and the medical community on September 22nd, the number of fentanyl patches prescribed to teenagers jumped more than 28 times from 2019 to 2020. This can be assumed as a consequence of the lack of effective education regarding the dangers of drug abuse. The School Health Act mandated Education on the Prevention of Drugs, but the curriculum is left to the school’s autonomy with an insufficient explanation regarding drug abuse. As a result, this leaves students not being aware of the gravity of the problem. For instance, on May 21st, several teenagers were arrested for illegally selling and abusing fentanyl patches. In a police investigation, they stated that they were not aware that fentanyl patches were highly addictive drugs and merely thought of them as a medication that made them “feel good.” In addition, the illegal distribution of fentanyl patches online is also a problem. Today, anyone can easily access drug promotion posts by searching the slang words for drugs on social media and various websites. As such, adolescents are easily accessing the narcotic painkiller due to a lack of education on their dangers, along with the help of illegal distribution networks.
Stop Fentanyl!
-Renovation of the Current System
The government should prepare effective measures to prevent fentanyl patches from being easily prescribed by doctors. First of all, doctors must prescribe the drug more cautiously to prevent it from being misprescribed. One solution is to manage the distribution process of all fentanyl patches by giving a unique identification number for each patch during production. As a result, the identification number on the patches allows them to be tracked and enables identifying the hospital that prescribed the investigated illegal fentanyl. Medics would then be more considerate in prescribing fentanyl, as the police can immediately identify which hospital prescribed the drug. Fentanyl prescriptions are currently available at various hospitals, such as plastic surgery clinics and orthopedics, making management and tracking more difficult. In addition, fentanyl patches that are being illegally distributed are mostly prescribed in small hospitals rather than general hospitals. Therefore, these patches must be first prescribed at a general hospital and only then be allowed to be given at private hospitals. It could also be a practical solution to ensure prescribing of fentanyl mainly in larger health facilities where multiple doctors reside, to prevent overprescription.
-Be Aware of the Danger
The risks and side effects of fentanyl abuse should be further publicized. Effective education that specifically describes fentanyl and informs the risk of its abuse is crucial. Drug education must be generally manualized under the supervision of the government so that a unified form of education is applied in all schools. Currently, drug prevention education only requires mandatory education hours without a unified format. According to an interview with a high school teacher, the Ministry of Education is currently reinforcing drug prevention manuals with the provincial offices, but reinforcement measures, especially for real-time educational sites, are in great need. In addition, measures are needed to prevent the illegal distribution of drugs through the Internet. The Internet Drug Transaction Monitoring System implemented by the government was established in 2015 but made no actual improvement as it could not detect transactions on social media and the Dark Web. Therefore, it is essential to update the network and structure diagram of the monitoring system, and the budget that has been maintained at 18 to 30 million won should be increased. In particular, it is necessary to further enhance punishment to prevent online drug deals and enforce police drug detection.
South Korea, which has so far been referred to as a drug-free country, is on the brink of being consumed by fentanyl. Teenagers, the future of Korea, are being exposed to the risks of drug addiction due to irresponsible prescriptions and a flawed system. In the future, institutional measures and educational changes are required to reinforce the awareness of fentanyl’s danger and prevent such careless prescriptions.