Fentanyl: The Drug That’s Ravaging Sacramento

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There’s a new opioid epidemic in town.

By Madeleine Thomas

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A fentanyl patch from Israel. (Photo: DanielTahar/Wikimedia Commons)

In just over three weeks, fentanyl, a synthetic opioid nearly 50 times more potent than heroin has caused more than 50 overdoses throughout Northern California.

Last week, authorities in Sacramento County confirmed two additional overdoses and another death, driving the number of overdoses up to 51 and the number of fatal overdoses to 11— in less than a month’s time. This comes a mere two days after authorities expressed optimism that the rash of overdoses sweeping local emergency rooms finally seemed to be slowing down. The drug isn’t just limited to Sacramento; fentanyl-related overdoses are escalating nationwide.

Fentanyl has been used pharmaceutically since the late 1960s to treat chronic pain associated with cancer. When abused, the opioid also functions as a popular heroin substitute. And it can be mixed with heroin, cocaine, or prescription pills. Fentanyl is cheap and extremely strong, as much as 50 to 100 times more powerful than morphine, according to the Drug Enforcement Administration. It’s also deadly: A dose equivalent to just a few grains of salt can be lethal.

A rash of fentanyl-related overdoses first hit Sacramento County toward the end of March. Within 48 hours, local emergency rooms reported at least a dozen overdoses, linked mostly to counterfeit prescription pills or to street Norco tablets laced with the opioid. Within a week, there had been 35 more overdoses, according to the Los Angeles Times. The Sacramento County coroner is currently waiting for the results from toxicology reports to confirm whether two other fatal overdoses were fentanyl-related as well.

“Users are often unaware that they are using fentanyl and, therefore, ignorant to the severe risks they face.”

Given the high number of overdoses, lawmakers aren’t dragging their feet on the epidemic. A bill making its way through the California Senate would add fentanyl to a list of drugs including heroin and cocaine, and would impose harsher penalties on anyone convicted of a drug commerce crime involving fentanyl, with the potential to add time to a prison sentence.

“Particularly troubling is the fact that users are often unaware that they are using fentanyl and, therefore, ignorant to the severe risks they face,” states a California Senate Committee Public Safety report on the drug. “Fentanyl is inexpensive to produce, making it a go-to heroin substitute for the drug cartels.”

The bill, SB-1323, was approved unanimously by the Senate’s Public Safety Committee, and will face another vote before the Appropriations Committee next week.

“Across the country, we have seen a huge spike in overdoses and deaths attributed to fentanyl,” said Republican Senator Bob Huff, who co-introduced the bill with Senator Patricia Bates. “At least 28,000 people died of opioid overdoses in 2014. Of those, fentanyl was involved in 5,554 fatalities, a 79 percent increase from 2013.”

The DEA had publicly doubted fentanyl’s ability to gain considerable popularity among opioid abusers due to its short high (compared to heroin) and its high mortality rate. Yet overdoses continue to rise throughout the nation. Last year, the DEA finally declared fentanyl a nationwide threat to public health and safety. Between 2013 and 2014, the National Forensic Laboratory Information System reported 3,344 fentanyl submissions, a rise from 942 the year prior.

“[T]he true number is most likely higher because many coroners’ offices and state crime laboratories do not test for fentanyl or its analogs unless given a specific reason to do so,” a 2015 DEA National Heroin Threat Assessment Summary report states. “Most of the areas affected by the fentanyl overdoses are in the eastern United States, where white powder heroin is used, because fentanyl is most commonly mixed with white powder heroin or is sold disguised as white powder heroin.”

To be sure, California is not alone in its struggles against fentanyl. Some 25 states experienced increases in fentanyl overdoses between 2013 and 2014, according to the DEA’s threat assessment report. Law enforcement seizures of fentanyl also increased by 300 percent during that time period, particularly throughout the South, Northeast, and Midwest portions of the U.S. In Ohio, for example, there were 514 fatal overdoses tied to fentanyl in 2014, compared to 92 the year prior. In Maryland, there were 185 fatal overdoses in 2014, and just 58 in 2013. Florida saw 397 fatal overdoses in 2014, a rise from 185 in 2013. And in New Jersey, there were 80 fentanyl-related deaths within the first six months of the state’s fiscal year alone, according to the DEA.

Fentanyl has actually swept the U.S. before. Roughly 1,000 people died from fentanyl-related causes between 2005 and 2007, according to the DEA, mostly throughout the eastern and midwestern U.S.—places like Chicago, Philadelphia, and Detroit. The majority of those overdoses were eventually traced back to a fentanyl lab in Toluca, Mexico, which was seized by Mexican law enforcement in 2006. Today, authorities believe most clandestine fentanyl is produced in China and sent to Mexico, where it is then trafficked into the U.S.

“We have not formally declared a public-health emergency, but we are treating it with great vigilance as we would in any emergency,” says Laura McCasland, communication and media officer for Sacramento County Health and Human Services. She says this is the first time she has seen fentanyl-related overdoses in the region since she started her job more than a decade ago.

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