Pubdate: Wed, 16 Mar 2016
Source: Orange County Register, The (CA)
Copyright: 2016 The Orange County Register
Contact:  http://www.ocregister.com/
Details: http://www.mapinc.org/media/321
Author: Jenna Chandler

POTENT PROBLEM

A powerful drug often used to spike heroin and cocaine - sometimes 
unknown to users - has killed an estimated 700 people in the eastern 
United States in the past couple of years and has now swept into Orange County.

Acetyl fentanyl is cooked in underground labs, usually in Mexico, to 
emulate the prescription drug fentanyl - the most powerful opioid on 
the market. It provides an intense high and is cheap to make, so 
dealers add it to enhance their products, experts say.

Last year, for the first time in Orange County, four people died of 
overdoses on acetyl fentanyl. Other forms of fentanyl, including the 
pharmaceutical fentanyl, were detected in 26 other overdose deaths, 
bringing the number of fentanyl-related deaths to 30, the highest 
count since at least 2012.

Among those killed was a 19-year-old from south Orange County. He 
overdosed sitting on his sofa, with a white powder on his nose and 
mouth and a cellphone on his lap. An incoming text message asked if 
he was still looking for "blo," according to a coroner's report.

The teen had dabbled in cocaine and consumed alcohol, his family told 
investigators, but a lab test revealed the white powder was fentanyl, 
not cocaine.

"Up until last year, we would not have expected that," said Jennifer 
Harmon, assistant director of forensic chemistry at the Orange County 
Crime Laboratory. "Now we're seeing all sorts of drugs in all sorts 
of forms. It's kind of scary."

In September, the county crime lab enacted a new policy to test every 
drug that comes through its doors after determining it could no 
longer be certain that even prescription drugs were what they purported to be.

Fentanyl, which has been called China White, is so dangerous the 
Centers for Disease Control and Prevention and the Drug Enforcement 
Agency have in the past year issued alerts about it.

They blamed the illicit form, primarily acetyl fentanyl, on a surge 
of overdose deaths in New Jersey, Pennsylvania and Rhode Island, and 
described fentanyl as a threat to public health.

"Often laced in heroin, fentanyl and fentanyl variants produced in 
illicit clandestine labs are up to 100 times more powerful than 
morphine and 30 to 50 times more powerful than heroin," said DEA 
Administrator Michele Leonhart.

Acetyl fentanyl was identified in 2013, two years before authorities 
in Orange County spotted it. The first batch of acetyl fentanyl to 
come through the county crime lab weighed about 1 kilogram and looked 
a lot like cocaine, said forensic scientist Terry Baisz, who tested it.

"It looked really bad. We knew it did not look right," she said.

Countywide, the number of DUI cases involving fentanyl doubled to 20 
between 2014 and October 2015, and fentanyl possession increased from 
three cases in 2014 to 12 as of November, the crime lab reported.

People have been dying from variants of pharmaceutical fentanyl since 
not long after it was first introduced in the early 1960s.

A fentanyl epidemic that hit the West Coast in the late 1970s led to 
the deaths of more than 104 people in California over a two-year 
period. The first two overdose deaths were in Orange County, which 
had one of the highest per capita heroin-usage rates in the state. By 
the end of 1980, 15 people in the county had died.

"When it first started coming through, not just us, but lots of 
people didn't really know what it was ... it was quite a bit of a 
panic," said Jim White, a retired forensic scientist from Newport 
Beach who worked at the county crime lab from 1968 to 2002.

"When I started doing drug analysis, you could almost guess by 
looking at it what it was going to be. The drugs were pretty 
reliable. Then we started seeing things that weren't what they said 
they were," White said.

That change, he said, started with fentanyl.

Pharmaceutical fentanyl, which is commonly prescribed in the form of 
patches and lozenges, is abused too. In eight of 15 fentanyl 
overdoses last year in Orange County, people died while in possession 
of the prescription form of the drug, according to a Register review 
of coroner cases released under a Public Records Act request. All 
eight had documented histories of chronic pain, opioid abuse or 
dependence, or depression.

The popularity of drugs ebbs and flows. New drugs surface; old ones 
resurface. Cutting drugs, either to dilute them or to make them more 
potent, isn't novel either. But a fentanyl resurgence is alarming not 
only because of how strong and deadly it is, but because people don't 
always know what they're getting - especially when the drugs are 
produced in sketchy labs.

"In some cases you've got folks buying heroin who think they're just 
buying heroin; they don't know fentanyl has been added," said Michael 
Durfee, a drug historian and assistant professor of history at 
Niagara University. "They're more or less playing Russian roulette."
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