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PHILADELPHIA (AP) – The first time Nicki Saccomanno used fentanyl, she overdosed.
It was 2016, and the 38-year-old from Kensington had not known that the drugs had been cut with the deadly synthetic opioid. She's just remembers injecting herself with a bag, and then waking up surrounded by paramedics frantically trying to revive her.
Saccomanno, who has been addicted to heroin for 10 years, was shaken. But, before long, there was barely anything else to take away from the intense pain of withdrawal. Every corner, it seemed, was selling it. Saccomanno and other longtime heroin users
For younger users, like the twentysomethings who live in the camps off Lehigh Avenue, fentanyl is all they ever known. Like others before them, many of the painkillers to illicit opioids in the last few years – when they turned to their addictions, they were buying a drug much more powerful than their older counterparts had started on.
Young and old are paying for it with their lives. Fentanyl was present in 84 percent of Philadelphia's 1,217 fatal overdoses last year, and 67 percent of the state's 5,456 overdose deaths in 2017, according to a wide-ranging report of the opioid crisis in Pennsylvania released by the US Drug Enforcement Administration.
The report shows how, over the years, the opioid crisis ballooned over an overdose crisis – how fentanyl contaminated the state 's heroin supply, overwhelmed county morgues with overdose victims, and shocked advocates, people in addiction, and law – enforcement officials alike with its sudden ubiquity.
But to all of them, the explosion of fentanyl makes a kind of terrible sense: Fentanyl is significantly cheaper to produce than heroin. It draws a significantly larger profit. It's definitely more powerful and more addictive than heroin, even Kensington's supply, which has long been known in the country.
These days, Saccomanno uses a combination of heroin and fentanyl, even though she hates it.
"You get sicker," she said. "You need to get more fentanyl more often. It makes you feel better and harder. But you can not find anything else. "
'A dramatic shift'
Pure economics.
That's what law-enforcement officials say is driving the rise of fentanyl in Pennsylvania.
"It's a serious drug, like that in cancer patients," said Pat Trainor, spokesman for the Philadelphia branch of the DEA. But it turned out to be unusual and would disappear from the scene again.
"Two or three years ago, we really saw a pretty dramatic shift," Trainor said. "It was very easy to get rid of in the low-quality heroin, and it's really shifted now that it's pretty much largely unchanged."
In Philadelphia, he said, a kilogram of heroin, or 2.2 pounds, sells for $ 50,000 to $ 80,000, and a drug trafficker can make about $ 500,000 in profit off it. A kilogram of fentanyl sells for $ 53,000 to $ 55,000, is 50 to 100 times stronger, and can turn a profit of up to $ 5 million.
"For a lot of drug-trafficking organizations, it's that simple," said Trainor.
Most of the fentanyl that ends up in Pennsylvania is manufactured in China and smuggled through Mexican drug-trafficking organizations in the United States along the same routes, according to the DEA report.
People have also tried to make it closer to home, however. Unlike heroin, which is derived from opium poppies, fentanyl and its analogues can be produced in a lab. Earlier this year, DEA agents raided what they thought was a methamphetamine lab in western Pennsylvania. To their surprise, it turned out that the room's occupant had been trying to make fentanyl.
Seeking out fentanyl
Earlier this year, researchers from the Philadelphia Department of Public Health, conducting a survey of opioid users at Kensington's needle exchange, posed a question to 400 people in active addiction.
They knew that they were most likely to be loved by people, and wanted to know how to be addicted. And so they asked drug users what they would do if they knew that they were buying drugs.
The answers they received shocked them. Of the drug users the Health Department surveyed, 45 percent told that they were not trying to avoid fentanyl at all – they would be more likely to use a bag of fentanyl.
"There was more acceptance – it had become part of the community. "Kendra Viner, manager of the department's Opioid Surveillance Program." "And people between 25 and 34 years old were significantly more likely to say they would seek out fentanyl."
A woman who identifies herself as "Shy," has long been a user along Kensington Avenue, said to be willing to test her fentanyl, but often resigns herself to the fact that she is not going anywhere else.
In interviews on Kensington Avenue, the drug users said they felt they did not have much choice: Even though fentanyl was more dangerous, they said, their tolerance for opioids has become so high that it is not enough to stave off withdrawal.
"Before, people were scared of fentanyl, people would not do it – but now my body is hooked on it," said Kia, a 23-year-old interviewer at the Emerald Street encampment last week. "If I wake up and do not do heroin cut with fentanyl, I'm still sick."
Physicians and addiction researchers have been advocating for some time for the treatment of people who are addicted to drugs. Viner said more research on fentanyl in Kensington who uses the neighborhood's needle exchange. It's harder to track the clothes and preferences of the hundreds of people who are flying under the radar, coming to the neighborhood just to score.
Still, the DEA wrote in its report, the findings in Philadelphia – echoed by treatment providers and people in addiction across the state – are deeply alarming. They're a sign that they're driving the market – not the other way around.
William, a Bensalem man who came to Kensington earlier this week for fentanyl, said he felt a little more killing his friends and loved ones.
"Withdrawal – imagine the worst flu you've ever had," he said – then increase that bread by 10. "And you know that that one thing you hate – the thing that makes you feel this way – is the only thing that will make you feel better. "
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Online:
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Information from: The Philadelphia Inquirer, http://www.inquirer.com
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