An epidemic within an epidemic, the reach of fentanyl increases | Heroin epidemic

"The real killer is clearly synthetic opioids, and what we do know is that they are not only mixed with heroin, but also with cocaine, methamphetamine, and other drugs." said Joseph Coronato. "I call it the" synthetic storm. "I believe that in five years, most or all of the cases will involve synthetic products."

Fentanyl, which is 50 to 100 times more powerful than heroin and morphine, started making headlines and attracting attention several years ago when it became more prevalent on the scene of recreational drugs.

Less than six years ago, in 2012, fentanyl was included in only 42 overdose deaths. In 2016, one in three people who died of an overdose had, knowingly or not, taken fentanyl, according to the records.

Now, the state's preliminary reports show that fentanyl is on par with heroin as the leading drug in overdose deaths. About 676 people from New Jersey died of fentanyl in their systems from January to June 2017.

If this rate continued for the rest of the year, the total would be the largest number of deaths related to the presence of fentanyl that the state has ever recorded, even surpassing heroin.

The final data for 2017 is not yet available, but the State Attorney General's office recorded about 2,750 deaths in that year, up 24% from the previous year, said Lisa Coryell. According to experts, synthetic opioids have played a leading role in the rise.

What makes fentanyl more lethal than heroin, is its potency. One or more granules of opioid are enough to be deadly. Mr Coronato said that about 80% of people in Ocean County, who died of an overdose this year, were positive for synthetic opioid.

"Not all bodies are able to handle that," Coronato said. "Narcan can work at first, but disappears, when fentanyl lasts and can cause continued overdose, which is why people really need to go to the hospital."

They may not be able to stop people from taking substances containing fentanyl, but Babette Richter, an ARCH nurse at South Jersey AIDS Alliance in Atlantic City, said she could try to prevent more deaths.

New Jersey syringe access programs, including those led by the AIDS alliance, with advice and funding from the Department of Health, began providing clients with fentanyl test strips and an awareness in July.

The strips, which are used by other state and city health departments in California, Philadelphia and Columbus (Ohio), are commonly used to detect the presence of fentanyl in test-type tests. drug testing in the urine.

Public health experts reoriented strips to detect fentanyl in drug samples by asking people to mix water with drug residues and leave the strip in the water for five minutes.

If a line comes up, fentanyl is present and people should consider not using the medications, or take precautions and make sure that someone can deliver Narcan if necessary, said the officials. health.

"Some of our associates told us that they do not use these drugs if fentanyl was there, but a lot of things are going anyway," said Richter. "It's all about harm reduction. We are educating people that if they are going to use it, maybe they should only use part of it or use it slowly to wait and see what happens. "

According to the experts, some dependent people are deliberately looking for fentanyl and similar compounds like carfentanil because they do not have to buy as much to get the same price.

But mixing drugs for illegal sales is an imperfect science – the presence or the amount of fentanyl is often unknown, especially by the people who buy and use it.

It's hard to take synthetic opioids out of the streets, said Cape May County Attorney Jeffrey Sutherland. They are often already mixed with other substances and are difficult to detect when they arrive in the country.

"It's cheaper, easier to hide, easier to transport, easier to hide," he said.

Officials at the state attorney general's office earlier this year said massive amounts of fentanyl were being sold in New Jersey. Authorities seized 31 pounds of fentanyl – or 5 million lethal doses – from Camden in March, much of it sent by mail from China, they said.

"All we hear is that things are enlightening. Only one small pellet has been added, which makes things much more powerful, "said Coronato. "Because it is chemically prepared, it takes so little that it affects the whole lot, and it is absolutely deadly and it kills people."