Cocaine with fentanyl crack: a new deadly threat

Wednesday, October 31, 2018 (HealthDay News) – Fentanyl, a potent and dangerous synthetic opioid, is now appearing in crack cocaine and leading to life-threatening overdoses.

During a recent four-day period, a Philadelphia hospital treated 18 patients for an apparent overdose of opioids while they were smoking only crack, researchers said.

"None of them had the intention of using opioids or fentanyl, but their drug testing as well as their clinical presentation demonstrated that they had been exposed to very high doses of fentanyl, "said Dr. Utsha Khatri, lead author of the study. She is a resident in emergency medicine at the University of Pennsylvania Hospital.

Khatri and his colleagues reported that three of the patients died of their overdose in November 1st. New England Journal of Medicine.

Fentanyl is becoming more prevalent in drugs seized by law enforcement, said Emily Feinstein, executive vice president of the Center on Addiction in New York.

Among these illegal drugs include heroin and cocaine, as well as methamphetamine, ketamine and counterfeit drugs, Feinstein said.

Fentanyl is 50 to 100 times more potent than heroin, and a quantity equivalent to the size of a grain of rice can kill you, she said.

"Fentanyl is so cheap and drug cartels have great access to it.It is an extremely effective filling agent because it creates a strong addiction.So it does not kill them, people get an intense, addictive reaction, "said Feinstein. "It's not expensive, it has a strong forte and it makes people come back for more."

According to the US National Institute on Drug Abuse, the number of cocaine-related deaths in combination with synthetic opioids has increased 23-fold. This represented 4,184 deaths in 2016.

"We are really in a fentanyl epidemic right now," said Feinstein. "The overdose mortality rates are really caused by fentanyl."

At Khatri Hospital, the 18 patients all arrived with signs suggestive of opioid intoxication: lethargy, precise pupils and dangerous slowdown of their breathing.

Doctors administered naloxone, an OD drug, to 17 patients, who required higher doses than usually required to cure an opioid overdose.

Urine tests performed on 16 patients showed that they had used cocaine and 15 patients also had confirmed exposure to fentanyl at concentrations corresponding to severe poisoning, said the authors of the study. ;study.

Khatri urged hospital emergency departments to keep quick test strips for fentanyl on hand so that doctors can respond quickly to unintentional fentanyl overdoses.

Fentanyl has made its way into powdered and powdered cocaine, Feinstein said.

The New York City Department of Health has launched a campaign to protect young adults partying in bars and occasionally using cocaine, Feinstein said.

Bartenders are trained to administer naloxone and signs hang bathrooms that warn people not to consume cocaine alone, she said.

"It's a naïve opioid population that consumes cocaine for recreational purposes and does not realize how widespread fentanyl is," Feinstein said.

Feinstein pointed out how fast fentanyl can kill.

"In case of overdose, the time to death is much shorter than that of heroin.You talk in minutes, instead of hours," she said. "You have a much shorter window in which your life can be saved."

More information

The US National Institute on Drug Abuse says more about fentanyl.