Cincinnati’s emergency rooms were flooded with an estimated 174 drug overdoses and three deaths in the span of six days in an outbreak that has health and law enforcement officials baffled.
Health officials called the sudden spike in overdoses unprecedented, a crisis they have never seen before in a that city typically sees about four overdoses a day.
But Cincinnati wasn’t alone in seeing a spike of overdoses last week. Rural Jennings County in Indiana also received attention after reports of a dozen overdoses in the span of a few hours on Aug. 23 flooded in, according to local news reports.
Police quickly found that the Indiana culprit appeared to be heroin boosted with the synthetic opioid fentanyl. The synthetic opioid and a similar product called carfentanil are believed to be the cause of the Cincinnati outbreak as well.
Cincinnati and Jennings County are just some of the localities that are experiencing dramatic spikes in overdoses linked to fentanyl, which is as much as 100 times stronger than morphine and is believed to be the cause of music icon Prince’s overdose death in April.
From 2013-14, the number of drug products seized by law enforcement that tested positive for fentanyl increased by 426 percent in 27 states, according to a CDC study. Law enforcement seized 1,015 products in 2013 and 5,343 in 2014.
Synthetic opioid deaths jumped by 79 percent, from 3,105 in 2013 to 5,544 in 2014 in the 27 states.
Overall, opioids including prescription painkillers and heroin killed more than 28,000 people in 2014, the highest amount recorded.
The spikes have caught the attention of lawmakers, who last month passed comprehensive legislation to tackle opioid abuse.
Fentanyl is a synthetic opioid that isn’t made from opium like other drugs such as Oxycontin. It is prescribed for treating severe pain and can be distributed through transdermal patches or lozenges.
However, most of the recent cases of fentanyl overdoses stem from illegally made fentanyl, which is manufactured overseas and then cut with heroin or cocaine, according to the Centers for Disease Control and Prevention.
Sometimes the addition of fentanyl is made without the drug user’s knowledge in a move to boost the high, the CDC said.
“If you are a drug dealer and you want to make your product more competitive, mixing fentanyl into it makes it stronger,” said opioid addiction expert Andrew Kolodny, chief medical officer for the treatment clinic system Phoenix House.
Kolodny said the people who are overdosing on heroin or fentanyl are overwhelmingly already addicted to opioids.
“The issue isn’t that a lot of people out there are taking fentanyl or heroin,” he said. “If you really want to address this crisis, the appropriate responses to this problem are preventing new cases of opioid addiction, and that boils down to more cautious prescribing.”
President Obama signed the Comprehensive Addiction Recovery Act into law in July. The bill aims to expand access to treatment resources and distribute more doses of the overdose antidote naloxone to first responders, among other measures.
But lawmakers are starting to realize that CARA isn’t enough.
Sen. Rob Portman, R-Ohio, who sponsored CARA, said Wednesday he plans to introduce legislation when the Senate reconvenes next week to address fentanyl shipments from overseas. The legislation aims to give the U.S. Postal Service more tools to find and flag suspicious packages for customs officials.
Common Adverse Reactions Associated With Fentanyl HealthGrove
