- Dozens in Sacramento suffer overdoses of drug believed to be fentanyl
- Opioid up 50 times stronger than heroin is potentially lethal in small doses
Thursday 31 March 2016 14.00 BST
Last modified on Thursday 31 March 2016 20.04 BST
Seven people have died in Sacramento, California, from what authorities think may be overdoses from counterfeit prescription painkillers containing the powerful opiate fentanyl.
It is the first time that fentanyl, a growing problem on the east coast and in Canada, has surfaced in northern California, according to DEA special agent Casey Rettig.
Related: Fentanyl: drug 50 times more potent than heroin ravages New Hampshire
Opioid abuse has burgeoned into an epidemic in the United States, with Barack Obama this week announcing a new initiative to combat it, after last month promising $1.1bn to the effort. At a recent drug summit, he pointed out that more Americans die each year from opioid abuse than car accidents.
Dr Olivia Kasirye, the county health officer, said that some of the Sacramento overdoses –among the seven that have been fatal and nearly two dozen others that have not – have been linked to a white oblong pill marked M367 on one side, resembling a generic version of the name-brand drugs Vicodin, Lortab and Norco, which contain hydrocodone. But the counterfeits showing up in Sacramento may actually be made of pure fentanyl.
Fentanyl can be 25-50 times more potent than heroin and 50-100 times stronger than morphine, Rettig said, making a small amount potentially lethal.
Kasirye said that some of those who overdosed reportedly took only one to two pills, which had been purchased from strangers or obtained from family or friends.
“I’ve never seen anything like this,” Kasirye said.
The cases began surfacing on 24 March, and within days had grown from five potential overdoses to double-digit cases with patients admitted to three local hospitals and more being reported directly by the coroner’s office.
“It happens very quickly,” Kasirye said of the overdoses. “People would start feeling dizzy after a few minutes and within 20 minutes were collapsing.”
The Sacramento coroner has not yet released causes of death or confirmed what caused the overdoses.
Fentanyl’s potency is one of the reasons it is increasingly attractive to smugglers, who can make a larger profit with smaller quantities, Rettig said.
While a kilo of heroin can be purchased for about $5,000 and sold for about $80,000, according to Rettig, a kilo of fentanyl costs only about $3,300 and has a street value of “over a million in revenue”.
Authorities said they believe laboratories in China may be producing counterfeit fentanyl and shipping it into Mexico, where it is packaged and smuggled across the border.
With a growth in opioid abuse, physicians in California and other states are being asked to take more caution when prescribing, including checking a recently upgraded state database that tracks prescriptions to ensure patients are not holding multiple scripts.
But the unintended consequence of that restriction may mean that some addicts who had been obtaining the pills legally are now having to buy them illegally.
“For some of them, what they were saying is that they are not able to get it from their doctor any more,” Kasirye said about the Sacramento cases. “Many of them were actually functional, had homes, had children, had families … They’re not the typical picture you hear of what an addict is.”
Rettig said that “unfortunately it’s likely” that more cases may be reported.