Since 2015, more than 100 people in Cook County, Illinois — eight from the Northwest suburbs — have died from illegal fentanyl overdoses. Fentanyl drug varieties are up to 100 times more potent than heroin, and 80 times more potent than morphine. The CDC describes Fentanyl as a rapid-acting opioid (synthetic opiate) drug that alleviates pain without causing loss of consciousness (analgesic). Fentanyl depresses central nervous system (CNS) and respiratory function. Exposure to fentanyl may be fatal — usually from respiratory arrest. If the respiratory arrest doesn’t kill the victim, it might cause irreversible brain damage.
Many police departments now carry Narcan (naloxone) as an antidote to opiates that may cause a miracle reversal of symptoms for heroin. However, Fentanyl overdoses may require several administrations of the Narcan antidote. Police use a nasal spray effective for heroin, but an effective antidote for Fentanyl may require intravenous administration by paramedics or emergency room staff. Paramedics carry a version of Narcan that can be administered intravenously.
Fentanyl is sometimes sold on the black market in the form of transdermal fentanyl patches such as Duragesic, diverted from legitimate medical supplies. The patches are cut up and eaten, or the gel from inside the patch smoked.
Another illegal form of fentanyl on the streets is the Actiq fentanyl lollipops, which are sold under the street name of “percopop”. The pharmacy retail price ranges from US$15 to US$50 per unit (based on strength of lozenge), with the black market cost anywhere from US$20 to US$80 per unit, depending on the strength. Legally, the lollipops are used by military medics in combat trauma, such as IED blast injuries.
Fentanyl has also been detected in illegally-produced and distributed Oxycontin tablets.
Heroin dealers are known to mix fentanyl powder with heroin to increase potency or compensate for low-quality heroin. In 2006, illegally manufactured, non-pharmaceutical fentanyl mixed with cocaine or heroin caused an outbreak of overdose deaths in Chicago, Illinois; Dayton, Ohio; Detroit, Michigan; and Philadelphia, Pennsylvania.
Public health authorities became focused on the fentanyl overdose outbreak in September 2015 when the Cook County Health and Hospital System’s John H. Stroger Jr. Hospital treated nine people with overdoses in one day.
The Cook County medical examiner’s office reported 124 deaths from fentanyl, or a combination of fentanyl and another drug such as cocaine or heroin, since January 1, 2015. Two people died in Mount Prospect, and deaths have been reported in Elgin, Elk Grove Village, Inverness, Palatine, Hoffman Estates, and Schaumburg. About eight years ago a male bodybuilder that worked out at Xsport Fitness North died from “Oxycontin” overdose. He did not die at the gym, but shortly before he died, he claimed at the gym to know more about mixing anabolic steroids and painkillers than doctors.
Fentanyl is also a concern for its potential use as a chemical agent in terrorism, as it can be released as an aerosol, can contaminate water, and can contaminate food or agricultural products.
In October 2002 (The 2002 Nord-Ost siege), the Russian military possibly used “a fentanyl derivative” in a chemical cocktail mix to incapacitate Chechens terrorists holding hostages in the Moscow Dubrovka Theater. About 130 of the hostages died succumbing to the aerosol or gas pumped in by the Russian Spetsnaz. Physicians in Moscow criticized the Russian government’s failure to disclose the nature of the agent that was used to incapacitate the terrorists. There are reports that naloxone was used to successfully treat some hostages.
See also …
New Scientist Mystery of Russian gas deepens
CDC/NIOSH Emergency Response Car FENTANYL: Incapacitating Agent
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