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Heroin mix tied to dozens of deaths

May 5, 2006

Unusually potent heroin laced with a powerful painkiller has killed more than two-dozen people and sent more than 300 to hospitals across the eastern USA during the past three weeks, local and federal officials say.

Federal agents from the Drug Enforcement Administration have joined police in cities from the East Coast to Chicago in scrambling to find the source of the deadly concoction. It surfaced in Chicago on April 13 and has been linked to 11 deaths there since then, police spokeswoman Monique Bond says. Chicago paramedics treated 144 overdoses from April 13 to April 27, says Donald Walsh, assistant deputy fire commissioner for emergency medical services.

Just as Chicago officials began reporting a surge in heroin-related deaths and overdoses, authorities in Camden, N.J.; Wilmington, Del.; Salisbury, Md.; Harrisburg, Pa.; and several other communities did, too.

Chicago: Eleven deaths since April 19; 144 overdoses reported April 13-27; 24 overdoses reported on April 19, including 15 people who were found unconscious in a park on the South Side.
Camden, N.J.: Seven deaths since April 14; 51 overdoses reported at Cooper University Hospital April 20-28; in southern New Jersey, 75 overdoses reported since mid-April.
LaSalle County, Ill.: One death April 28 linked to heroin pending toxicology tests.
Harrisburg, Pa.: Two deaths, about 36 overdoses reported in the area since mid-April.
Philadelphia: One death, eight overdoses reported since April 22.
Rockford, Ill.: Two deaths, nearly a dozen overdoses reported since April 19.
Salisbury, Md.: One death, eight overdoses reported since April 20.
Delaware: Five deaths, 18 overdoses during the past month.

Source: USA TODAY research

Use of fentanyl unusual

The culprit in many of the cases appears to be heroin mixed with fentanyl, a potent form of synthetic morphine that is used to treat extreme pain. Veterinarians use one formulation of it to immobilize large animals. The mixing of such a powerful, costly drug with heroin for street sales is very unusual, says Mary Cooper, chief of congressional and public affairs for the DEA.

Heroin sold illegally in the USA typically is diluted, or "cut," with common household substances such as sugar, flour, quinine or starch. Such fillers help drug traffickers boost profits.

The recent deaths and overdoses have dramatically illustrated addicts' vulnerability to distributors who mix illegal drugs, as well as the broad reach of the drug rings that move heroin from Mexico and Colombia to cities across the USA, Cooper says. She notes that a distributor with 1 kilogram of heroin about 2.2 pounds can produce 25,000 doses that typically sell on the street for $10 each.

"It can go everywhere and anywhere," she says.

Less than 1% of the U.S. population used heroin in 2004, according to the National Survey on Drug Use and Health. Heroin accounts for about 8% of drug-related emergency room visits, according to the Drug Abuse Warning Network, which collects data from hospitals for the U.S. government.

Heroin generally is diluted by midlevel distributors in the USA, says Douglas Collier, a senior agent for the DEA's New Jersey division. Distributors may dilute a kilogram of heroin once or twice before packaging it for street-level dealers, he says, and a local dealer may cut it again before packing it into individual doses.

Dealers are careful not to dilute the heroin too much for fear of losing sales, Collier says. "Customers will go where the purity is."

It's unclear why dealers might have mixed fentanyl with heroin. Cooper says it might have been part of a marketing ploy to create a powerful batch of heroin that would attract addicts.

In Chicago last week, police got a hint of many addicts' desperation when officers began passing out handbills in communities where overdoses had occurred. The handbills were intended to steer addicts away from those locations. Instead, scores of addicts showed up, looking for a dose of the ultra-powerful mix, Bond says. "We were basically providing free advertising for the dealers."

Addicts 'dropping like flies'

Among the areas hit by the recent wave of heroin-related death and overdoses:

Camden has had seven deaths since April 14, an usual surge in a city that had 40 heroin-related deaths in all of 2005.

"The local hospitals have been getting a steady stream of people, well above the norm," says Bill Shralow, spokesman for the Camden County Prosecutor's Office. "Some samples have had fentanyl. We're continuing to investigate."

Doctors at Cooper University Hospital have been treating about nine overdoses a day, says spokeswoman Linda Michael. From April 20 to April 28, they tallied 51 cases.

Steven Marcus, executive director of the New Jersey Poison Information and Education System, says state officials counted 75 non-fatal overdoses from April 13 to April 27, far above normal.

"Our addicts are dropping like flies," he says. "This shows how dangerous this stuff is."

In the Harrisburg area, there have been two deaths and about three dozen non-fatal overdoses, city spokesman Randy King says. In a 24-hour period beginning April 18, the city had 10 overdoses.

The city put out an alert that day, King says. "We told people you're playing Russian roulette with your life if you use this stuff. It made no difference."

Harrisburg usually has no more than one heroin overdose a month, King says.

In Rockford, Ill., a city of 151,000 people 80 miles west of Chicago, two people died of heroin overdoses last month, and nearly a dozen people had non-fatal overdoses, says Dominic Iasparro, deputy chief of detectives for Rockford police. Authorities are awaiting toxicology results to see whether the heroin contains fentanyl, but they have noticed a spike in overdoses, he says.

Delaware has had five deaths and 18 non-fatal overdoses in the last month, says Delaware State Police Sgt. Melissa Zebley.

Nearby, one person has died and eight others have overdosed in the Salisbury, Md., area since April 20 on what was believed to be fentanyl-laced heroin or straight fentanyl, says Judith Sensenbrenner of the Wicomico County Health Department.

"Certainly we have heroin use here," she says, "but we don't tend to see that number of overdoses."