Suspected fentanyl overdoses: Death toll rises to 9

The death toll from suspected overdoses of a powerful painkiller on the streets of the Sacramento, Calif., region rose to nine Friday as officials raced to find the source of illicit drugs.

Authorities said a total of 36 people have overdosed from what authorities believe is the powerful opiate fentanyl. Just one of those deaths was outside the county, in adjacent Yolo County, said Laura McCasland of the Sacramento County Department of Health and Human Services. All those deaths have been in the last two weeks.

Experts say the rise of fentanyl is fueled by widespread prescription drug abuse that claims thousands of lives each year. Since 1999, more than 165,000 people in the U.S. have died of causes related to painkiller use.

Once centered on the East Coast, use of the drug now seems to be spreading west, probably through Mexican drug cartels, medical and law enforcement officials said.

“This is just another face of the opioid epidemic,” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness.

Over the last week and a half, health workers in Sacramento reported dozens of overdoses and several deaths from fentanyl. The painkiller offers an intense, euphoric high and is sometimes used to cut heroin and cocaine or passed off as another drug.

The pills resembled Norco, a prescription painkiller similar to Vicodin and Percocet. But lab tests didn’t find Norco’s active ingredients and the tablets were likely fentanyl pills manufactured to resemble Norco, McCasland said.

One official said the street price of the pills was no more than $5.

A few grains of the odorless, white powder, often called China White or Apache, can be enough to kill.

Prescribed to cancer patients for decades, fentanyl is the most powerful painkiller available for medical treatment, up to 100 times stronger than morphine. It’s typically administered as a lozenge, patch or injection to patients with severe pain.

In recent years, an illegally manufactured version of the drug has begun spreading, with cases concentrated in the eastern half of the United States.

Between 2012 and 2014, the number of seizures of illegally used fentanyl nationwide increased more than sevenfold to 4,585, according to federal officials.

Sgt. Salvador Robles of the Sacramento County sheriff’s major narcotics impact division said investigators have a “strong lead” on a Sacramento County home where two of the overdoses occurred and are hoping to trace the cases back to the source of the fentanyl.

Robles said he didn’t know whether this was a single bad batch, or a larger problem.

“My only tip is, if you’re addicted to Norco or any pills, do not take them right now,” he said.

An increase in doctor-prescribed painkillers over the last decade has left many patients addicted to opiates, intensifying a heroin epidemic that is ravaging many towns nationwide, experts said.

In 2014, 28,647 people died of overdose deaths from opioids, including heroin, the highest toll ever recorded, according to the U.S. Centers for Disease Control and Prevention.

In Sacramento County, heroin use has increased within the last decade as use of methamphetamines has dropped, Robles said. Fifteen years ago, seizing a few ounces of heroin in Sacramento County was rare, he said, but “now we’re finding it in (kilos).”

Approximately 700 people died from fentanyl and its analogs nationwide between late 2013 and late 2014, according to a recent report from the DEA.

Past investigations have revealed that Mexican cartels are purchasing fentanyl produced in China then using traditional trafficking routes to bring it into the United States. In 2014, DEA officers seized 26 pounds of fentanyl in a stash house in Los Angeles.

Alexander, the Johns Hopkins physician, said that demand will remain strong until the prescription drug epidemic is under control. He said doctors should limit how often they prescribe opiates to patients and expand treatment programs for those who are already addicted.

“Do we need to be worried about it? Yes,” Alexander said. “But I don’t think . these deaths can be separated from the surge in overuse of prescription opioid. It’s part and parcel of the same problem.”

In remarks Tuesday at a conference on drug abuse, President Barack Obama said more Americans now die each year from opioid overdose than in traffic accidents. He has asked for more than $1 billion in federal funding to help expand access to treatment programs.

Earlier this month, officials from the CDC released new guidelines strongly discouraging doctors from prescribing opiates, including OxyContin and Vicodin, for patients with chronic conditions such as back problems, migraines and arthritis.

“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” wrote CDC Director Dr. Tom Frieden and a colleague in the New England Journal of Medicine.