To Camelia Valdes, heroin is frustrating.
It’s a threat she’s seen tear apart countless lives in Passaic County, where she serves as prosecutor, while she tries to communicate a grave health threat to an at times apathetic public.
But if heroin is frustrating, fentanyl is downright frightening.
“Thankfully we’ve only seen it pop up a few times around Paterson so far,” Valdes told NJ.com. “Because once that gets out there, it’s a whole new ballgame.”
Fentanyl is a powerful opioid—up to 50 times more powerful than heroin—that is prescribed to people with chronic pain, such as end-stage cancer patients. It is colorless and odorless, making it nearly impossible for the average person to detect. Increasingly, it’s appearing on New Jersey streets, cut with or substituted for heroin, leading to the death of dozens of unsuspecting users each year.
It’s a silent threat, one that’s difficult to detect but law enforcement says lies in wait. With heroin usage in New Jersey at levels not seen for years, there’s a market for drugs like fentanyl, according to the Ocean County Prosecutor’s office.
“Fentanyl is a tremendous concern to me,” said Joseph Coronato, the Ocean County Prosecutor. “It’s so powerful, but when you’re addicted you’re chasing the rabbit. They‘ll say ’wow, this is tremendous stuff, I’ve got to get it.' It becomes like a marketing tool.”
When fentanyl does significantly enter an opioid market, the results can be devastating. From 2005 to 2007, fentanyl was blamed in scores of deaths in New Jersey and more than 1,000 nationwide.
But experts say today, due to funding cuts and poor information exchange, New Jersey is currently only equipped to react to such an outbreak after the damage is done.
“There’s currently nothing in place in New Jersey that mandates the reporting of drug overdoses,” said Steven Marcus, medical director of the New Jersey Poison Information and Education Center, who investigated the 2005 fentanyl outbreak.
Compounding the issue, Coronato said that users don’t often know that their heroin has been cut with or substituted with fentanyl until it’s too late.
“It’s pure poison,” he said. “Addicts, they say that’s powerful stuff, that’s what I need. They think they can manage it, but this is something they really can’t.”
Coronato saw this firsthand more than once in 2014. In February, nine people died or were hospitalized after heroin laced with fentanyl, unbeknownst to the user, appeared on Ocean County streets on envelope folds marked “Bud Light.”
In July, an 18-year-old Stafford man was found dead of a drug overdose. Investigators found several wax folds stamped “Hello Kitty” near his body containing a white powdery substance. It turned out to be nearly entirely fentanyl.
In neighboring Monmouth County, at least three people died from fentanyl-toxicity this past fall, according to county law enforcement records.
“It’s extremely powerful and it’s difficult to control when you’re administering it. Unfortunately if a person is naïve to the opioid it can be very dangerous,” said Marcus. “We had one case where a woman was prescribed a patch for fentanyl. It appeared she rubbed the patch or scratched it in a way that changed how it was being distributed to her body and she died. So it can be very dangerous.”
Incomplete Data
According to state records, which experts say are likely incomplete, fentanyl contributed to the deaths of 49 people in 2013, the most recent data available, up from 31 in 2011.
Marcus said tracking drug’s prevalence in the Garden State is difficult, because there is currently no mandated, uniform system of tracking drug overdoses.
“There really is no good, real time, data on drug overdoses in the state. When someone wants to know the number of overdoses from any drug, the best that can be given is available after a waiting period by the medical examiner, the health department, maybe,” he said.
A bill currently sitting in committee in the New Jersey state Senate and Assembly seeks to change that and provide funding to Marcus’ office, but it remains to be seen if it will be warmly received.
Fentanyl, in its pharmaceutical form, is often administered by injection, intravenous drip, or provided to patients as a lollipop or a transdermal patch. It is expensive and, in its purest form, is generally only prescribed to patients in the most extreme of cases or as an anesthetic.
But fentanyl, or an analogue of it known as acetylfentanyl, can also be made fairly easily and, because of its potency, can be sold in very small quantities.
“One gram of pure fentanyl can be cut into approximately 7,000 doses for street sale,” the Center for Disease Control said in a 2008 report.
“Manufacture of (fentanyl) requires minimal technical knowledge, and recipes for making (fentanyl) are available on the Internet.”
From 2005 to 2007, fentanyl primarily manufactured in a rogue laboratory in Mexico contributed to the death of more than 1,000 people around the country, including at least 178 in New Jersey.
“There was a case where it was not being made by a major pharmaceutical company,” Marcus said. “It’s extremely powerful and it’s difficult to control when you’re administering it. Unfortunately if a person is naïve to the opioid it can be very dangerous.”
From The Associated Press
