Part 2: Wasted Youth/New Killer
Holly Wainwright was puzzled when she picked up her son's death certificate at Town Hall and saw the cause of death.
She was told months earlier that her 23-year-old son, found dead in her bathroom, overdosed on heroin. But she saw something different on the death certificate.
“I went down to the police station,” Wainwright said. “I'm shaking like a leaf. I pointed to the death certificate and asked the officer, 'Can you explain something to me? What is this word?' ”
The word was “fentanyl,” a synthetic opiate painkiller 80 times more powerful than morphine.
Her son, Michael Sharpe, became one of a growing number of people overdosing on fentanyl in the area and across the country.
An examination of death certificates in 28 cities and towns by The Enterprise found 16 people overdosed on fentanyl from Aug. 31, 2006, to Aug. 31, 2007.
That is a sharp increase from the 13 who died in the previous 2 1/2 years in those communities, highlighting a troubling and deadly trend.
Fentanyl is typically used to treat people with severe pain, and is prescribed under the name Actiq, Duragesic and Sublimaze, according to the National Institute on Drug Abuse.
But the drug is now on the street, sometimes mixed with heroin or cocaine, sometimes sold as heroin to create what police call a “hot shot” that often kills.
The fentanyl threat is now so serious that the Drug Enforcement Administration in New England set up a special response team to help police if they see a rash of overdoses believed tied to the drug.
“Recognizing it is so dangerous, we have to move quickly,” said June W. Stansbury, special agent in charge of the Drug Enforcement Administration's New England field office.
But sometimes, if there is not a cluster of deaths, police — and families — don't know fentanyl was the cause until weeks or months later, after toxicology tests are completed.
In the meantime, addicts flock to the drug.
“They believe it to be a more potent form of heroin,” said Stansbury. “What we have come to learn is when there is fentanyl out there on the street, instead of avoiding it, they tend to want it more.”
Fentanyl was first created in Belgium in the late 1950s and used by doctors as an anesthetic in the 1960s. Fentanyl prescribed by doctors also can be administered by injection, a transdermal — or skin — patch, or lozenge.
The National Institute on Drug Abuse notes some of the fentanyl tied to overdoses in the United States was produced in clandestine laboratories, then mixed with heroin or substituted for heroin.
Nationally, there were 8,000 emergency room visits due to overdoses of fentanyl or fentanyl combined with another drug, in 2004.
Of the 16 fentanyl overdose deaths uncovered by The Enterprise, 10 of the victims had used fentany mixed with an opiate, such as heroin, oxycodone or methadone. Also, in six of the 16 cases, the drug had been mixed with some type of anti-depressant.
The death certificates did not detail how many of the deaths involved injection or chewing the skin patches.
The fentanyl deaths tied to heroin mixtures are often the result of minute errors by the dealers preparing the doses for street sale, experts say.
“The amount of fentanyl equivalent to the size of six grams of salt would be enough to kill,” said DEA special agent Anthony J. Pettigrew.
While fentanyl has been tied to some heroin-related deaths, there have not been any “significant” seizures of the drug by the DEA in the Northeast yet, compared with elsewhere in the country, Pettigrew said. Fentanyl time-release pain patches and lollipops for pediatric patients are also sold by dealers with tragic consequences.
Michael J. Welch Jr., 24, of Raynham died last year after, authorities believe, chewing a fentanyl patch to bypass the time-release safeguards. By chewing the patches, users are getting a potentially fatal three-doses of fentanyl in one shot. His mother, Debra Welch, said people aren't getting the message that abusing fentanyl can kill.
“It was easy for them to get it, and they were able to afford to get it,” she said. “They must have heard about how it was going to make them feel. They obviously haven't heard enough negative about the negative.”