By LEW K. COHN, Inquirer Publisher
The Gonzales County Sheriff’s Office has responded to two separate incidents in the past five days in which deceased bodies were found and fentanyl was present at the scene, Sheriff Keith Schmidt said Thursday.
The incidents took place in various locations around the southern end of Gonzales County, and in each case a man in his 30s was pronounced dead by a Gonzales County justice of the peace after the victim was found unresponsive. Both incidents are being investigated as possible drug overdoses, Schmidt said.
“Fentanyl is a controlled substance with a high risk of addiction and dependency,” Schmidt’s office said in a statement. “It can cause shortness of breath and death when taken in high doses or combined with other substances, especially alcohol or other illicit drugs like heroin or cocaine.
“Some drug dealers mix fentanyl with other drugs like heroin, cocaine, methamphetamine and MDMA. This is because it takes very little to induce a high with fentanyl, making it a cheaper option. This is especially risky when people taking medication are unaware that they may contain fentanyl, a cheap but dangerous additive. They may be taking stronger opioids than their bodies are used to and are more likely to overdose.”
This is a growing problem not only in Gonzales County but elsewhere in the United States. Synthetic opioids, including fentanyl, are now the most common drugs implicated in drug overdose deaths in the United States. In 2017, fentanyl was implicated in 59.8 percent of opioid-related deaths, compared to 14.3 percent in 2010, according to the National Institute for Health’s National Institute on Drug Abuse.
According to the Centers for Disease Control and Prevention (CDC), overdose deaths with synthetic opioids other than methadone, which include fentanyl and fentanyl analogs, increased more than 16 percent from 2018 to 2019. Synthetic opioid overdose deaths were nearly 12 times higher in 2019 than in 2013, and in 2020 opioids accounted for nearly three-quarters of the more than 93,000 fatal drug overdoses in the United States.
Pharmaceutical-grade fentanyl, a synthetic opioid, was first developed in 1959 and introduced as an intravenous anesthetic in the 1960s. Fentanyl has been approved by the US Food and Drug Administration for use as an analgesic (pain relief) and anesthetic, particularly for cancer patients.
It can be given as an injection by a doctor or nurse in a hospital or clinic, or prescribed in the form of a transdermal patch or lozenge. Fentanyl is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic and is a Schedule II narcotic under the U.S. Controlled Substances Act of 1970.
Like heroin, morphine, and other opioid drugs, fentanyl works by attaching to the body’s opioid receptors, which are located in areas of the brain that control pain and emotions. After taking opioids multiple times, the brain adapts to the drug, reducing its sensitivity and making it difficult to enjoy anything other than the drug.
The effects of fentanyl include relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.
Overdose can cause drowsiness, changes in pupil size, cold and clammy skin, cyanosis, coma, and respiratory failure resulting in death. The presence of a triad of symptoms such as coma, pinpoint pupils, and respiratory depression strongly suggests opioid intoxication.
Naloxone, or Narcan, is a drug that can treat a fentanyl overdose if given right away. It works by quickly binding to opioid receptors and blocking the effects of opioid medications. But fentanyl is stronger than other opioids like morphine and may require multiple doses of naloxone.
While fentanyl is legally manufactured and distributed in the United States, some pharmaceutical products are siphoned off through theft, fraudulent prescriptions, or illegal distribution by and among patients, physicians, and pharmacists.
Fentanyl is also manufactured illegally, with much of the production taking place in Mexico using chemicals from China. It’s sold illegally as a powder, put on blotting paper, put in eye drops and nasal sprays, or made into pills that look like other prescription opioids, like hydrocodone or Tylenol with codeine #3. It can also be mixed with or look like benzodiazepines like alprazolam (Xanax) or Diazepam (Valium) or even ADHD medications like Adderall.
She is known by street names like Apace, China Girl, China Town, China White, Dance Fever, Goodfellas, Great Bear, He-Man, Poison and Tango & Cash.
The US Department of Criminal Justice states that criminal drug networks sell these pills through social media, e-commerce, the dark web, and existing distribution networks. As a result, these fake pills are rampant and deadlier than ever. DEA lab tests show that four out of ten counterfeit pills laced with fentanyl today contain a potentially lethal dose. In addition, the number of counterfeit pills containing fentanyl has increased by almost 430 percent since 2019.
From August to September 2021, Drug Enforcement Agency agents, working with federal, state and local law enforcement partners, seized 1.8 million counterfeit fentanyl-laced pills and arrested 810 drug traffickers in urban, suburban and rural communities across the United States. The quantity of deadly fentanyl-laced counterfeit pills seized by the DEA during this period “is enough to kill more than 700,000 Americans,” the DEA said. That was on top of the more than 9.5 million potentially fatal counterfeit pills the DEA seized in 2020, more than the previous two years combined.
During this time, DEA also seized 712 kilograms of fentanyl powder: enough to manufacture tens of millions of deadly pills. The DEA seized 158 guns and many of the enforcement actions involve violence and overdose deaths. In addition, the DEA seized 4,011 kilograms of methamphetamine and 653 kilograms of cocaine.
Stopping the illicit fentanyl trade is also dangerous for law enforcement, Schmidt’s department said.
“Fentanyl poses a significant threat to law enforcement personnel and other first responders who may come into contact through routine law enforcement, emergency, or life-saving activities,” the statement said. “Fentanyl can be taken by mouth, inhaled through the nose or mouth, or absorbed through the skin or eyes. Exposure to a very small amount can result in significant health complications, respiratory depression, or death.”
Fentanyl can be detected in pills and powders using fentanyl test strips, but it is illegal to purchase them for use in the state of Texas as they are considered drug paraphernalia under the Texas Controlled Substances Act. In the last session, a bill was introduced to eliminate criminal penalties for possession of test strips, which made it past the committee but never saw the light of day in either house of the Texas legislature.
This article includes information from the DEA, NIH, CDC, and other government agencies.