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Report Says US Fentanyl Deaths Exceed 1,000 in Two Years, but Report Incomplete

Jul 25, 2008 | Parker Waichman LLP

The Associated Press (AP) reports that over 1,000 people died in a two-year period due to an illegal version of the painkiller Fentanyl.  The information was derived from a government report providing the first national figures on the Fentanyl deaths.

The first cluster of Fentanyl overdoses appeared in 2005 in Chicago; by 2006, “clusters were identified in Philadelphia, Detroit, and other cities.”  Over time, hundreds of Fentanyl-related deaths were reported; this week’s tally from the Centers for Disease Control and Prevention (CDC) reports 1,013 deaths from early April 2005 through late March 2007.  "This was really an epidemic," said Dr. Steven Marcus, executive director of New Jersey's poison control center and a co-author of the new report.

Health officials say the increase in overdoses seems to have ended, in part due to law enforcement's shutdown of a Toluca, Mexico Fentanyl operation in May 2006, according to Dr. T. Stephen Jones, the study’s lead author.  But some deaths from illegal Fentanyl still occur.  "It almost disappeared entirely. The shutting down of the Toluca facility was probably a major factor," said Jones, a consultant retired from the CDC.  The new report is being published this week in a CDC's Morbidity and Mortality Weekly report.

Fentanyl is a prescription painkiller typically prescribed via a patch to cancer patients.  Because Fentanyl is also ‘a powerful, euphoria-inducing narcotic—30-50 times more potent than heroin—it is often used illegally for it’s street drug effects with heroin addicts possibly unaware that the deadly version of Fentanyl is included in their injections.  Illegal Fentanyl is “sold as a powder, often mixed with cocaine or heroin, and sometimes used as a heroin replacement.”  As far back as the 1980s there have been reports of isolated Fentanyl-related outbreaks involving deaths in addicts.  For instance, the famed “China White" outbreak is best noted for its severe, deadly reactions.  That outbreak involved users dropping “dead with needles still in their arms.”

In the more recent outbreak, which seems to have been initiated in Chicago, those patients who recovered from Fentanyl overdoses reported that they had received “free heroin in orange and pink plastic bags by new drug dealers trying to attract more customers.  The Chicago cases are summarized in the July issue of Clinical Toxicology.”

It was when an outbreak occurred in Camden, New Jersey in April 2006 that Marcus notified federal officials.  Marcus says the investigation was “unusual” because some health officials were reticent to devote resources on illicit drug fatalities.  "The response when I deal with public health officials is, 'Drug abuse is a dangerous habit, and drug abusers know it's a dangerous habit, so why are we making a big deal out of it?'" Marcus said.

Meanwhile, the report separates deaths by those due to illegally made Fentanyl and those due to illegal use of pharmaceutical Fentanyl.  Because Medical examiners cannot differentiate between the two, investigators used information from the scenes, among other information, to separate the two groups.  Also of note, the figures in this week’s report only cover New Jersey and Delaware and the “cities of Chicago, Detroit, Philadelphia, and St. Louis.”    "It's an incomplete picture," Jones said.


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