Fentanyl overdoses cause troubling rise in suburban opioid deaths

A drug described as “heroin on steroids” is contributing to a rise in opioid overdose deaths across the suburbs, authorities say.

Fentanyl, an easily abused painkiller even stronger than heroin, factored heavily into an increase in opioid-related deaths in suburban Cook, DuPage, Kane and Will counties, coroners say.

The story appears the same in Lake and McHenry counties, where cases pending toxicology tests are likely to put 2016 death totals over previous records from 2015.

The increasing prevalence of fentanyl in the systems of overdose patients - on its own or combined with heroin or other drugs - has health officials and anti-drug advocates renewing their call to fight the opioid problem from all fronts.

  Chelsea Laliberte, executive director of opioid-fighting Live4Lali, called news of an increase in fentanyl deaths is "extremely disheartening." Mark Welsh/ February 2016

“It's extremely disheartening,” said Chelsea Laliberte, founder of the anti-heroin nonprofit Live4Lali in Arlington Heights. “There's always something more we can do.”

Kane County Coroner Rob Russell, who describes fentanyl as “heroin on steroids,” agrees. He called his county's 14 confirmed fentanyl overdose deaths in 2016 a “huge number” and said the drug has advocacy groups worried “because it's so much more powerful and can take more lives.”

Kane County Coroner Rob Russell says the "huge number" of fentanyl overdose deaths in the county last year is concerning because the drug is so potent, stronger even than heroin.

Fentanyl use was “sporadic” among overdose cases in Will County in the past, Coroner Patrick O'Neil said, but the drug became prevalent last year.

In 2015, there were five fentanyl deaths, and five more involving fentanyl and heroin. Last year, those numbers rose to 17 from fentanyl and 18 from fentanyl and heroin, all part of a record 76 deaths from heroin or similar drugs, O'Neil said.

DuPage County saw a similar phenomenon, Coroner Richard Jorgensen said. Heroin deaths in 2015 and 2016 stayed consistent at 36. But in 2016, there were 26 deaths from a combination of fentanyl and heroin - up from seven the previous year - and 16 deaths from fentanyl alone - double the previous year's total of eight.

Fentanyl also comes in patches and is typically administered to people in chronic pain, including end-stage cancer patients. It is also used as an anesthetic. Associated Press File Photo

Fentanyl long has been a legitimate medication used in hospitals after surgeries and sometimes prescribed in patch form for chronic pain patients to take at home, Jorgensen and McHenry County Coroner Anne Majewski said. The drug is not plant-based like heroin, which comes from the opium poppy, but chemically created in laboratories by pharmaceutical companies.

The troubling twist is fentanyl - and similar synthetic drugs that mimic its effects - are being created in illicit labs in other countries and smuggled into the U.S. to be peddled to people looking to get high, Jorgensen says. The drug can be powdered and mixed into heroin, which users often inject.

The Drug Enforcement Administration in Chicago says the fentanyl hitting the streets here largely is produced in China.

Special Agent James Jones said dealers involved with Mexican drug rings often keep their clients in the dark as to what they're buying.

“In order to make their drugs more potent or more marketable, some dealers are choosing to cut fentanyl in with their heroin,” Jones said, “or they will sell heroin as fentanyl.”

The more potent painkiller produces a stronger high, attracting users whose addictions have been raging for months or years, said Dr. Adam Rubinstein, president of Opioid Addiction Recovery Services in Vernon Hills and medical director for the nonprofit groups Live4Lali and Hope Over Addiction.

“People who are already addicted to heroin are often looking for a better mechanism to re-create the initial high they felt when they were first using,” Rubinstein said. “They find things that are more potent in a chase for the initial high, and fentanyl is the next step.”

These users often underestimate the increased potency of fentanyl and take too much, he said, quickly slipping into an overdose that can cause them to stop breathing.

First responders in Illinois now are required to carry naloxone, an overdose reversal drug that blocks the receptors in the brain stimulated by opioids and allows users to breathe again. The drug has saved hundreds in the area, especially in DuPage and Lake counties, which were early adopters of programs to put the antidote in police officers' hands.

But with overdoses from fentanyl, Rubinstein said some patients need as many as eight doses to be revived.

“Police and firefighters need to be carrying more naloxone than they normally do,” Laliberte said.

She said addicts and their families need to admit their risk for overdose and carry naloxone as well, now that it is available without a prescription in some pharmacies, thanks to state and federal laws Live4Lali's advocacy helped pass. Communities also need to prioritize drug prevention and education, harm reduction and medication-assisted treatment for addicts, support for the families of addicts, and true admission that opioids are a problem - here and now.

“Denial is the most powerful drug,” she said.

By reporting increased fentanyl deaths as the latest evolution in the opioid issue, O'Neil said coroners hope to garner the attention of lawmakers who can lead the fight. Majewski in McHenry County said she also hopes to call out doctors who are prescribing fentanyl for, say, chronic back pain and challenge them to reserve it for the uses she said it originally had - treatment of severe post-surgical pain and end-of-life pain management for cancer patients.

“It's just a horrible thing,” Jorgensen said about fentanyl and its synthetic counterparts. “We need to educate people that these really strong drugs are out there.”

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