Fentanyl derivative causing more overdose deaths

A variant of a popular drug is causing an increased number of overdose deaths in Cook County this year.

Forty-four overdose deaths so far this year can be attributed to ingestion of acrylfentanyl, one of dozens of derivatives of the powerful synthetic opioid fentanyl, the Cook County medical examiner's office reported. In all of 2016, acrylfentanyl was attributed to seven deaths in the county, according to the medical examiner's office.

The 44 deaths are among 141 the medical examiner's office has attributed to fentanyl and its derivatives so far in 2017. Last year, the medical examiner's office reported 562 of the opiate-related deaths in the county were due to ingesting fentanyl or one of its derivatives. That's more than half the 1,091 opiate-related overdose deaths that year.

The drug was determined to be the cause of music superstar Prince's death in 2016.

Fentanyl is a powerful drug used by physicians to treat severe pain. It is 50 to 100 times more potent than morphine, but health officials believe some derivatives of the fast-acting, short-lasting drug can be as much as 10,000 times more potent than morphine.

Dr. Steve Aks, emergency medicine physician and toxicologist at the Cook County Health & Hospitals System's Stroger Hospital, said fentanyl overdoses are harder to treat than many other opiate overdoses because they are more resistant to the opiate-overdose antidote naloxone.

"In many cases, one dose of naloxone, the heroin antidote, will revive a person who has overdosed on heroin," Aks said. "But we are seeing people in our emergency department who need increased doses of naloxone - in some cases as many as four doses - for the patient to be stabilized. The EMS and emergency medicine community needs to be aware of the potential need for additional naloxone in such cases."

While acrylfentanyl overdoses are increasing, other derivatives such as furanyl fentanyl and despropionyl fentanyl are more common killers, the medical examiner's office said.

Another fentanyl-related combination of drugs ominously called "gray death" because of its concrete-like appearance and strong potency is increasingly concerning local coroners as it is causing more deaths among illicit drug users in other states, according to many suburban coroners.

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