Pubdate: Mon, 26 Jun 2006
Source: Star-Ledger (Newark, NJ)
Copyright: 2006 Newark Morning Ledger Co
Contact:  http://www.nj.com/starledger/
Details: http://www.mapinc.org/media/424
Author: Amy Ellis Nutt
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)

AN ULTRA-LETHAL DRUG SPREADS THROUGH JERSEY

Authorities Alarmed As The Toll Of Fentanyl-Laced Heroin Soars

Drug dealing in Camden, where daily life is a brutal business, rarely 
registers a yawn. But the drug that killed three young men and 
hospitalized 42 others in South Jersey last weekend has shattered the 
usual indifference.

The killer cocktail: heroin laced with fentanyl, a synthetic opiate 
that is 80 to 100 times more potent than morphine.

Ten and $20 bags of the substance are easy to come by on the streets 
of North Camden. Dealers market the high-octane heroin under names 
such as "Flatline," "Knockout" and "Get High or Die." And the 
advertising is proving all too genuine, with hundreds of deaths 
reported across the country since 2005.

While the South Jersey-Philadelphia region has recorded 70 
fentanyl-related fatalities in the past year, there is evidence the 
epidemic has slowly snaked its way along New Jersey's coast since 
January. From Camden to Ocean to Monmouth to Middlesex to Bergen to 
Hudson and finally to Passaic, victims of fentanyl-adulterated heroin 
(and occasionally cocaine) have ended up in county morgues.

"What a lot of people don't know is that 125 micrograms -- that's 
about four grains of salt -- is enough to create an overdose effect," 
said Jerry Daley, director of a Camden-Philadelphia drug trafficking 
program, operated out of the White House's Office of National Drug 
Control Policy. "And (when mixed into heroin or cocaine) it's not 
readily visible to the eye, taste or smell."

While fentanyl has been legally used for decades in anesthesia and 
pain management (New Brunswick's Johnson & Johnson patented the 
Duragesic transdermal patch 16 years ago), the fentanyl found in the 
tainted heroin, say drug and law enforcement officials, is 
manufactured illegally.

A Rapid Death

The narcotic is a quick killer that users can smoke, snort or inject.

Earlier this year, a victim was found in a fast-food restaurant in 
St. Louis, the syringe still in his arm. In Michigan, a dozen people 
in one room were found passed out, overdosed on fentanyl-tainted heroin.

And last Sunday, at Camden County's Riviera Motor Inn, the body of 
30-year-old James MacDonald was found in a standing position inside 
his motel room, bent over at the waist and leaning against the door. 
A bag filled with powder labeled "Chemistry" was discovered nearby.

"With an overdose of fentanyl -- and it doesn't take much -- you just 
stop breathing," said Steve Marcus, executive director of the New 
Jersey Poison Information and Education System. "It also has a funny 
habit of tightening the muscles in the chest so you can't breathe -- 
like drowning. It's not a nice high. Either you pass out, you get 
muscle contractions in your chest, or you die."

Tim Ogden, an agent in the U.S. Drug Enforcement Administration, last 
week told a gathering of officials from a dozen states, including New 
Jersey, that the problem of fentanyl abuse has not yet been 
adequately addressed.

"In my almost 30 years of law enforcement experience, I haven't seen 
a threat that concerns me this much," he said.

Menace Spreads

Sporadic, but localized, clusters of fentanyl-related deaths have 
been reported since the late 1970s. What alarms law enforcement and 
public health experts now is that the tainted heroin seems to be 
spreading all across the country.

In Detroit, 33 people died in just one week in May. In Cook County, 
Chicago, 55 have died since the beginning of the year. Delaware, 
Maryland, Missouri, Ohio, Pennsylvania -- all have confirmed 
fentanyl-related deaths.

With more than 250 victims nationwide, even the Centers for Disease 
Control and Prevention is now investigating what it calls an 
"outbreak." In late May, when a team was sent to Detroit to gather 
information, Bernadette Burden, a CDC spokeswoman, told reporters, 
"This is new territory for CDC investigators."

A Lack Of Interest

Public awareness of the problem, however, is practically nonexistent.

"It struck me as amazing, the lack of interest," said Marcus, who 
also is a professor of Preventive Medicine and Community Health at 
UMDNJ. "In general, people out there have an attitude of, well, drug 
addicts know what they're doing is dangerous ... but there are people 
out there dying who shouldn't be."

Compounding the problem, says Marcus, is the difficulty in getting 
accurate statistics. For example, medical examiners in Chicago and 
Detroit began testing for minute levels of fentanyl (hard to detect 
through standard toxicology tests), only when the deaths started mounting.

"There is nobody, to my knowledge, putting this together, either in 
the state or in the nation," said Marcus. "And we're not exactly 
being proactive in New Jersey."

That may be changing. On Tuesday, officials from Philadelphia and 
Camden County, the U.S. Drug Enforcement Agency, the FBI and 
Philadelphia's behavioral health department agreed to coordinate 
their investigations into fentanyl-related deaths.

North Jersey, however, is just starting to take notice.

"A doctor in the ER at University Hospital told me two weeks ago that 
he saw eight drug overdoses in just one weekend," Marcus said. "He 
couldn't be sure that it was the tainted heroin, but it was an 
unusually large number of overdoses that had to be treated with an antidote."

Newark health officials were alarmed enough to call a meeting about 
fentanyl earlier this month with representatives from law 
enforcement, emergency medicine and substance abuse programs.

Seeking The Source

The source of the drug continues to baffle experts.

Since 2000, five illicit fentanyl labs have been taken, four of them 
in California and one in suburban Newton Square, Pennsylvania, 
according to the National Drug Intelligence Center.

Last week, agents from the DEA and the Chicago Police Department 
arrested 29 alleged members of a street gang suspected of trafficking 
fentanyl-laced heroin.

In May, agents from the Mexican Federal Investigative Agency and the 
Organized Crime Division of the Mexican Attorney General's Office 
raided a lab in Toluca, Mexico. U.S. officials believe it was a main 
source of the fentanyl-laced heroin that found its way to the streets 
of Camden, Chicago and Detroit.

As to whether that lab was the source of the lethal drugs that 
hospitalized dozens and killed three in Camden County last weekend, 
Daley demurs.

"To my knowledge there is no way of confirming, right now, that the 
product on the street is related to Toluca, but it's believed some 
had already been shipped out before the lab was broken up."

The symptoms of overdose survivors provide a clue.

"There are similarities between them -- respiratory distress, 
seizures and then they pass out," said Bill Shralow, spokesman for 
the Camden County prosecutor's office. "We have heroin overdoses once 
or twice a week here, but when you have dozens in just a couple of 
days and three deaths, it looks more and more like what we saw a few 
months ago."

In response to the rash of overdoses, Camden police on Monday 
arrested 39 people trying to buy heroin in the city. Twenty-four 
hours later, 51 more were arrested, caught in the exact same location.

"Remarkably, even the most recent heroin-related fatalities have not 
stopped people from coming to Camden to buy drugs," said acting 
Camden County Prosecutor James P. Lynch.

Several of the residents at the Riviera Motor Inn, just a few miles 
from Camden City, admit that there is a steady stream of users and 
dealers in the area.

Maintenance man Hector Flores, who found the body, knew MacDonald 
only in passing. "He seemed like an ordinary guy, a nice guy" said 
Flores. "I felt bad. I mean, he was somebody's dad, somebody's 
brother. ... It was a wasted life."
- ---
MAP posted-by: Beth Wehrman