Ocean County Fentanyl-Related Deaths on Rise Fourth Straight Year

By GINA G. SCALA | Dec 06, 2017

When Superstorm Sandy struck, Ocean County proved it could weather a storm and come back stronger. But can the county combat the rising number of fentanyl-related deaths with as much resilience? For Joseph Coronato, county prosecutor, there is only one answer: yes – but he acknowledges there are challenges.

“There are more than 40 different types of fentanyl. It’s why I call it the synthetic storm,” he said recently, noting the painkiller is over 100 times more powerful than morphine, and over 50 percent more potent than heroin. “Combating it is challenging.”

Drug-sniffing K-9 officers can’t be used to track the drug because of its potency, Coronato said, noting they would overdose and die. Even police officers are at risk of overdosing if they absorb it through their skin.

“It’s that deadly,” he said, noting adding it to heroin makes the drug much more powerful, and much more deadly. The demand for it is high because fentanyl holds the opiate in a person’s system longer than pure heroin, he said. Doctors prescribe it to cancer patients because it gets buried into the muscle and bones, relieving pain longer. “When cancer patients use it, they use gloves to protect themselves.”

Addicts like the drug because they aren’t shooting up as often, Coronato said, and drug dealers are eager to make it because it improves their bottom line.

“It’s cheaper to cut with heroin. If it costs $40,000 or $50,000 to make heroin, it’s only about $2,000 to cut it with fentanyl,” he said. “Drug dealers are all about the money. There is always someone else to replace a dead body.”

Fentanyl can be injected, snorted or sniffed, smoked, taken orally by pill or tablet, and spiked onto blotter paper. Fentanyl patches are abused by removing their gel contents and then injecting or ingesting, according to the Drug Enforcement Administration’s fact sheet on the drug. Patches have also been frozen, cut into pieces, and placed under the tongue or in the cheek cavity. Illicitly produced fentanyl is sold alone or in combination with heroin and other substances and has been identified in counterfeit pills, mimicking pharmaceutical drugs such as oxycodone, according to the DEA.

“Reports on fentanyl (both pharmaceutical and clandestinely produced) increased from nearly 5,400 in 2014 to over 14,600 in 2015, as reported by federal, state, and local forensic laboratories in the United States,” according to the National Forensic Laboratory Information System.

Its effect on the body, like that of other commonly used opioids, is relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction and respiratory depression.

“Addicts have this misconception opiates prevent them from being sick,” Coronato said, noting it takes a body just five days to become acclimated to the effects of fentanyl. When the effects wear off, most people go through the normal withdrawal symptoms, making them sick.

By the Numbers

When Coronato was appointed by Gov. Christie to head the Ocean County Prosecutor’s Office in January 2013, “My first week, there were eight overdose deaths in Ocean County of young people ranging from 28 to 18 years old. I knew the problem was growing: In 2012, there were 56 individuals who had died from opioid drug overdoses; there were 56 by the summer of 2013. And by the end of the year, there were 112 people who died.”

In 2014, 10 percent of the overdose deaths in the county had fentanyl in their system, he said. That figure jumped to 35 percent in 2015, 60 percent last year, and is already at 65 percent this year, he said.

“When you have that many bodies with a common denominator, then you know it is a problem,” said Coronato, who was instrumental in introducing police and other first responders to the distribution of Narcan, an opioid “antidote” that seemed like a miracle drug to combat overdoses. “It works on it (fentanyl-laced heroin) until the Narcan wears off and the fentanyl goes back into a person’s system. That person can still OD. It’s why if you spray with Narcan, you have to go to the hospital.”

Still, the bottom line is Narcan is saving lives, but only recycling the addict, Coronato told members of the Little Egg Harbor Senior Advisory Group earlier this fall.

“We need the next phase, which is the opiate overdose response program. When someone addicted comes into the system, we want him or her to get into treatment,” he said at the time, noting about 85 percent of the breaking and entering, shoplifting and other crimes in Southern Ocean County is drug-related because addicts need to feed their addictions.

Where does fentanyl come from?

Fentanyl was first developed in 1959 and introduced in the 1960s as an intravenous anesthetic, according to the DEA fact sheet. It is legally manufactured and distributed in the United States.

“Fentanyl pharmaceutical products are currently available in the following dosage forms: oral transmucosal lozenges commonly referred to as fentanyl ‘lollipops’ (Actiq), effervescent buccal tablets (Fentora), sublingual tablets (Abstral), sublingual sprays (Subsys), nasal sprays (Lazanda), transdermal patches (Duragesic) and injectable formulations,” according to the DEA. “Clandestinely produced fentanyl is encountered either as a powder or in counterfeit tablets and is sold alone or in combination with other drugs such as heroin or cocaine.”

Most of the fentanyl-laced heroin on the streets now comes from China, Mexico and Russia, Coronato said.

“One other thing the president has done, and he’s told me this directly, he has elevated the issue of fentanyl and carfentanil to the presidential level in his conversations with the Chinese,” Gov. Christie, who chairs the Trump administration’s commission on opioid abuse, said last month. “And he has made very clear to President Xi that (while) we will take responsibility for demand we have for fentanyl and carfentanil, in this country, that President Xi has to take responsibility for the supply that’s flooding this country.”

Nationwide Crisis

The synthetic storm isn’t confined to Ocean County. Although it’s been more prevalent along the East Coast, it’s beginning to become a larger issue in places such as Ohio and West Virginia, Coronato said. In fact, last month the Centers for Disease Control and Prevention released a report of deaths involving fentanyl and fentanyl analogs in 10 states from July 2016 until December 2016. The report found more than half of the people in Maine, Massachusetts, Missouri, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, West Virginia and Wisconsin who died of opioid overdoes during the second half of last year tested positive for fentanyl.

“It isn’t being made by a manufacturer,” Coronato said of the drug. “It’s some guy in his basement. You don’t need the bulk, like you do with heroin, so it’s easily transferred, like a pack of sugar.”

And drug dealers are playing with the form of the drug, he said. In Monmouth County, fentanyl tablets have been found. It’s not something that has been seen yet in Ocean County, he added.


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