Local health officials sound alarm on fentanyl

Ventura

Fatal overdoses in Ventura County and elsewhere could rise because of heroin that's been laced with the potent opioid fentanyl, according to an alarm sounded by local health officials.

Fentanyl and derivatives that can be far more powerful than morphine have emerged elsewhere in Southern California and across the nation, believed to be imported from other countries. Mixed with heroin, methamphetamine or cocaine, the colorless, odorless opioid can exponentially increase a drug's danger.

"People are using these drugs expecting one result and getting a much more potent result, a result that can end up with death," said Dr. Robert Levin, Ventura County public health officer.

In a news release issued this week, public health officials and members of a Ventura County workgroup formed to fight heroin and prescription drug abuse claimed there have been local cases of overdoses involving fentanyl mixed with heroin as a primary or contributing cause.

But the Ventura County Sheriff's Office's crime lab has not confirmed any overdose cases involving what Undersheriff Gary Pentis called "clandestine" or "nonpharmaceutical" fentanyl transported from other countries and mixed with heroin.

Pentis said cases processed by the lab show overdoses involving fentanyl in its pharmaceutical form as a painkiller that can be abused by addicts. He cited recent data showing that opioid overdose deaths in Ventura County fell slightly in 20014 and 2015.

But he also noted that the risk of drugs laced with fentanyl is real, citing reports as nearby as Orange County.

"We're soon going to see some of it," he said, noting that in many of the documented cases, users don't know that their heroin has been laced with a drug that can be 100 times more powerful than morphine. "That's when you see more overdoses."

Derivatives of fentanyl can be even more potent, as much as 10,000 times more powerful than morphine.

Patrick Zarate, chair of the Ventura County Rx Abuse & Heroin Workgroup, clarified the news release's statement about documented overdose cases in Ventura. He said there has been one overdose case in which fentanyl-laced heroin could be in play but has not yet been confirmed by toxicology testing. He said other overdoses have involved pharmaceutical fentanyl.

"We want to let people know that this is a highly toxic substance," said Zarate, also chief operations officer for Ventura County Behavioral Health. "We all want to be proactive."

The threat of laced drugs is tangible enough that some law enforcement agencies have already changed the way they deal with overdoses.

At the Ventura Police Department, officers no longer conduct preliminary tests of any substance that could be fentanyl in a measure designed to reduce the risk of skin exposure to the drug. At the Simi Valley Police Department, officers proceed as if any heroin they recover could contain fentanyl.

Dr. Christopher Young, who began work as Ventura County's medical examiner on July 2, said he's not aware of any fentanyl-laced heroin deaths in the county. He also noted that toxicology tests may not be able to pinpoint where substances were mixed or taken separately, particularly in cases where multiple drugs are used.

But the risk of fentanyl and its derivatives is real, said Young, formerly a state medical examiner in Oregon. There, he said, numerous deaths have been attributed to a drug called furanyl fentanyl and made to look like prescription painkillers.

"In these cases, an individual consumes pills purchased on the street which look exactly like a prescription drug with a known concentration, but in reality they end up taking a lethal dose of furanyl fentanyl," he said.

The drugs are widely distributed.

"People are able to order this stuff in the mail in many instances," Young said. "Then you have drug dealers providing drugs that are not what they say they are."

Carfentanil is another derivative. It can carry a potency 10,000 times stronger than morphine and is sometimes used as an elephant tranquilizer.

The risks of fentanyl and its derivatives are why county health officials aimed aspects of their news release at people who use street drugs.

"Extreme care should be exercised if any fentanyl exposure is suspected," they said in the release. "Even a few grains can lead to overdose or death."