Fentanyl main driver of overdose deaths

CHARLESTON, W.Va. — Preliminary statistics from state officials show fentanyl, a synthetic opioid more deadly than heroin, has killed more West Virginians than any other drug in 2017.

The most up-to-date statistics available from the West Virginia Department of Health and Human Resources also show overdose deaths related to fentanyl have doubled heroin-related overdoses for the first part of 2017. While fentanyl has similar effects to heroin, it is about 50 times more potent, according to the Centers for Disease Control and Prevention.

Fentanyl is often mixed with heroin, cocaine or methamphetamine, according to the CDC. Charleston police have seized methamphetamine laced with fentanyl and pills stamped to look like oxycodone made from pure fentanyl, according to Lt. Mike Chapman, bureau chief of investigative services for the Charleston Police Department.

“They’re putting fentanyl in just about anything and everything these days,” Chapman said, adding that pure fentanyl is also locally sold.

Pharmaceutical fentanyl is typically used to treat cancer pain, according to the CDC. Local police and the DHHR said the fentanyl leading to overdoses is illegally made.

Opioids continue to fuel the drug crisis in West Virginia. The DHHR said, as of mid-October, the medical examiner’s office reported 558 people had died of overdoses this year. There were 884 overdose deaths in 2016, and Dr. Rahul Gupta, state health officer, said the overdoses counted so far this year are mainly from January through April.

But as early as 2015, oxycodone and hydrocodone-related overdoses made up about 40 percent of the deaths — 296 out of 735 drug overdoses.

Heroin-related overdoses made up 27 percent of the deaths — 201 out of 735 overdose deaths.

That year, fentanyl-related overdose deaths jumped from 55 the previous year to 180 — about 24 percent.

Last year, fentanyl deaths exceeded heroin deaths. Fentanyl-related deaths made up 363 out of 884 overdoses — about 41 percent — compared to 256 heroin-related overdose deaths — about 29 percent.

And in 2017, fentanyl-related overdose deaths are making up the bulk of the problem. The DHHR reported, of numbers tallied on Oct. 16, 320 out of 558 overdose deaths were related to fentanyl — about 57 percent. Another 146 were related to heroin — about 26 percent.

Of the 320 fentanyl-related overdoses so far in 2017, about 131 of those (about 40 percent) involved fentanyl analogues. Those overdoses also continue to increase, according to state officials. Overdoses related to analogues increased from 29 in 2015 (16 percent of fentanyl-related overdoses) to 94 in 2016 (25.9 percent).

Overdoses related to carfentanil, which caused more than 20 people to overdose in a few hours in Huntington last year, increased from zero in 2015, to 34 in 2016 and 54 so far in 2017, according to the DHHR.

Fentanyl is 50-100 times more potent than morphine. Carfentanil, a fentanyl analogue, is estimated to be 10,000 times more potent than morphine.

“We continue to see new fentanyl analogues very very frequently,” said Yolanda Sowards, public health analyst for Appalachia HIDTA. “That’s a national trend, and West Virginia is no exception.”

Gupta said more heroin is being cut with cheaper fentanyl and related analogues more often, while fentanyl is also being pressed into pills. He referred to the increase in fentanyl overdoses as “a straight line moving up.”

Gupta said, as more health care providers have used the state’s controlled substance database to monitor prescriptions, and efforts to better train doctors have increased, prescription drug sales have declined.

“We’re seeing a transition and an evolution for people,” Gupta said. “As it gets harder to get those prescription drugs, people are turning to more readily available alternatives on the street.”

“They’re really playing Russian Roulette,” he said, noting that buyers don’t know the strength of the purchase.