Summit County overdose deaths linked to fentanyl
December 4, 2015
Two recent overdose deaths were linked to fentanyl, according to a toxicology report released by the Summit County Coroner's Office. A potent narcotic, fentanyl is 50 to 80 times more potent than morphine and can be deadly when combined with street drugs.
In the case of two Sept. 26 fatalities, the injectable combination of fentanyl with cocaine resulted in the death of a 27-year-old man, while fentanyl and morphine resulted in the death a 21-year-old Breckenridge man.
Summit County Coroner Regan Wood confirmed that syringes were present at both scenes.
"You get this strange combination of things," said University of Colorado professor Robert Valuck, who coordinates the Colorado Consortium for Prescription Drug Abuse Prevention.
Fentanyl can be difficult to initially detect, simply because it does not appear in most standard toxicology screens. Valuck said most users are unaware of the exact content of the drugs they purchase. That factor, combined with an individual's history of drug use, can make for an uncertain result.
"It's really common that these polydrug overdoses are more common than single drug overdoses," Valuck said. "It's the rule, not the exception."
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He said sometimes dealers would cut drugs with fentanyl and other substances to make them more potent and, therefore, more marketable.
"That's why dealers will scramble to put whatever they can in there," he said.
IN THE DARK
Both substances were likely purchased from one of many markets on the Darknet, where anonymity tools conceal IP addresses. As more users purchase drugs off of the Internet, shipped over from across the country, the availability of different types of drugs changes rapidly.
Even as investigations have unraveled a few of the markets, as was the case with Silk Road last year, new markets are created just as quickly.
"The Darknet is kind of like whack-a-mole," Valuck said. "The people are still there, the additions are still there and the substances are still there."
While the demand for various substances, including fentanyl, "bubbles up from time to time," he noted the demand for heroin and other street drugs rises when access to prescription drugs is cut off, either by price or by the closure of a "pill mill."
For instance, in 2013 a Silverthorne man was indicted for his involvement in a local "pain clinic," resulting in the distribution of several controlled substances.
"It's not just big urban centers," Valuck said. "It's Denver, but it's also Pueblo, it's Routt County, Weld County, Summit County—it's all over the place."
He added that drug use was independent of location, socioeconomic status, and one of the few causes of death that has increased, not decreased, in the past few years.
"For most things, we're driving mortalities down, but, for drug poisonings, we're not," he said. "It's a really difficult problem. We figure out where we see ODs, ER visits, supply, police activity and try to paint a picture, but it's inherently crude."
He noted most users start between ages 12 and 19, the focus of prevention programs. He said most pull leftover narcotics, like Vicodin or Percocet, from the medicine cabinet.
THE ROAD TO RECOVERY
Across the country, an estimated 10 to 15 million Americans are estimated to be in need of treatment for substance abuse. Valuck said just a tenth of that number seek help or are sent to rehabilitation.
He said the stigma of drug use and the fear of getting caught are part of the issue.
"We say it's a neurobiological problem, but the public still thinks it's a choice problem," he said.
Several groups across the state are focused on harm reduction, which is focused on helping prevent mortality even if users continue to abuse the drugs. For example, Colorado is expanding access to naloxone, an opioid antagonist that counteracts the effects of narcotics, useful in the case of an overdose.
Kroger stores across the state will have naloxone available to be prescribed by pharmacists to at-risk drug users, their friends and family. In Summit County, naloxone will be available at Safeway and City Market in the future.
Bev Marquez, CEO of Rocky Mountain Crisis Partners, said about 35 percent of the statewide phone line's calls were related to drug or alcohol use. Of those calls, half were family or friends calling with concerns about potential drug abuse.
"I think what happens is people don't know what to do to help. So they end up not doing anything," she said. "You don't have to know how to help. We can help you figure out a plan."
She encouraged concerned individuals to make a call and start the conversation, whether that involves getting help or determining whether a family member or friend is abusing drugs. Rocky Mountain Crisis Partners can also conduct outreach calls at the request of a family member.
"It's better to talk about it and be wrong, then to not talk about it," she added.
The center can be reached at 844-493-8255 (TALK).
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