At least 49 people died of overdoses in California in October after heroin laced with the powerful opioid fentanyl was introduced, state public health officials said Monday.
Though less potent than other opioids, fentanyl is 100 times more potent than morphine, and doctors say it should be considered an additive to heroin.
As a result, state officials announced they are working with authorities in Los Angeles, Orange, San Diego and San Bernardino counties to expand emergency overdoses teams trained to administer the overdose reversal drug naloxone.
The Los Angeles Times reports that 80 people have died of opioid overdoses so far this year and that many could have been saved if authorities were able to identify the sources of the heroin that was laced with fentanyl. Heroin is often manufactured in countries such as China and controlled by criminal networks — then smuggled into the U.S. by wholesalers and users.
When the clandestine fentanyl is combined with heroin, many users who take both opioids don’t realize they’re taking dangerous substances, said Dr. Jerome Owens, chief of the infectious diseases division at UC San Francisco’s David Geffen School of Medicine.
Fentanyl is 100 times more potent than morphine and more powerful than heroin. Photo courtesy of US Drug Enforcement Administration.
“It makes people who are using heroin or using other opioids completely unaware that they’re taking a compound that is far more potent,” he said. “As a result, the person is more likely to take more.”
Heroin is often manufactured in countries like China and controlled by criminal networks — then smuggled into the U.S. by wholesalers and users. Photo courtesy of US Drug Enforcement Administration.
He said the death toll in California is actually a relatively small number compared to deaths involving fentanyl and heroin overdoses nationally, which the Centers for Disease Control and Prevention estimates are in the tens of thousands.
At least 12 additional people in California died of fentanyl-related overdoses in November, and 42 more patients in two other states have tested positive for fentanyl. In those cases, the patients died from overdose or from a pulmonary embolism, or blockage of the airways, that killed them.
The pharmacies where the drugs were obtained, the pharmacies where the heroin was manufactured, and the wholesalers who distributed it were never formally identified in those cases. But officials said the same drug came from all three places.
In 2018, California saw 159 opioid-related overdose deaths so far in 2018, with fentanyl responsible for 82 of those deaths. At the end of October, California had 483 opioid-related overdose deaths.
About two-thirds of the overdose deaths resulting from opioid use were related to heroin or fentanyl, but a disproportionate number were among people with an opioid addiction who didn’t have a prescription for the drug, state officials said.