Sunday, May 21, 2006

The Full Article, in case the FreePress link doesn't work.


At least 12 people died in 24 hours Thursday and Friday in Wayne County from a potent prescription drug mixed with heroin and cocaine, said officials who expect more deaths over the weekend.
Officials issued an alert late Friday, saying they feared drug dealers were adding fentanyl, a powerful drug prescribed to cancer patients, to heroin and cocaine to boost the high for their customers. The victims ranged in age from 20 to 45 and were found in crack houses and on the streets in Detroit, Dearborn Heights, Lincoln Park, Redford and Westland. Eight deaths were reported Friday and four on Thursday, mostly from a heroin-fentanyl mix. Names of victims were not released. Hospitals and authorities in Oakland and Macomb counties reported no similar deaths.
Fentanyl is supposed to be used only by those suffering from around-the-clock pain. If consumed in large amounts, it can cause breathing problems, possibly fatal, according to the U.S. Food and Drug Administration.
Like heroin, fentanyl can act as a strong sedative, giving users a drowsy high. But it's potentially more dangerous. Last year, the FDA issued a public warning about inappropriate use of the prescription drug.
From September through March, the Wayne County Medical Examiner's Office confirmed 106 drug deaths, the majority linked to combinations of fentanyl and heroin. But the increase in deaths Thursday and Friday prompted county and state officials to announce a health alert Friday.
Officials from the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta are headed to Wayne County on Monday to assess the problem, said Wayne County Executive Robert Ficano.
"We are not trying to have panic, but this is a very serious public health issue," Ficano said Friday. "The dramatic spike within the past 24 hours shows that there's a very lethal amount that is being distributed on the street at this very moment."
T.J. Bucholz, spokesman for the state Department of Community Health, said the CDC is interested in Detroit's cases because of similar events reported in other cities.
The CDC is particularly interested in whether the Detroit drugs may have come from Chicago, where there have been reports of fentanyl-laced heroin causing overdoses and death, Bucholz said.
Similar outbreaks of deaths linked to mixtures of fentanyl and heroin were reported last weekend in the Philadelphia area.
Last weekend, 22 people went to Chicago hospitals after overdosing on the fentanyl-heroin mix.
Two CDC officials said Friday they were unaware the agency was sending investigators to Detroit. The CDC typically does not investigate Fentanyl-related deaths.
"We have no information about CDC being asked to investigate," said agency spokeswoman Bernadette Burden. Oakland County Medical Examiner Ljubisa Dragovic called the Wayne County deaths "significant" and said they could indicate people were getting their drugs from the same source.
"That calls for looking at the location" of the victims, "whether they were from the same neighborhood or dope house to see if there is any geographic pattern. Then you would have to focus on the suppliers."
Ficano and Chief Wayne County Medical Examiner Carl Schmidt said there is a good chance that street dealers don't know what fatal mixture lies in the drug packages they are selling. Schmidt said victims are injecting or snorting the drugs.
Area hospitals, law enforcement agencies and EMS networks have been notified of the drug crisis.
"Drug use does dramatically go up on the weekends, both recreational and those of addiction," Ficano said. "From what I understand it's almost an instantaneous death when you take it with the combination."
Ficano said he's also concerned that people who injected drugs could be lying dead, undiscovered, in crack houses or drug dens. Michele Reid, Wayne County's medical director of mental health services, said there is treatment for people who overdose on the drug if they get to an emergency room immediately.
Those who take the drug mixture may notice extreme euphoria followed by difficulty walking, or a deep slumber accompanied by heavy snoring, she said.
Major dealers may be cutting the drugs with fentanyl to give their product a better boost.
"It's competitive," Ficano said. "They can brag that they have the substance that gives you a better high. It's capitalism."
Fentanyl, first made in Belgium in the late 1950s, can be about 80 times more powerful than morphine, according to the U.S. Drug Enforcement Administration.
Today the potent prescription painkiller is dispensed in the form of a patch, say federal officials.
In 2003, the last year for available U.S. figures, there were 418 deaths in Wayne, Macomb and Oakland counties from opiates, a drug category that includes Fentanyl, other prescription drugs like OxyContin and heroin. Out of those 418 deaths, 72 were from heroin. One variation of fentanyl is sometimes known as China White, according to medical experts.
A national health official said the number of deaths in Detroit is high.
"That's a lot," said Leah Young, spokeswoman for the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services.

Additional Warning Info from FreePress Article
(this stuff I didn't know when I lay in my bed feeling as if my breathing might stop)

Related links:
• More information: dea/concern/ fentanyl.html
Fentanyl facts
What it is: The painkiller can be about 80 times more powerful than morphine.

Legal use: It's a prescription drug often used for chronic pain, especially for cancer patients.

Illegal use: It is mixed with heroin, or with heroin and cocaine.

If you develop adverse effects: Call your doctor or emergency officials. Report problems with fentanyl to the Food and Drug Administration at 301-443-1240, 24 hours a day. Or call 800-332-1088.

Signs of an overdose: Labored or shallow breathing, extreme sleepiness or sedation, difficulty walking or talking, and feeling faint, dizzy and confused.

Niraj Warikoo
(Oral transmucosal fentanyl citrate)

• A product of Cephalon Inc. (145 Brandywine Parkway, West Chester, PA 19380 | 800-896-5855)

• Sold as Actiq® pronounced ac (like "back") tek (like "Beck")

• (from the 'warning label' section of the Actiq® label)

Actiq® is indicated only for the management of break-through cancer pain in patients with malignancies who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain.

Patents considered opioid tolerant are those who are taking at least 60 mg morphine/day, 50 mcg transdermal fentanyl/hour, or an equianalgesic dose of another opioid for a week or longer.

Because life-threatening hypoventilation could occur at any dose in patients not taking chronic opiates, Actiq is contraindicated in the management of acute or postoperative pain. This product must not be used in opioid non-tolerant patients.

Actiq is intended to be used only in the care of cancer patients and only by oncologists and pain specialists who are knowledgeable of and skilled in the use of Schedule II opioids to treat cancer pain.

Patients and their caregivers must be instructed that Actiq contains a medicine in an amount which can be fatal to a child. Patients and their caregivers must be instructed to keep all units out of the reach of children and to discard opened units properly.

SOURCE: Physicians' Desk Reference, 59th edition, 2005 (page 1122)


At 4:00 PM, Blogger Lynda said...

I think it is very important to listen to your body. Sometimes doctors get that I know better than you attitude too! So, how can we not think they could be wrong.

Same with lung cancer screenings for non-smokers.


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