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David Whiting: Fentanyl deaths jump in Orange County, but overall opioid deaths dip for first time ever

Orange County Register - 3/28/2019

March 28-- Mar. 28--My examination of hundreds of Orange County coroner records finds an alarming spike in fentanyl deaths. But for the first time ever, it also shows a dip in overall accidental opioid overdoses.

Consider that 194 souls died last year of accidental opioid overdoses in Orange County, a drop of 17 deaths compared to two years ago.

When you are swimming against a tsunami of death, that is nothing less than remarkable.

Still, any death is crushing and there certainly is no reason to celebrate.

The youngest woman who died from an accidental opioid overdose last year was 19 years old. She succumbed to the opioid onslaught almost exactly 12 months ago.

For her family's privacy, her name is omitted here. But I will share that this teenager was loved and lived with her family on Orange County's gold coast.

She battled insomnia, anxiety, depression. Her killer was heroin.

The same week, an 18-year-old man died a similar death in south Orange County. With a history of anxiety and depression, he was found with seven drugs in his system, including alprazolam (Xanax) as well as hydrocodone and morphine.

Sometimes it's difficult to tell the difference between dealers and doctors. Worse, the dark cloud of fentanyl is proving to be nearly unstoppable.

Three waves of addiction

When I first got involved in reviewing coroner records, oxycodone led the death squad and what started out as an effort to reduce pain turned into a war against an epidemic of addiction.

Yet the scene today is even more complex and devastating.

Oxy, as it's known, tore through the U.S. starting in the 1990s. Dealers and addicts broke into warehouses and pharmacies. Scores of doctors prescribed the pain-masking drug with abandon.

Young people in particular favored "pharm parties," where oxy from parental medicine cabinets made for a readily available cornucopia of drugs.

Yet oxy was expensive and sometimes difficult to obtain -- especially for young people with growing addictions. Soon, these young people who had a taste for opioids started switching to heroin, usually by snorting it through their nose. Needles often followed.

Tragically, that continues. Just last month, for example, four doctors in Southern California were arrested on a variety of related charges.

But by 2005, the landscape started to change.

The rise of heroin was so fast that within a decade, the national Centers for Disease Control and Prevention reported that the number of overdoses caused by heroin and the number of deaths from prescription opioids were nearly identical.

In Orange County, the coroner reported that in the last five years the rise in heroin deaths rocketed an astounding 119 percent.

But while all this was happening, a third plague was in its embryonic stage -- fentanyl.

Between 2013 and 2015, fentanyl came into its own. In the next two years, it became an unstoppable storm and it's still growing.

Now, fentanyl is on its way toward eclipsing both heroin and prescription drugs. In crunching local coroner numbers, I discovered fentanyl deaths here already exceed heroin deaths.

My review found Orange County had 69 accidental heroin overdoses last year. Yet during the same period, the county saw a total of 76 accidental fentanyl deaths.

Heroin on steroids

The Centers for Disease Control warns, "Fentanyl is 50 to 100 times more potent than morphine.

"It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product."

The nonprofit Narconon is equally alarmed. "American drug dealers," the organization points out, "have discovered how profitable trafficking in fentanyl is.

"Since it is far more powerful than heroin, it takes only the tiniest amount of fentanyl powder to get a person high," Narconon points out. "A tiny bit more results in a fatal overdose."

If that's supposed to be a warning, it's lame. If you're an addict, fentanyl's powerful potency is attractive in a very twisted way. More bang for your buck.

But buyer beware.

The National Forensic Laboratory Information System details the dangers of street drugs: "The sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl."

Today, fentanyl is so pervasive that even drug enforcement is losing.

The National Institute on Drug Abuse cautions, "Synthetic opioids, primarily illegal fentanyl, passed prescription opioids as the most common drugs involved in overdose deaths in the United States."

Closer to home, the outlook is equally grim.

The Orange County coroner last year released a report stating, "The number of fentanyl-related deaths saw an increase of 164 percent between 2014 and 2016 and an increase of another 54 percent between 2016 and 2017."

Since then, the powerful drug's grip has only grown stronger.

My review of death records for 2018 found that heroin was involved in 69 deaths while fentanyl claimed as many as 76 lives.

I went on to break down deaths by gender: 53 men and 16 women died from accidental heroin overdoses while 62 men and 14 women overdosed on fentanyl.

The gender gaps are typical. Regardless of the drug, men overdose in far greater numbers than women.

But it's a shock when you separate accidental opioid deaths by age.

Older men at risk

One of the most troubling trends I have seen in recent years is a continued increase in older people dying from accidental opioid overdoses.

Two years ago, I wrote, "The highest concentration of victims were middle-aged women."

Sadly, little changed in 2018 for women. Orange County coroner records for last year show that more than half the women who died from accidental opioid overdoses were 40 or older.

The oldest was 74 and lived in Aliso Viejo. She died in September and struggled with insomnia, anxiety, arthritis and migraines. Thirteen prescription drugs were in her system, including hydrocodone and oxycodone.

But now, older men in Orange County, too, are more apt to succumb to accidental opioid overdoses.

Last year, 48 men under the age of 40 died from accidental opioid drug overdoses. At the same time for men 40 and older, opioids were responsible for 61 deaths.

The oldest was a 78-year-old Huntington Beach man who suffered from insomnia and epididymitis, an inflammation of the groin. He died with six drugs in his body, including hydrocodone and oxycodone.

Narconon reports that one of the main causes for older people dying from accidental drug overdoses is that doctors are prescribing multiple medications.

Sometimes, patients get confused. Sometimes, doctors fail to track clashing prescriptions.

Nationwide, 70,200 people died from drug overdoses last year, 68 percent from opioids. If today is a typical day in America, another 130 people will die.

Pray they're not someone you know.

By the numbers

* Accidental opioid deaths last year in Orange County: Total, 194 -- men, 138; women, 56

* Heroin related: 69

* Fentanyl related: 76

Source: Orange County coroner; numbers are unofficial

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