An unverified report received by the Sentinel is that in the San Bernardino Mountain communities in the last six weeks there have been six fentanyl overdose deaths.
Fentanyl is a synthetic opioid developed in 1960 as a pain medication. It is also sometimes used as a sleep aid. It was approved for medical use in the United States in 1968. It is on the order of 100 times stronger than morphine and 60 times as powerful as heroin. Some fentanyl analogues are up to 2,000 times as powerful as heroin.
In the last two decades, fentanyl has become more and more popular as a recreational drug, appealing particularly to those enamored of heroin. In some circles it is mixed with heroin, methamphetamine or cocaine. It has a rapid onset, with its effects substantially diminishing after two hours.
Fentanyl patches, which transmit minute amounts of the drug transdermally are considered an essential medicine in the treatment of cancer pain.
Adapted for street use, fentanyl is imbibed in much the same fashion as when it is used medically: by injection, nasal spray, skin patch absorption, through the cheek or as a lozenge or tablet. In addition, those using the drug illicitly will sniff or snort it, and those marketing it illicitly have taken to pressing it into pill form, sometimes in conjunction with other drugs.
In some markets, it has displaced heroin.
In the last decade, fentanyl-related deaths have risen dramatically. At issue is the drug’s potency. As it is most often substituted for heroin, and in some cases mixed with heroin, users can very easily overdose on the drug by using it in a physical quantity measured by mass or weight that is as little as one-twentieth that of the typical amount used by a heroin addict.
Based upon available information, it appears one of four or five circumstances accounts for the sudden upturn of Fentanyl-related deaths in the area around Lake Arrowhead. One is that a new drug dealer has arrived in the San Bernardino Mountain community, extending to Crestline, Lake Gregory, Lake Arrowhead, Blue Jay, Crestpark, Cedar Glen, Sky Forest, Twin Peaks and Rim Forest, one who has perhaps “stepped on” or cut the drug with a buffer such as mannit, a baby laxative, or mannitol, and is representing the product as heroin. If there is too rich of a fentanyl to buffer mixture, the result can be fatal. Another is that a newly arrived drug dealer is selling heroin laced with fentanyl. Another is that an established dealer has recently obtained a new source of drugs and is either selling buffered fentanyl as heroin knowingly or is selling it unknowingly while representing it as heroin, without giving his customers notice of what they are actually buying. Another is that what is being represented as fentanyl is actually an even more powerful fentanyl analogue such as carfentanil or ohmefentanyl.
The Sentinel was unable to verify the report of six fentanyl-related deaths since mid-April in the mountain communities. The Sentinel confirmed a rash of deaths, but because of standard policies of medical confidentiality, was able to establish that just two of the deaths were overdose related.
Five of the deaths suspected of being fentanyl overdoses were of people in their twenties or very early thirties.
A close friend of one of those confirmed to have died in a fentanyl overdose told the Sentinel that there is “definitely” a growing trend of fentanyl use among the younger set within the mountains.
“Personally, I don’t use drugs, and I didn’t know [her friend] was using it [fentanyl],” she said. “I didn’t know about pills or anything like that before, but I know at this point that is how she got it. They are now putting fentanyl into pill form. They press it into pills along with many other drugs. I’m not involved or a part of that, but I can tell you just by being around, they are easily available.”
Asked how she knew her friend’s death was an overdose, she said, “She did not seem suicidal, but it was either an overdose or it was suicide. I did not see her as being suicidal, but she was in a bad position in life. She grew up as a foster child and there were people in her foster family who were not always nice to her. I don’t know how it happened, if she just took too much or what. She was always a party girl.”
She said that fentanyl can kill in more ways than one. A fentanyl-related death occurred in the mountains about six months ago, she recalled, which she said was not an overdose. In that case, she said, the drug triggered a seizure in the user, who then drowned while in a bathtub.
Fentanyl use, she said, is hidden, and many people are oblivious to its presence. Nevertheless, she said, there are clear telltale indicators that give away to someone who can read the signs when someone is using it. There is no doubt it is a growing problem, she said.
“Nobody talks about it,” she said. “Drug addiction is horrible. It is so sad. Parents are losing children over this. Drug addiction is a mental illness. This should be talked about and dealt with. I don’t want to see any more kids, 18-year-olds, caught in this and ending up dead. I want to speak out about this for her sake. I think she would have wanted people to know. I don’t think she wanted to die like that.”
-Mark Gutglueck