A devastating trend: Fentanyl-laced cocaine overdoses raise major concerns across Ohio, new analysis shows

CLEVELAND, Ohio — Cocaine, Ohio’s leading illicit stimulant, is fast becoming its deadliest when laced with fentanyl, a new statewide analysis done for The Plain Dealer shows.

The mixture is fueling a trend that has caused law enforcement and medical experts across the state to scramble to address the problem and issue severe warnings.

It’s hard to miss the concern: From billboards to dire alerts from coroners and rehabilitation experts, authorities are eager to spread word of the state’s leading form of overdose.

An analysis this month of state records by the Ohio High Intensity Drug Trafficking Area program, a congressional initiative that tracks major drug trends, offers the first definitive numbers: Unintentional overdose deaths caused by cocaine mixed with fentanyl jumped from 7 in 2010 to 784 in 2018.

Last year, 3 of 4 cocaine overdoses involved fentanyl, the analysis says. In 2014, when the trend began its first measurable increase, 1 in 5 cocaine overdoses involved fentanyl.

Orman Hall, the public health analyst for the agency, studied state death records and provided the analysis. He said many people who die from the mixture have no idea that the cocaine was spiked with fentanyl.

“It’s definitely a very significant and very devastating trend," Hall said.

‘What we see most often’

In 2017, the state saw a sharp spike in the number of overdose deaths caused by fentanyl-laced cocaine, as 1,078 people died. Last year, the numbers dipped. Authorities said that stemmed from drug dealers avoiding a powerful type of fentanyl.

This year, however, numbers are expected to rise again, as fentanyl use has grown, especially in large cities. Statewide figures will be released in February or March.

“[Cocaine mixed with fentanyl] is what we see most often,” said Amy Schaefer, an investigative supervisor with the Summit County Medical Examiner’s office.

Officials in other parts of the state are seeing it, as well.

“We know fentanyl can be mixed into cocaine and [into] methamphetamine," Franklin County’s coroner, Anahi Ortiz, said in a Facebook post following the deaths of 10 people in that county in September. “These can be deadly combinations for those using."

In Cuyahoga County, 26 people overdosed in a span of weeks in May. Officials cited fentanyl in cocaine as the main cause.

In response to that, the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County helped distribute 15,000 test strips to community groups and agencies for areas where the highest number of overdoses took place. The strips can determine whether fentanyl is present in a drug.

Overall, the agency has helped distribute 45,000 strips so far this year. Next year, the agency will double that, said Scott Osiecki, the board’s chief executive officer.

In interviews with those who have been revived after overdosing on cocaine laced with fentanyl, users have said they did not know, or want to take, the powerful synthetic opioid, Osiecki said.

For instance, many in drug treatment admit to using cocaine, but they adamantly deny using opioids. When they are shown the results of their drug tests, they said they had no idea that they had ever taken fentanyl, Osiecki said.

The synthetic is 50 times more potent than heroin and legally used to help cancer patients in pain.

To spread the word in Cleveland about the dangerous mix, federal prosecutors and community groups have placed billboards across the county that feature photographs of donuts and pretzels:

If these contain fentanyl, would you eat them?

They don’t. Your cocaine might.

Law enforcement officials and drug experts said some dealers mix fentanyl with other drugs because it is cheap and potent.

The number of unintentional overdoses involving stimulants laced with fentanyl has jumped from none in 2010 to 355 last year, according to Hall’s analysis.

Fentanyl is involved in nearly 70 percent of all stimulant overdoses. Those stimulants include prescription drugs that were diverted and have had fentanyl illegally mixed in, as well as illicit drugs, such as methamphetamine.

“This keeps morphing," Osiecki said. “First, there were opioid pills. People later moved to heroin and fentanyl, and later people began adding fentanyl to other drugs. It continues to evolve."

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