Possible fentanyl overdoses reported in Gonzales County

The Gonzales County Sheriff’s Office has responded in the past five days to two separate incidents where deceased individuals were found and fentanyl was present at the scene, Sheriff Keith Schmidt said Thursday.

The incidents took place at separate locations in the southern end of Gonzales County and, in each case, a male in his 30s was pronounced dead by a Gonzales County justice of the peace after the victim was found unresponsive. Both incidents are being investigated as possible drug overdoses, Schmidt said.

“Fentanyl is a controlled substance with high risk for addiction and dependence,” Schmidt’s office said in a statement. “It can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol or other illicit drugs such as heroin or cocaine.

“Some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose.”

This is a growing problem not only in Gonzales County, but elsewhere in the United States. Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. In 2017, 59.8 percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010, according to the National Institute for Health’s National Institute on Drug Abuse.

According to the Centers for Disease Control and Prevention (CDC), rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased more than 16 percent from 2018 to 2019. Overdose deaths involving synthetic opioids were nearly 12 times higher in 2019 than in 2013 and in 2020, opioids were responsible for nearly three quarters of the more than 93,000 fatal drug overdoses in the United States.

Pharmaceutical grade fentanyl, a synthetic opioid, was first developed in 1959 and introduced in the 1960s as an intravenous anesthetic. Fentanyl was approved by the U.S. Food and Drug Administration for use as an analgesic (pain relief) and anesthetic, especially for cancer patients.

It may be administered by a physician or nurse in a hospital or clinical setting as an injection or prescribed in the form of a transdermal patch or lozenge. Fentanyl is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic and is a Schedule II narcotic under the U.S. Controlled Substances Act of 1970.

Like heroin, morphine, and other opioid drugs, fentanyl works by binding to the body's opioid receptors, which are found in areas of the brain that control pain and emotions. After taking opioids many times, the brain adapts to the drug, diminishing its sensitivity, making it hard to feel pleasure from anything besides the drug.

Fentanyl's effects include relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.

Overdose may result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning.

Naloxone, or Narcan, is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone.

While fentanyl is legally manufactured and distributed in the United States, some pharmaceutical products are diverted via theft, fraudulent prescriptions or illicit distribution by and among patients, physicians and pharmacists.

Fentanyl is also manufactured illegally, with a great deal of production taking place in Mexico using chemicals obtained from China. It is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills designed to look like other prescription opioids, like hydrocodone or Tylenol with codeine No. 3. It can also be mixed in with or made to look like benzodiazepines such as alprazolam (Xanax) or diazepam (Valium) or even ADHD medication like Adderall.

It is known by street names such as Apace, China Girl, China Town, China White, Dance Fever, Goodfellas, Great Bear, He-Man, Poison and Tango & Cash.

The U.S. Department of Criminal Justice states criminal drug networks are selling these pills through social media, e-commerce, the dark web and existing distribution networks. As a result, these fake pills are widely available and are more lethal than ever. DEA laboratory testing reveals that today, four out of 10 fentanyl-laced fake pills contain a potentially lethal dose. Moreover, the number of fake pills containing fentanyl has jumped nearly 430 percent since 2019.

From August through September 2021, Drug Enforcement Agency agents, working in concert with federal, state and local law enforcement partners, seized 1.8 million fentanyl-laced fake pills and arrested 810 drug traffickers in cities, suburbs and rural communities spanning the United States. The amount of deadly fentanyl-laced fake pills seized by DEA in that time “is enough to kill more than 700,000 Americans,” the DEA said. That was added to the more than 9.5 million potentially deadly fake pills that DEA seized in the 2020, which was more than the previous two years combined.

During that time, DEA also seized 712 kilograms of fentanyl powder: enough to make tens of millions of lethal pills. DEA seized 158 weapons and many of the enforcement actions are tied to violence and overdose deaths. Additionally, DEA seized 4,011 kilograms of methamphetamine and 653 kilograms of cocaine.

Stopping the flow of illegal fentanyl traffic is also dangerous to law enforcement officials, Schmidt’s department said.

“Fentanyl poses a significant threat to law enforcement personnel and other first responders who may come in contact through routine law enforcement, emergency or life-saving activities,” the statement said. “Fentanyl may be ingested orally, inhaled through the nose or mouth, or absorbed through the skin or eyes. Exposure to a very small amount may lead to significant health-related complications, respiratory depression, or death.”

Fentanyl can be detected in pills and powders by using fentanyl testing strips, but they are illegal to purchase for use in the state of Texas as they are considered under the Texas Controlled Substances Act to be drug paraphernalia. A bill was filed last session to remove criminal penalties for the possession of testing strips that made it out of committee, but did not see the light of day on the floor of either chamber in the Texas Legislature.

This article contains information from the DEA, NIH, CDC and other governmental agencies.