Fentanyl Amps Up Danger
Patti Dobranski; Richard Gazarik, Tribune-Review/Pittsburgh Tribune-Review
Geoffrey Dankovich's life ended May 28 in a hotel room in Fayette County. He was 27.
Hours before his death, Dankovich and a companion allegedly purchased patches infused with fentanyl, a powerful medication for chronic pain, from Jeffrey Moore, 43, of Redstone Township, a man he did not know.
Dankovich and his friend cut one patch in half and chewed the pieces to suck out the gel, which is designed to deliver the narcotic over a three-day period. Both also stuck a patch to their bodies, police said.
Under the combined effects of the fentanyl, cocaine, opiates and muscle relaxers, Dankovich fell unconscious and died. The Fayette County Coroner's Office ruled his death a drug overdose.
Across the nation, there has been a surge in fentanyl-related deaths, according to statistics compiled by federal agencies. The National Drug Intelligence Center reported in its 2006 drug threat assessment that Pennsylvania is becoming one of the primary markets for fentanyl.
There were 120 deaths linked to fentanyl patches in the U.S. in 2005, according to the U.S. Food and Drug Administration, up from 100 the previous year.
Fentanyl is one of nine narcotics listed by the FDA as responsible for the most emergency room treatments for drug overdoses.
Between 1995 and 2000, there were more than 108,000 cases of opiate abuse nationwide that required treatment in emergency rooms. More than 42,000 cases involved fentanyl abuse, according to the Substance Abuse and Mental Health Services Administration.
The National Drug Intelligence Center in Johnstown suspects there may be more fentanyl-related deaths than the reports include because many overdoses were classified as heroin-related. Chemically, fentanyl is hard to distinguish from heroin. Testing for it requires specialized toxicological screening.
In Pennsylvania, the Centers for Disease Control and Prevention reports that in 2005 more than 13,400 people were admitted for treatment for heroin abuse; another 3,300 were treated for abusing other opiates such as fentanyl. However, the CDC did not break down the exact number of fentanyl users. In 2004, more than 19,000 were admitted for heroin treatment, another 4,300 for other opiates.
Developed in the 1960s, fentanyl is a synthetic narcotic used by cancer patients and those with chronic pain. The medicine became available in patch form in the 1990s.
Abusers risk overdosing when they dilute or cut fentanyl, according to the substance abuse administration. Normally, physicians prescribe 45 micrograms of the drug as a pain reliever, which is less than the weight of a grain of salt.
Sources of the drug include health care workers, according to experts.
The U.S. Drug Enforcement Agency reports that the patches are being stolen by health care professionals and employees of hospitals and doctors offices, then sold on the streets. The state Attorney General's Office said narcotics agents are reporting that many of the patches are coming from prescriptions.
"Fentanyl prescriptions are being overprescribed," spokesman Kevin Harley said. "They go to a doctor and say they need one patch and are getting three. There are still a lot of bad pain doctors out there. They'll go to a doctor and say, 'My knee hurts. I need a fentanyl patch.'"
Bill Houcker, spokesman for the DEA's regional office in Philadelphia, said agents are monitoring use.
"We are always looking for trends because addicts are constantly looking for new drugs. They'll do it, and it will kill them," he said. …