NOEL KING, HOST:
There is a frightening new dimension to the opioid crisis. People who are using cocaine are overdosing, not on cocaine but on fentanyl. Fentanyl makes heroin even more dangerous, and now it's showing up in cocaine as well. And that could make the addiction crisis even worse. From member station WBUR in Boston, Martha Bebinger reports.
MARTHA BEBINGER, BYLINE: The only sign of drug use found near Chris Bennett's body was a pipe, but it looked like the 32-year-old from southeastern Massachusetts had stopped breathing and died of an opioid overdose. Chris Bennett's mother, Liisa, couldn't understand what happened. Then she saw the toxicology report.
LIISA BENNETT: He was smoking cocaine that was laced. That's what he had in his system was cocaine and fentanyl.
BEBINGER: Bennett says she was stunned. She'd heard about fentanyl being added to heroin and had warned Chris.
BENNETT: My focus was making sure, you know, that he wasn't going to do the heroin that was laced.
BEBINGER: But she never suspected the crack cocaine Chris smoked occasionally might kill him.
BENNETT: Absolutely not.
BEBINGER: Police Chief Fred Ryan has seen four cocaine-fentanyl overdoses recently in Arlington, a suburb of Boston.
FRED RYAN: That's the next wave of the addiction crisis is fentanyl-laced cocaine.
BEBINGER: In Connecticut, 220 people overdosed on a mix of cocaine and fentanyl last year - a dramatic increase. Massachusetts State Police recorded 199 samples of cocaine that included fentanyl last year - nearly three times what they found the year before. Florida had the most seizures of fentanyl-laced cocaine in a November report from the Drug Enforcement Agency. Tennessee, Rhode Island and New York City have issued public warnings. But Jess Tilley says those warnings are not enough. She distributes NARCAN and safe-use supplies to drug users in western Massachusetts. Tilley says few cocaine users understand the current danger.
JESS TILLEY: We don't want to cause widespread panic, but with how deadly fentanyl is, I believe we really need to get the word out there that it could potentially be in every batch of cocaine, just like we tell everyone to approach all their heroin like it could potentially have fentanyl.
BEBINGER: That means teaching cocaine users to test the drug before snorting, smoking or injecting, then to start with a small amount, to use in pairs and to carry NARCAN, says Traci Green, an epidemiologist at Boston Medical Center.
TRACI GREEN: The tools that are going to be most effective are the ones we already have. There's hope (laughter). You know, we have quite a lot that we can work with here.
BEBINGER: Green says some data suggests fentanyl is showing up in bags of cocaine by accident, the result of messy packaging, not malicious intent. But other doctors, law enforcement agents and drug users suggest cartel leaders are using cocaine to make more people addicted to opioids. Here's Rafael. We are only using his first name because Rafael buys cocaine and other illegal drugs often several times a day on the streets of Boston.
RAFAEL: People who were just using cocaine occasionally, now they're using cocaine every day.
BEBINGER: Because of the fentanyl.
RAFAEL: It's all about making them need the product.
BEBINGER: The market expansion theory baffles some in the drug community who say adding fentanyl to cocaine will either scare off buyers or kill them. Either way, they call for renewed urgency to slow what might become a deadly new wave in the opioid crisis. For NPR News, I'm Martha Bebinger in Boston.
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