MELISSA BLOCK, host:
A lethal concoction of cocaine or heroin and the powerful prescription painkiller fentanyl has been linked to well over 100 deaths across the eastern part of the U.S. A rash of overdoses from the lethal combination has been reported from New Jersey to Georgia to Michigan and in many other states.
MICHELE NORRIS, host:
Fentanyl is a form of synthetic morphine often used to relieve extreme pain, especially in cancer patients. The fentanyl mix has taken a particularly high toll in Wayne County, Michigan, which includes Detroit.
Dr. Michele Reid is medical director of the Detroit/Wayne County Mental Health Agency. She joins us now. Dr. Reid, good to talk to you.
Dr. MICHELE REID (Detroit/Wayne County Mental Health Agency): Good to talk to you too.
NORRIS: Can you give us the sense of the scope of this problem?
Dr. REID: I think we've been concerned about this problem for several months, but over the last five or six days, we've had an inordinate amount of deaths for people we presume to have been using drugs that are laced with the fentanyl. Since last Thursday there have been 19 deaths here in Wayne County.
NORRIS: 19, I understand a very large number. If you go all the way back to last fall, how many?
Dr. REID: Absolutely. Over 100 deaths have been linked to the use of heroin and fentanyl and some use of cocaine and fentanyl.
NORRIS: Who are the victims?
Dr. REID: These victims are people from all walks of life. They are from suburban areas, they are from the city, there are people who are employed. Substance abuse affects a very wide group of individuals.
NORRIS: Doctor, why is this combination so deadly, so lethal?
Dr. REID: Well basically you're taking two narcotics together, two types of medications that are central nervous system depressants. So basically what's occurring is you're depressing the breathing centers and the brain. And if you add alcohol on top of it that makes it even worse.
So if you are using this type of drug, the drug would make you feel much more tired than you usually would. Reports are hearing of people snoring just very, very loudly right before they would die. Staggering, difficulty in your breathing, confusion. Any of these type of symptoms that would be markedly different than what you're used to from a given amount of drugs that you would take, you should notice it.
I would emphasize that if any such symptoms go on that we're encouraging everybody to have immediate medical attention and that all the emergency medical services are prepared to treat this with an injection of narcant(ph) to reverse the effects of the fentanyl combined with the heroin and cocaine.
NORRIS: How and why is this powerful prescription painkiller showing up in street drugs?
Dr. REID: We're perplexed by this. We're working with the Drug Enforcement Administration and the Center for Disease Control to answer that very question. The medication is either being diverted from legal sources or there are illegal labs that have been formed that are actually producing the drug. And at this point, we don't know which it is.
NORRIS: Do you have any idea why drug traffickers are using fentanyl in particular? Are they trying to produce a better high, a particularly potent strain of heroin or cocaine?
Dr. REID: That's what we presume. Heroin itself and cocaine are frequently cut with other medications. We do not believe the individuals who are using these street drugs are aware that the fentanyl is in there nor does it appear that it's being done intentionally for the purpose of harming individuals. Just, like you said, to possibly boost a high or have a more potent high, not realizing that it could be a dangerous combination, especially if people are also using alcohol on top of it.
NORRIS: Now I understand, officials in Wayne County issued an alert late Friday, before the weekend. But federal drug officials had issued a warning back in November. Why didn't Wayne County issue an alert earlier?
Dr. REID: I think what happens is when individuals die, we just didn't know. After you have a death - we're one of the few medical examiners offices that routinely does toxicology tests. But it could take as much as two or three months after an individual dies before the final toxicology's available.
And even in these 19 cases, we're saying presumed fentanyl because the circumstances of the death lead one to believe it's similar to the ones that were confirmed fentanyl. But actually those cases of the individuals who died on Thursday, we will not have a definitive cause of death until the toxicology results are out. Could be as much as two to three months from last Thursday.
So we're letting the public know even prior to our having confirmed that it is fentanyl just because of those very concerns.
NORRIS: Have you ever seen anything like this?
Dr. REID: No. This is the first time I've seen anything like this. And it's very concerning, very troubling.
NORRIS: Dr. Reid, thanks so much for talking to us.
Dr. REID: Thank you so much for having us.
NORRIS: Dr. Michele Reid is medical director at the Detroit/Wayne County Mental Health Agency.
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