JANESVILLE—The wave of overdose deaths in Janesville might be growing, and fentanyl might be the reason.
Fentanyl was found to be the cause of an overdose death in early April, and that's got officials wondering if the recent increase in overdoses is not from heroin but from fentanyl.
Police assumed the April death was another heroin overdose, but heroin was not found in testing, said Sgt. Chad Pearson, who heads the Janesville Police Department Special Investigations Unit.
Detective Chris Buescher knew that a form of the drug called acryl fentanyl had killed 44 people in the Chicago area earlier this year, so the body was then tested for fentanyl, and two variants of the drug showed up, acryl fentanyl and tetrahydrofuran fentanyl.
Heroin will kill, Pearson said, but fentanyl is even more likely to kill because it's more potent—Pearson has been told it's 10 to 15 times more potent.
The police department issued a warning Friday, saying fentanyl is on the streets here. Police hope the information saves the lives of people who think they're selling and buying heroin.
Pearson believes at least some of the drugs being sold here are pure fentanyl.
“They're snorting and injecting fentanyl, believing it's heroin,” Pearson said.
Janesville police reported 55 overdoses last year, 12 of those fatal. That was after four heroin overdose deaths in 2015 and five in 2014.
This year, Janesville is on a pace to exceed 2016 numbers, with 23 overdoses so far, six of those resulting in death.
Pearson's unit keeps track of the names and numbers on a board in its office.
“It's a grim reminder of our obligations to our community,” and it's discouraging to see the numbers rise, Pearson said.
Fentanyl was created as a prescription drug, but authorities say in recent years it's been manufactured in China, sold to drug dealers and smuggled into the United States. China only recently declared it illegal to make.
Police believe the local fentanyl is coming from Chicago and Rockford through Beloit to Janesville.
Acryl fentanyl killed 44 people in Chicago and its suburbs from Jan. 1 through April 8, according to a news report.
Acryl and tetrahydrofuran fentanyl—the variants found in the recent overdose victim--are similar to carfentanyl, an extremely potent form of the drug that has been known to cause overdoses simply through touching it, Pearson said.
Dr. James MacNeal, head of emergency medical services at Mercyhealth in Janesville, said doctors don't know what drugs patients are overdosing on as they treat them.
Their focus is to treat the symptoms, not identify the drug, as it is not pertinent to treatment in this case, MacNeal said.
“We don't screen for it on a standard tox exam. The way we have been finding out about it is from law enforcement or autopsy results. Unfortunately, that number seems to be creeping up,” MacNeal said.
Naloxone—sometimes administered in a form called Narcan—can reverse a heroin overdose, but it's been found to be less effective in some fentanyl cases.
MacNeal said naloxone is a first step in treatment.
“You can stand there and give them Narcan until the cows come home, but if it's not going to work, then you're just wasting that time. So our providers are taught to be very aggressive and get an advanced airway very early in the clinical course of a suspected overdose. That way, if Narcan is not going to work, then we aren't dealing with a patient that's lacking oxygen, continuing to deteriorate right in front of our eyes,” MacNeal said.
“To say Narcan is the only thing you need for an overdose is not true,” he said.
Fentanyl is “the next wave of the opioid crisis,” according to testimony by Louis Milione, assistant administrator of the Drug Enforcement Administration, to a House of Representatives Committee on March 21.
The federal Drug Enforcement Administration has found international drug organizations are mixing fentanyl and related substances with heroin or pressing it into pills and then selling in the illicit U.S. market, “where demand for prescription opioids and heroin remain at epidemic proportions,” Milione said.
Fentanyl analogs such as acryl fentanyl are made to avoid criminal prosecution, Milione said.
Until those new formulations go through the process of being placed on the federal or state schedule of illegal drugs, each criminal prosecution must establish that the drugs produce a similar effect on the central nervous system, which requires expert testimony, Milione testified.
“Manufacturers and distributors will continue to stay one step ahead of any state or federal drug-specific banning … by introducing and repackaging new products that are not listed as such in any of the controlled substance schedules,” Milione is quoted as saying in his testimony.
Gazette reporter Ashley McCallum contributed to this story.