Editorial: Deadlier than heroin, the fentanyl outbreak demands help from state, feds

Southwest Ohio's problem is worst in the state

There’s a killer on the loose, responsible for more than 400 deaths in the last two years.

It’s the drug fentanyl, a painkiller 50 times more potent than its cousin, heroin. And that much more deadly.

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Last year, in Hamilton County alone, 298 people died with fentanyl in their blood, according to the coroner’s office. That’s more than double the deaths from 2014, when 126 died.

In 2013, the number of fentanyl deaths was 13. In 2012, nine.

The 2015 number is likely to rise, because the coroner’s office still has dozens of cases pending.

This is nothing less than a public health emergency, and it demands an urgent response -- not just from health departments, but from state and federal law enforcement. With a death toll like this, the FBI and the Drug Enforcement Administration should, with local police, create a dedicated task force to figure out where this drug is coming from, how it's getting to our neighborhoods and crack down on the illegal network.

Critical Problem in SW Ohio

The situation is especially serious here in Southwest Ohio. The U.S. Centers for Disease Control and Prevention on Tuesday released a 50-page report on fentanyl in Ohio, and it found this region to be the worst in the state.

Read the full CDC report

The CDC ranked Hamilton as the worst county in Ohio for fentanyl-related deaths. Butler County was ranked fourth-worst, Clermont sixth-worst and Warren County 11th of 88 counties.

For reasons that aren’t clear yet to law enforcement or public health officials, this part of Ohio is a hotspot for the illegal dealing and abuse of this deadly drug. Sometimes fentanyl is mixed with heroin or cocaine. Sometimes it is sold alone. Sometimes addicts know what they are getting; sometimes they don't.

The Hamilton County Heroin Coalition issued a warning about fentanyl in February, saying the drug is "producing frightening results and requires even more tools and awareness to combat." Newtown Police Chief Tom Synan is a leader of the coalition and says, "We haven't been able to figure out why here. It's almost like we're one step behind."

We Need Help From the Feds

Local law enforcement needs help from state and federal agencies to stop what appears to be an international trade in this lethal drug.

Fentanyl is a legally manufactured, prescription drug mainly intended to relieve the suffering of end-stage cancer patients. But its also illegally manufactured by clandestine labs, and much of what ends up on our streets is from these rogue labs, says the CDC and other sources.

There appears to be a network, possibly extending across the Pacific, for the illegal manufacture, distribution and sale of bootleg fentanyl, and it’s ending up here and killing people by the hundreds.

It’s believed to be made in secret labs in Mexico. Some of it may even be coming from China, earning it the nickname of “China White” among users, the CDC says.

A Recipe for an Overdose

Bootleg fentanyl is often mixed with heroin or cocaine. Addicts may not even know that it’s in the doses they bought from their suppliers. That’s partly what makes it so fatal. Injecting a drug 50 times more powerful than the drug you think you bought is a recipe for an overdose death.

Some addicts seek it out precisely because it is so powerful, Synan says. In either case, a lucrative market for it appears to have developed here.

The FBI's Cincinnati office said it was aware of fentanyl, but didn't seem to see it as an investigative priority. The Cincinnati office of the DEA said its agents hadn't seen much of it yet in the heroin shipments they've seized.

We’d like to know what these federal law enforcement agencies are doing to investigate and stop the flow of this killer drug into Southwest Ohio. We want to know if this is considered an urgent priority.

Because it should be.

Step Up the Urgency

The CDC, in its just-released report, made many recommendations, most of them aimed at public health agencies. They are worthy recommendations, particularly about expanding the availability of naloxone, the overdose antidote. (Victims of fentanyl overdoses often need multiple doses to be revived, and sometimes even that doesn’t work.)

But there were many recommendations to keep gathering data on who overdoses, and where and when it happens -- essentially to keep track of who dies. Monitoring and tracking this problem is important, but lacks the necessary urgency.

If 400 people had died in this county from the Zika virus, you can bet it would be a high priority and millions of dollars would be spent and hours of manpower would be redirected to fight it.

Why isn't that happening with this epidemic that's literally killing people in the streets?

We need an urgent, coordinated response from law enforcement and public health before more people die.

WCPO's Heroin Project: How Do We Respond?

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