A batch of "bad heroin" has killed 22 people in western Pennsylvania over six days, prompting state and local officials to try to combat the spread of the drug.
The heroin is mixed with narcotic Fentanyl, which can be 10 to 100 times more potent than morphine, officials said. It is believed to be distributed in bags stamped with the words "Theraflu" and "Bud Ice," according to the Office of the Medical Examiner of Allegheny County.
Allegheny County Medical Examiner Dr. Karl Williams said he noticed an unusual trend beginning on Friday when there were three reported overdose deaths. After realizing there was a problem, Williams said, he took samples of the drugs and tested them in the lab.
"I see Fentanyl occasionally throughout the years, usually ... in misuse of pharmaceutical drugs," he told the Los Angeles Times. "But the sampled stamp bags were half heroin and half Fentanyl. That means someone is manufacturing a large quantity of that combination and distributing it in Allegheny County and surrounding areas."
All the overdose victims had a history of heroin abuse and most of them showed evidence of recently injecting the drug, Williams said.
Using Fentanyl to spike heroin is common across the U.S., Williams said, citing the drug "China White."
"In 1988, 16 people died in Pittsburgh in a widespread epidemic of China White," he said. "A local chemist manufactured one batch of the drug and a local dealer sold it as heroin."
Officials are warning the community of the danger.
"These drugs are creating an extremely dangerous and potentially lethal combination for users," Pennsylvania Atty. Gen. Kathleen Kane said in a statement Monday.
Thus far, the heroin has been identified in Allegheny, Westmoreland, Armstrong, Butler, Lawrence and Beaver counties. However, Kane said, the drug "could already or eventually be available in other counties across Pennsylvania."
Pittsburgh Mayor William Peduto also urged caution.
"Those who are in possession of this potent formula are in danger of losing their lives," he said in a statement Monday. "It will kill you. The danger cannot be overstated."
This is not the first time the region has experienced a high number of drug overdoses. From 1980 to 1990, Allegheny County recorded an average of 58 overdose fatalities per year, the Pittsburgh Post-Gazette reported. Since 2000, however, the county has recorded about 222 fatalities per year.
According to Williams, about 6,000 cases of suspected controlled substances are submitted to the county's lab for analysis each year. The majority of these cases are determined to be cocaine base (crack), heroin or marijuana.
Dr. Neil Capretto, the medical director at Gateway Rehabilitation Center -- which has centers in Pennsylvania and Ohio -- said more people in the western Pennsylvania region are using heroin now than ever before.
"I call it 'the perfect storm,'" he told The Times. "Starting in the late '90s, we had a rise in prescription medicine like oxycontin ... but what ends up happening is almost everyone starts with those drugs and runs out of resources and someone else says you can get the same high or feeling by using heroin, which is cheaper."
As of Tuesday, three patients had checked themselves into Gateway's Pittsburgh rehabilitation center in the wake of the fatalities, he said.
One patient who was used to injecting seven bags of heroin at a time, three or four times a day, told Capretto his drug dealer had warned him about the Theraflu drug when he purchased it last week.
"He went home and instead of doing seven he shot up two," Capretto said. "He fell to the floor and his mother revived him with CPR. He said had he done his normal amount he would have been dead. That scared him. The next day he came into Gateway."
The average age of a heroin addict at the rehabilitation center is 24, he said, but there are people as young as 14 and as old as 50. Capretto said drug addicts hear about overdose deaths and "unfortunately think 'that's the good stuff.'"
"Many of them will seek out that drug and then the demand and price [of the drug] goes up," he said. "None of them want to die, but they want to get a stronger feeling. Twenty years ago, heroin was just an inner-city drug.... It's spread like a disease. People literally cannot get away from it."
Fentanyl is "very potent," which entices addicts, he said.
"There are probably chemists making Fentanyl in labs, like Walter White did in 'Breaking Bad,'" he said. "What we don't know right now is whether this is a limited trend. Has it run its course? Or is this a tip of an iceberg of a bigger event?"
Williams said the Allegheny County Medical Examiner's Office is continuing its investigation, along with officials from the U.S. Justice Department's Drug Enforcement Administration, the state Health Department and local and state police.
Pittsburgh Narcotics Cmdr. Linda Rosato-Barone told The Times that "there is nothing to report yet" and that she can't comment any further on the investigation.
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