It has been a deadly December.
Public health officials on Thursday reported 42 suspected opioid overdose deaths in Erie County for the month so far, half of them since Dec. 19 and six alone on Dec. 27.
As things stand, Erie County is poised to end the year with 357 confirmed or suspected opioid-related deaths for 2016, a significant increase over the 256 deaths in 2015 and 128 in 2014.
Officials say the statistics could have been even worse if not for a host of initiatives that the government, health officials and medical community have taken to address a drug epidemic that has swept through communities across the United States with devastating results.
It's suspected that a laboratory-tweaked version of the potent synthetic painkiller fentanyl may have contributed to the recent wave of deaths here, according to Erie County Executive Mark Poloncarz. Toxicology tests are underway to confirm the suspicion.
“This is a tremendous increase in deaths from previous weeks,” Poloncarz said in a statement on Twitter.
Fentanyl is an opioid painkiller usually reserved for cancer patients that acts similar to the way heroin does, except it’s many times stronger.
Labs in China produce fentanyl and fentanyl-related compounds and sell them to drug trafficking groups in Mexico, Canada and the U.S., according to the Drug Enforcement Agency.
The fentanyl-related compounds are usually mixed into or sold as heroin, often without the customer’s knowledge. The drug is considered particularly dangerous because it is more powerful than morphine or heroin, and takes only a tiny dose to be lethal.
The DEA earlier this year released a report on the “global threat” of counterfeit prescription pills containing fentanyl. In its release this month of the 2016 National Drug Threat Assessment, the DEA noted that the opioid epidemic has been exacerbated by the reemergence of illegal versions of fentanyl manufactured in foreign countries and then smuggled into the U.S.
New counterfeit versions of fentanyl – which can be snorted, injected or swallowed in pill form – don't show up on the list of banned substances in the U.S.
Fentanyl contributed to about 75 percent of the opioid-related deaths in Erie County in 2016, said Dr. Gale Burstein, Erie County health commissioner. Prescription opioids include such powerful synthetic pain medications as oxycodone, hydrocodone and fentanyl. Heroin is an illegal opioid derived from opium.
Fentanyl "is a very dangerous drug because of its potency," she said. "People are buying a white powder on the street. There can be deadly batches of drugs. There is no quality assurance. You don't know what you are getting."
Jean Kline knows this from hard experience.
Her son, Benjamin, died at age 28 in July from a drug overdose. She was shocked when she saw the autopsy report.
"He had taken straight fentanyl. He was a heroin-user, but there was no heroin in the drug he took. It blew me away," said Kline of South Buffalo.
She described her son as a bright, middle-class young man who worked full time, someone who didn't fit stereotypes of a drug user.
"But he is the face of addiction today," she said.
Kline said her son knew heroin might contain fentanyl and realized this posed a risk.
"The thing is addicts are so drawn to the drug – it's so strong – that they are willing to take risks," she said.
Toxicology tests found two chemically similar versions of fentanyl in her late son's blood – butyryl-fentanyl and furanyl fentanyl – but no heroin.
"He knew the risks. We talked about it, but he figured a little bit wouldn't kill him. You know, this is called an epidemic, but drug dealers know what they're peddling. I think it's more like murder. People need to be careful," Kline said.
Despite the grim statistics, Burstein sees optimistic signs, including growing awareness of the problem and initiatives to address it.
Among other things in the past year or so, thousands of people have received naloxone training from the county to revive those on the verge of overdose deaths, although the speed of fentanyl's potentially deadly action poses a challenge to responders, she said. Erie County launched its Opiate Epidemic Task Force and Crisis Services began a 24-hour hotline – 831-7007 – for addicts and family members needing help. The governor and State Legislature enacted legislation to make it easier for addicts to receive treatment and insurance coverage.
Burstein also cited I-STOP, a law that created a computer data base requiring doctors to consult a real-time prescription monitoring registry to make sure an individual does not already have a prescription for the medication.
She speculated that it's likely the number of deaths in the area would be greater if not for these and other efforts.
"In the big picture, things are working. We saw a leveling off of deaths in October and November, and then things exploded in December. There is a dangerous product on the street, and we have to work with law enforcement to get it off," she said.
Overdose deaths from opioids, including prescription opioids and heroin, have more than quadrupled since 1999, according to the Centers for Disease Control and Prevention. Overdoses involving opioids killed more than 28,000 people in the nation in 2014, and more than half of those deaths were from prescription opioids.