South Florida

Heroin, fentanyl a deadly duo as Florida overdose deaths skyrocket

Bottles of "certified reference drug standards" used to identify synthetic drugs in deceased victims at the Miami-Dade County Medical Examiner's toxicology lab.
Bottles of "certified reference drug standards" used to identify synthetic drugs in deceased victims at the Miami-Dade County Medical Examiner's toxicology lab. MIAMI HERALD STAFF

William Logan Kennedy, a chronic drug abuser who cycled in and out of Miami jails, died last year slumped over his bed in an Overtown home. Next to him: a syringe and a bag of what was suspected to be heroin.

It wasn’t. Instead, toxicologists determined this year, the 49-year-old handyman succumbed to a more dangerous and potent painkiller called fentantyl — a synthetic narcotic often peddled to unknowing users as heroin.

Kennedy was only latest victim of fentanyl, which is a growing and major contributor to a sharp spike in abuse deaths from hard-core opioids in Florida. In a newly released report, medical examiners statewide recorded a doubling in combined deaths from fentanyl and heroin.

“It’s part of a national pandemic,” said Jim Hall, a drug abuse epidemiologist with Nova Southeastern University.

The trends are even worse in South Florida, according to the annual Florida Department of Law Enforcement report. Heroin deaths jumped 100 percent in Miami-Dade, almost 210 percent in Broward and 425 percent in Palm Beach counties in the first half of 2015 compared to the same period from the previous year. Deaths linked to fentanyl, which is often illegally imported from clandestine labs in China and Mexico, skyrocketed 310 percent in Miami-Dade and 100 percent in Broward, but dipped about 8 percent in Palm Beach, the report said.


Heroin and fentanyl were also among the handful of drugs — including sedatives, cocaine and morphine — that caused the most deaths in Florida.

Public health and toxicology experts say the nearly uniform upward trends have continued through the second half of 2015 and so far in 2016. Indeed, skyrocketing heroin and fentanyl abuse is fast becoming a crisis in cities across the United States.

This week, lawmakers in Washington, D.C., called attention to the woes in Florida, where heroin deaths, as of 2014, had increased 900 percent from three years earlier. Rep. Ted Deutch, D-Gainesville, said Florida could expand treatment for 300,000 low-income people if the state legislature expands eligibility for Medicaid under the Affordable Care Act.

“We can help a whole lot of people if we could figure out a way to expand Medicaid and get people the care that they need,” Deutch said at the meeting on Thursday.

And on Saturday, the Drug Enforcement Administration’s director in Washington will host a press conference epidemic as part of the 11th National Prescription Drug Take-Back Day.

The wave of opioid abuse has been particularly grim in South Florida, where a crackdown on prescription painkillers such as Oxycodone is believed to have led to the spike in heroin and fentanyl abuse.

Fentanyl, which can be up to 50 times more potent than heroin, is a prescription painkiller but law enforcement investigators have found illicit varieties from Mexico and China are flooding the streets. The Miami Herald chronicled the rise of synthetic drugs, including fentanyl, in its Pipeline China series last year.

Chinese authorities banned the manufacturing and exporting of synthetic fentanyl and its variants last fall after the U.S. State Department and Justice Department put pressure authorities in Beijing.


Federal law enforcement efforts have stepped up. Last month, a Miramar man was sentenced to 10 years in prison for importing variants of fentanyl from a prisoner in Canada, who was in turn ordering the drugs from China.

This week, a federal grand jury indicted a Lake Worth man, Christopher Massena, who is accused of giving fentanyl to a 23-year-old man who overdosed and died. He is also accused of dealing heroin, and heroin mixed with fentanyl.

“Fentanyl is another dangerous face of the illegal narcotics trade,” U.S. Attorney Wifredo Ferrer said in a statement on Friday. “It is a controlled substance that is up to 100 times stronger than morphine and can be lethal, even in very small doses. As a community, we must be vigilant and educate ourselves and others regarding the dangers associated with all drug abuse.”

Although state numbers have not been compiled from medical examiners for all of 2015, the deadly uptick for heroin and fentanyl has shown no signs of letting up.

Miami-Dade toxicologists reported a total of 85 heroin and 102 fentanyl-related deaths last year. For heroin, the number rose 40 percent over 2014. But for fentanyl, it leaped an astonishing 365 percent.

The escalating number of deaths is partly attributable to the mixture of fentanyl with heroin in illegal street sales, creating a deadly cocktail, public health experts and toxicologists say.

Dr. Diane Boland, director of toxicology at the Miami-Dade Medical Examiner’s Office, said heroin has been a “constant presence” in death investigations and fentantyl is increasingly being mixed with it.

“Drug paraphernalia recovered at the scene and analyzed by indicated that fentanyl was mixed with heroin prior to use,” increasing the “lethality of the mixture substantially,” Boland wrote in a report to county and law-enforcement leaders in January.

“In many cases, the death was so sudden that the question arose as to whether the deceased knew they were ingesting fentanyl as opposed to heroin.”

The rise in heroin and fentanyl has helped spur Miami’s first needle exchange program, approved by the Florida Legislature this year, and set to begin in July. The center will help educate users about the dangers of the both drugs — users often share needles, spreading diseases such as HIV and hepatitis.

The centers will also provide Narcan, a drug that can be used to reverse the effects of opioid overdoses.

The rise in opioid overdoses is not surprising, said Jackson Memorial Hospital Dr. Hansel Tookes, who has been a vocal advocate for needle-exchange programs in a city that traditionally not been as hard hit by heroin until recent years.

“Unfortunately, this is one of the consequences of an inexperienced public that doesn’t have any sort of education about harm reduction,” Tookes said.

McClatchy correspondent Tony Pugh contributed to this report.