Potent, often disguised: What to know about fentanyl causing overdoses in South Florida

In less than a week, fentanyl has been linked to at least 10 overdoses in South Florida — a sudden and scary spike in victims of a synthetic drug that can be up to 50 times more powerful than heroin and is far and away the state’s deadliest opioid.

On Sunday, four men were hospitalized after overdosing in a home near Fort Lauderdale. Three days earlier, a group of students that included West Point cadets — including one player on the Army football team — were hospitalized after overdosing on fentanyl-laced cocaine while on spring break at a vacation rental property in Wilton Manors.

Whether the two incidents are related, possibly pointing to a dangerous mixture being peddled in the Fort Lauderdale area, was not yet clear. But both mass overdose incidents were in Broward County, which already leads the state in deaths associated with fentanyl. But fentanyl cases are on the rise in Miami-Dade too, usually mixed with other drugs so users are unaware of what they’re taking.

“We’re seeing more cases testing positive for both cocaine and fentanyl,” said Liz Zaney, a toxicologist with the Miami-Dade Medical Examiner’s Office.

Here’s what you need to know about fentanyl:

▪ South Florida’s deadly fentanyl typically isn’t the medicinal variety. The synthentic drug was developed as a painkiller and is still widely used in hospitals. Over the past decade, experts say the bulk of the fentanyl addicting and killing people is the illicit type, often created in clandestine labs outside of the United States.

For years, the drug and its variants arrived in the United States directly from labs in China, as chronicled in the 2015 Miami Herald series Pipeline China. But in recent years, Mexican cartels — using chemicals purchased from China — have become the primary source of the drug entering the country, according to the U.S. Commission on Combating Synthetic Opioid Trafficking’s final report published in February.

For example, a woman named Michelle Contreras — with ties to the Sinaloa Cartel — was arrested in 2020 after police said she trafficked 10,000 fentanyl pills into Miami. Last fall, she went to trial in Miami-Dade state court and lost. Now, she’s serving 25 years in Florida prison.

▪ Mixed with other drugs, fentanyl remains a killer. As with the overdoses in Wilton Manors, fentanyl is more frequently being mixed with other drugs, generally cocaine — and users often don’t know what they are ingesting is the powerful synthetic opioid.

Most notably, six young people died in upstate New York last year after overdosing on cocaine laced with fentanyl. In San Francisco, bars are now even providing test strips for people who intend to use cocaine or ecstasy, and not fentanyl.

Often, the fentanyl is also disguised as Percocet or other pills. That’s what happened in the cases of spring breakers Christine Englehardt and Walter Riley IV, who died last year on South Beach after being given green pills that looked like the powerful painkiller Percocet.

So far at least, none of the 10 Broward victims have died, though most were hospitalized. In the Wilton Manors case, the drug was so potent that two people got sick simply trying to help the overdose victims.

▪ Fentanyl peddlers face strict criminal laws — especially if someone dies. Across the country, law-enforcement agencies and lawmakers have become more aggressive in cracking down on fentanyl trafficking.

The suspected drug dealer who allegedly gave Englehardt and Riley the fentanyl is awaiting trial in Miami-Dade, accused of murder. He’s charged under a 2017 Florida law that made it easier to charge someone with murder if they supply a fatal dose of fentanyl or synthetic variants, or a mixture of the drugs with others.

Since then, state and federal prosecutors across Florida have charged a handful of drug suppliers with first-degree murder.

That includes Vero Beach surgeon Johnny Clyde Benjamin Jr., who in 2018 was sentenced to life in prison after he was convicted of supplying the bogus oxycodone pills — they were actually a fentanyl variant — that killed a woman.

In the Wilton Manors case, authorities have arrested Axel Casseus, 21, the man suspected of providing drugs to the cadets. But he isn’t charged in the case of the cadets, none of whom have died. For now, the Broward Sheriff’s Office said, he is charged with selling the drugs to an undercover detective.

▪ Fentanyl continues to wreak havoc in Florida and beyond. Synthetic opioids, mostly fentanyl, were to blame for nearly two-thirds of the over 100,000 reported drug overdose deaths in the United States in the yearlong period ending in June 2021. According to federal health officials, that’s a rate increase of 30 percent from the previous year.

In Florida in 2020, the last year for which statewide totals are available, opioids caused 6,089 deaths across Florida, a 43 percent increase from the year before.

According to the Florida Medical Examiners Commission, fentanyl by far caused the most deaths of any drug in Florida in 2020, the start of the coronavirus pandemic. The number: 5,302. The second highest? Cocaine, at 2,400 deaths.

The number of deaths associated with fentanyl, or its synthetic cousins, hasn’t slowed down in Miami-Dade. In 2019, the Medical Examiner’s Office recorded 257 cases. In 2020 and 2021, the office’s toxicology lab reported on Monday, the number was the same each year: 317. The vast majority of those deaths were overdoses.

Miami Herald staff writer Jay Weaver contributed to this report.

This story was originally published March 14, 2022 at 6:57 PM.