One Of These Pills Is Authentic Oxycodone. The Other Is Laced With ...

FENTANYL: A KILLER CONCEALED. This story is the first in a multi-part series examining the current state of the drug crisis on Staten Island.

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STATEN ISLAND, N.Y. — Fentanyl is the speeding bullet of a massive, well-organized and ruthless narcotics trade and the potent opioid has turned recreational drug use into a deadly game of Russian roulette on Staten Island and beyond.

Experts warn that the deadly narcotic is being added to painkillers and sedatives as well as heroin and party drugs by unscrupulous drug traffickers and dealers who don’t care whether users live or die.

Alone or combined with other substances, fentanyl is fueling a record number of overdoses among consumers ranging from weekend warriors to hardcore addicts on our borough, in the rest of New York City and throughout the country.

“[People] may just be looking to buy some pills or some cocaine which is traditionally sort of outside of this deadly-overdose sphere just by its nature, and they are unknowingly being sold fentanyl and could die from it, that’s how fatal it is,” District Attorney Michael E. McMahon said.

“We speak to overdose survivors and they’ll say, ‘I don’t understand what happened. I don’t use opiates,’” Clinical Director Amanda Wexler of the District Attorney Office’s Heroin Overdose Prevention and Education Program (HOPE) said about people who were unknowingly exposed to fentanyl.

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine, according to the Centers for Disease Control and Prevention (CDC) in Atlanta.

Consider these sobering facts:

• The Richmond County District Attorney’s Office and the NYPD investigated 79 drug-related deaths in 2021 through the Overdose Response Initiative.
• The nation’s opioid epidemic hit a new tragic milestone of the deadliest year for overdoses on record. More than 100,000 people nationwide died of an accidental drug overdose between April 2020 and April 2021, according to preliminary data from the CDC.
• Fentanyl now is the No. 1 cause of death — topping suicide, COVID-19 or car accidents — for Americans ages 18 to 45, according to Families Against Fentanyl.

Rescue drugs such as naloxone don’t always reverse a fentanyl overdose or additional applications of the opioid-antidote may be needed to save the user, experts say.

With odds stacked overwhelmingly against users, knowing in advance whether a drug is tainted with fentanyl is akin to checking whether a gun is loaded with a blank vs. a bullet before pulling the trigger.

The problem is that users don’t realize that many drugs traditionally thought to be safe now are in the bullseye range for overdoses.

“Fentanyl is undetectable by sight, smell, or taste,” according to Fentanyl: The 411, a fact sheet from the state Department of Health AIDS Institute.

Testing drugs before use is the only way to tell for certain whether they contain fentanyl; test strips are available at Community Health Action of Staten Island.

Experts caution that a single dose of the opioid could claim the life of even the healthiest person.

A mere two milligrams of fentanyl — a few white specks next to a penny in a photo supplied by the U.S. Drug Enforcement Administration (DEA) — could kill.

‘SATURATING’ DRUG MARKET

“I think it’s critically important that we alert people to the danger of fentanyl, which is completely saturating our drug market now,” New York City Special Narcotics Prosecutor Bridget Brennan said during an exclusive interview with the Staten Island Advance/SILive.com.

“Fentanyl is just poison,” said Brennan, who described the drug as “very, very lethal.”

A snort, pill or shot could prove deadly even for longtime addicts who think they know their limits.

“Many people who inject drugs in New York City are aware of the risks of fentanyl and generally do not seek it out,” according to the city Heath Department.

“Typically fentanyl is introduced into illicit drug mixes at the level of the supplier. As a result, people who use drugs and street-level drug sellers are unlikely to know whether a certain product does or does not contain fentanyl.”

Most illegal fentanyl peddled in this country is produced in Mexico with components from China.

“The unscientific way that fentanyl is manufactured by drug traffickers is part of why it poses such a threat,” Brennan said, adding that “there’s no precision in this. It’s really marketing in death.”

Recreational users are caught in the crosshairs because the opioid is being added to a wide range of drugs.

McMahon warned that “fentanyl has gotten much stronger and it’s showing up not just in heroin, which we saw originally, but also in cocaine and methamphetamine and, a really troubling trend recently, it’s in pill form.”

‘ONE PILL CAN KILL’

Experts say that drug traffickers are blitzing Staten Island and the nation with fake prescription pills laced with fentanyl and/or methamphetamine.

“One pill can kill,” warned DEA Deputy Special Agent-in-Charge Keith Kruskall during an exclusive interview with the Staten Island Advance/SILive.com.

Bogus pills that look like real prescription opioids such as oxycodone and hydrocodone, sedatives such as alprazolam, and stimulants including amphetamines have been recovered by the DEA in every state and the District of Columbia.

Methamphetamine increasingly is being used in these phony pills.

“Organizations are marketing these pills to appeal to prescription abusers on Staten Island so they think they’re taking Oxycontin or Xanax and they’re getting counterfeit pills most likely laced with fentanyl,” Kruskall said. “It could have a disastrous effect.”

Kruskall noted laboratory testing by the DEA indicates that two out of every five counterfeit pills contain a potentially-fatal dose of fentanyl.

The DEA supplied the Advance/SILive.com with photos of real and fake pills and it’s virtually impossible to tell them apart.

WHAT’S SAFE?

The only safe pills are those prescribed and distributed by licensed medical providers, the experts say.

“Anytime somebody buys a pill, if they don’t get that pill from a pharmacy‚ they’re risking their life,” Brennan said.

People making these counterfeit pills are not licensed chemists, Kruskall noted.

They’re not carefully measuring ingredients. Instead, they’re likely mixing fentanyl and other ingredients in a pill press machine in ways that typically result in different levels of fentanyl in each tablet, according to experts.

“One pill could definitely have a fatal dose,” Kruskall said. “Another pill will give someone the perfect high. Another pill won’t give them the high they’re looking for. They never know what they’re going to get.”

Fentanyl-tainted pills are readily available on various social-media and e-commerce platforms. In some cases, the pills are being marketed and sold to teens and young adults, the experts say.

“A significant number of high school and college students purchase Adderall and Xanax from dark web drug markets and/or through social media referrals, which market deadly versions of these drugs tainted with fentanyl and/or methamphetamine,” according to a fact sheet about counterfeit pills from the DEA.

“Some students begin using prescription stimulants, often referred to as ‘study drugs,’ in the belief it will benefit their academic performance, but the non-medical use of prescription stimulants has not been proven to improve academic performance.”

DANGERS OF INTERNET SALES

People of any age who are buying fentanyl-laced pills over the Internet might incorrectly think that they are purchasing real pharmaceutical drugs. Brennan is among experts who believe that users who don’t regularly take opioids, such as those who eschew pain pills in favor of taking sedatives for non-medical reasons, are at greater risk for overdosing from ingesting counterfeit pills.

Brennan noted that fentanyl is so potent that “if someone’s not been exposed to that before, they just are so likely to die.”

Staten Island was the epicenter of the pain-pill epidemic and some of those users have switched to heroin because it oftentimes is cheaper and easier to obtain.

Mexico often is the nexus for fentanyl-laced heroin.

The south-of-the-border nation has many acres of poppy plants cultivated for heroin, a market “completely saturated with fentanyl,” Brennan said.

The alarming trends are reflected in both drug seizures and overdose deaths.

In New York City, seizures of fentanyl have skyrocketed while recoveries of heroin are declining.

“Overdose deaths that are only heroin without any fentanyl present are very, very rare now,” Brennan said.

While avoiding illegal drugs is the best way to prevent an overdose, experts have some tips to minimize risks for consumers.

Test strips for use at home to detect fentanyl are available at many syringe-exchange programs, according to Fentanyl: The 411.

The only needle exchange program in our borough is Community Health Action of Staten Island.

“We do offer fentanyl test strips,” said Emilie Tippins, vice president of communications for Community Health Action of Staten Island.

“We have had them for some time and they’re part of our regular harm-reduction service package. Anyone who is enrolled in the syringe exchange program can get those test strips.”

Free test strips and naloxone kits are dispensed with instructions and other relevant information such as the dangers of using fentanyl and tips for avoiding and reversing overdoses.

“Part of that education is about preventing overdose to begin with, including using the test strips,” Tippins said.

Test strips are offered from Community Health Action’s Harm Reduction Health Hub at 166 Port Richmond Ave. in Port Richmond. Normal operating hours of 9 a.m. to 5 p.m. may be affected by COVID-19, so people seeking help are encouraged to first call 718-808-1824 for information.

The city Health Department sent out an alert about fentanyl for those who must use that includes the following safety tips:

• Use with someone else. If you overdose, it’s important to have someone around to help.
• Take turns using. Be prepared with naloxone and have a phone on hand in case you need to call 911.
• Test your drugs. Use a small amount first to see how strong your drugs are.
• Carry naloxone. Show others where it is and how to use it. More than one dose may be needed.
• Avoid mixing drugs. Mixing drugs, including alcohol, increases your risk of overdose.
• To reduce risk if the drug tests positive, users may avoid using it, use less or do a test shot.