Dangerous drugs are a major concern for all communities. Substance abuse crosses all economic, social, and demographic boundaries, tragically impacting individuals and their families. Prescription drug abuse – taking medication not prescribed to you – is extremely dangerous, as is combining pills with alcohol and other drugs. Abusing over-the-counter medications can also be deadly. Synthetic drugs, such as K2, Spice, Bath Salts, Molly, and other “designer” substances, are toxic chemicals used as an alternative way to get high. You are gambling with your health and life when you put these dangerous substances into your body. Fentanyl, a Schedule II narcotic and one of the most potent opioids available for medical treatment, is typically prescribed to treat severe or chronic pain. In recent years, clandestinely produced fentanyl, combined with heroin, cocaine, and counterfeit prescription drugs, has been linked to thousands of overdoses and deaths. It is 50- to 100-times more potent than morphine, and 30- to 50-times more potent than heroin. Fentanyl is lethal, even at very low levels. The U.S. Drug Enforcement Administration (DEA) notes that ingestion of doses as small as 0.25 milligrams can be fatal. Its euphoric effects are indistinguishable from those of morphine or heroin. This web page provides information on the signs of abuse, overdose and links to treatment resources, especially the Substance Abuse and Mental Health Services Association." Fentanyl can be absorbed through the skin, and accidental inhalation can occur, which poses a serious threat to law enforcement officers who encounter fentanyl during searches and field testing. Most law enforcement agencies, including the DEA, prohibit field testing of potential fentanyl/heroin exhibits, which further complicates probable-cause arrests without certified lab results. The image above depicts a lethal dose of heroin, about 30 milligrams, compared to a 3-milligram dose of fentanyl, which is enough to kill an average-sized adult male. Heroin abuse has drastically increased across the country, and initiatives have reported that fentanyl is being sold on the street as heroin or mixed with heroin. This poses a significant risk for overdose deaths when unsuspecting users purchase the drug without knowing its effects. The 2017 Central Florida HIDTA Drug Threat Survey also indicated that reported heroin seizures sometimes contained a mixture of fentanyl, hydrocodone, chocolate powder, mannitol, quinine, and/or caffeine. Because fentanyl is an opiate and specialized testing is required to detect its presence in biological samples, many fentanyl overdoses are initially classified as heroin. Adding to the difficulty in detecting fentanyl overdoses is the increasing occurrence of the fentanyl analog acetyl-fentanyl. This compound has been found in the toxicology of victims in the Northeastern U.S. and in the Central Florida High Intensity Drug Trafficking Areas (CFHIDTA) region. Acetyl-fentanyl is a Schedule I narcotic, and while it is only one-third the potency of fentanyl, it is obtainable as a research chemical. The standard biochemical test does not differentiate between fentanyl and acetyl-fentanyl, making the number of overdoses attributed to each compound unknown. Additional testing using chromatography or mass spectrometry is required to differentiate the two compounds. Although not all controlled prescription-drug users eventually switch to heroin, fentanyl-laced counterfeit prescription pills give drug-trafficking organizations (DTOs) broader access to the large controlled prescription-drug user population. For example, between January and March 2016, nine people died from counterfeit Xanax pills containing fentanyl in Pinellas County, Florida. CFHIDTA initiatives significantly increased their fentanyl seizures from 2.5 grams in 2015 to 6.8 kilograms in 2016, due in large part to an investigation conducted by the Osceola County Investigative Bureau (OCIB). In 2016, members of the OCIB responded to a fentanyl overdose death in Kissimmee, Florida. Officers encountered four suspects, two of whom had fentanyl on their persons. During the investigation, agents discovered a clandestine lab in the detached garage of the home and located approximately 7 kilograms of pharmaceuticals, which were later confirmed to be 6.6 kilograms of fentanyl analogues and 400 grams of other controlled substances. Agents also seized numerous boxes, presses, other loose powders, and die-cast molds used to manufacture counterfeit prescription pills. The members of this DTO were found to be distributing these pills in Central Florida and Tennessee, which contributing to five overdose deaths. The leader of this organization was sentenced to 15 years in federal prison for Conspiracy and Possession with Intent to Manufacture a Controlled Substance and contributing to the overdose death. In March 2016, Brevard County agents apprehended a suspect distributing heroin in Cape Canaveral/Cocoa Beach, Florida. During the execution of a search warrant at the suspect’s residence, agents seized 28 grams of heroin. Additionally, the suspect's source delivered 107 grams of suspected heroin to the residence while surveillance was being conducted, resulting in his arrest and the seizure of the suspected heroin. Later, testing revealed that the suspected heroin was, in fact, fentanyl. Carfentanil, an analog of fentanyl, is a synthetic opioid approximately 100-times more potent that fentanyl. While carfentanil was originally used to anesthetize large animals, suppliers no longer manufacture or distribute it, causing veterinarians to switch to thiafentanil. In August 2016, thiafentanil, also known as A3080, was approved as a Schedule II controlled substance. Thiafentanil is a highly potent and fast-acting opioid that resembles carfentanil but differs in the rapid onset action and short duration period. Since thiafentanil shares chemical and pharmacological similarities with Schedule II fentanyl, its abuse potential is considered similar to that of carfentanil. A pharmaceutical company in Windsor, Colorado, will be the exclusive distributor/supplier of thiafentanil in the United States. With the DEA’s approval, thiafentanil will be imported from a subsidiary laboratory in South Africa. Thiafentail, as well as carfentanil, may pose a significant threat to abusers, law enforcement personnel, and first responders. In March 2017, China banned carfentanil manufacturing and sale, closing a major regulatory loophole in the fight to end America’s opioid epidemic. The ban also applies to carfentanil’s less-potent cousins: furanyl fentanyl, acryl fentanyl, and valeryl fentanyl. The DEA called China’s ban a potential “game-changer” that is likely to have a big impact in the U.S., where opioid demand has driven the proliferation of a new class of deadly drugs made by chemists. The 2016 Medical Examiners Commission Interim Drug Report for the first half of 2016 (January-June) reported 148 deaths caused by fentanyl in the Central Florida region, representing 21% of the statewide total (704). This is an 83% increase from the 81 reported deaths in the Central Florida region during the first half of 2015. Of the analogs found in 2016, 57.4% were identified as acetyl fentanyl, though Florida Medical Examiner Districts performed analog testing on a volunteer basis only. The Sheriff’s Office is involved in a number of community partnerships; with NOPE, Live Free, local pharmacists and physicians to provide information to citizens and caregivers about drug abuse in general as well as the proper dispensing and disposing of prescription drugs. Education programs associated with NOPE and Live Free are presented to local schools and community groups on a continuing basis. Treatment is a critical element of this equation. This web page provides information on the signs of abuse, overdose and links to treatment resources, especially the Substance Abuse and Mental Health Services Association. Click HERE for a list of downloadable resources.