A new synthetic opioid contributes to spike in Triangle drug overdoses

In less than a week in late November, three people in Cary died of drug overdoses, and autopsies show that two of them were caused in part by a synthetic opioid that was not even illegal until last year.

The drug is furanylfentanyl, a variation of fentanyl, an established pain medication that is 20 times more powerful than heroin and 50 to 100 times more potent than morphine.

Furanylfentanyl was created as part of the ongoing quest to thwart drug laws and the tests to detect opioids in the body. Chemists tinker with the formulas for established drugs to come up with analogues that can either be taken alone or mixed with other drugs such as heroin, sometimes without the user’s knowledge.

Furanylfentanyl is so new that the U.S. Drug Enforcement Administration only just declared it a schedule 1 drug, like heroin and marijuana, in November. Schedule 1 drugs are ones the DEA considers to have no medical use and a high potential for abuse.

In North Carolina, furanylfentanyl’s arrival has been swift and deadly. State health officials did not detect the drug’s presence until 2015, when it was listed as a contributing cause of death in one fatal overdose. Last year, furanylfentanyl was blamed for 77 overdose deaths, according to preliminary numbers from the state Department of Health and Human Services.

Synthetic opioids like furanylfentanyl are a growing factor in the opioid crisis plaguing North Carolina and the rest of the country. The number of people who died of overdoses of heroin and other opioid drugs in North Carolina has exploded, from 150 in 1999 to 1,110 in 2015, according to the state Division of Public Health. Synthetic opioid deaths quadrupled between 2003 and 2015, to 288. Preliminary numbers show that fentanyl alone killed 332 people last year.

State health officials issued an advisory about fentanyl and furanylfentanyl a year ago, after 19 overdose deaths in the first part of 2016. They issued a similar advisory in 2014 when another fentanyl analogue, acetyl fentanyl, was found to have caused three fatal overdoses across the state early that year.

“The recreational use of synthetic drugs represents a major threat to public health,” Deborah Radisch, the chief medical examiner, said in a statement last spring. “It’s very important for medical professionals and law enforcement to be aware of these dangerous drugs, and know that people they encounter who may have used these drugs could require specialized care and treatment.”

Three dead

The three opioid overdoses in Cary began the evening before Thanksgiving, when Joshua Ari Marks was found dead of an overdose by his roommate in the apartment they shared on Sherwood Place.

The next afternoon, Thanksgiving day, police found Austen Connor Becker dead inside his home on Huntsmoor Lane. Two days later, on the evening of Nov. 26, police found Allison Leigh Hurt, 39, unconscious inside a room at the Hampton Inn and Suites on Hampton Woods Lane. Hurt died at Rex Hospital in Raleigh two days later.

State toxicology reports show that Becker died of furanylfentanyl poisoning, and that Hurt was killed by a mix of cocaine, morphine, heroin, fentanyl and furanylfentanyl. It’s not known whether Hurt knew all of the drugs she was taking.

An autopsy report from the state medical examiner’s office indicated a neighbor saw Becker pull into the driveway of his home the day before he died. Becker’s family was in the process of selling the home. His mother came to check on him the next day and found his body on a bedroom floor with a syringe in his right hand. Police also found a bag of syringes on the floor about three feet from Becker’s body.

State pathologists reported that police did not know whether Hurt was a guest at the hotel or living there. State records show that she was a native of Youngsville and had lived in West Raleigh, with a last known address in Winston-Salem. According to the autopsy report, a friend found Hurt in the hotel room. Police found a spoon with residue in the bathroom and an “unknown drug” in her purse. Police also discovered nine used needles in the room.

Cary police say they have not determined the source of the drugs that killed Marks, Becker and Hurt.

Furanylfentanyl was also a factor in the overdose deaths of one of two people in January in the hamlet of Bahama in northern Durham County. A Durham County sheriff’s report listed the cause of death for Jordan Bowen, 18, as cardiac arrest after he was found in his bedroom the morning of Jan. 14.

But an autopsy report by the state medical examiner indicated the cause of death was the ingestion of furanylfentanyl and cocaine. The night before Bowen died, he attended a party with his brother and girlfriend, according to the report. There, Bowen drank alcohol, smoked marijuana and took at least two Oxycontin pills. The next morning at 10:55 a.m., Bowen’s girlfriend called 911 after she found him unresponsive and partially on the mattress and floor.

Thomasi McDonald: 919-829-4533, @thomcdonald

Synthetic opioid deaths in N.C.

Fentanyl deaths:

2010: 108

2011: 130

2012: 112

2013: 95

2014: 158

2015: 219

2016: 332

Furanylfentanyl deaths:

2010: 0

2011: 0

2012: 0

2013: 0

2014: 0

2015: 1

2016: 77

SOURCE: N.C. Department of Health and Human Services