Before Philip Seymour Hoffman died of an apparent heroin overdose on Sunday, an anomalous 22 heroin overdoses were recorded in just six counties of Western Pennsylvania over the preceding week.
Police suspect that the synthetic opioid fentanyl may be responsible for the sudden epidemic of heroin-related deaths. Here's what you need to know about the substance and the havoc it's suspected of wreaking:
1. Heroin Laced With Fentanyl Has Been Linked to 100 Deaths Since September
Before the deaths in Pennsylvania this past week, 22 heroin overdoses were recorded in Rhode Island over a 13-day period in early January.
The Providence Journal reported that 13 of those who died tested positive for fentanyl.
In Maryland, 37 heroin overdoses have been linked to fentanyl since September.
According to the CDC, fentanyl is over a hundred times more potent of an opioid than heroin. The drug is so powerful that overdose can occur almost instantaneously, the Baltimore Sun writes:
The drug's potency is so strong that it can reach the brain within minutes, triggering respiratory failure.
"We sometimes find individuals who have been using heroin and the needle is right there in their arm," said David Fowler, the state's chief medical examiner, who diagnosed the recent deaths. "It can happen unbelievably fast."
Philip Seymour Hoffman's body was reportedly discovered with a needle sticking out of one arm.
2. Fentanyl Is Used for Cancer Patients & as an Anesthetic
First synthesized by Paul Janssen in 1960, fentanyl has historically been used to treat breakthrough pain in cancer patients, a pain that comes on for short periods of time when the pain normally suppressed by other medications suddenly breaks into awareness. It's also been used as a pre-surgery anesthetic in combination with a benzodiazepine.
Fentanyl is so potent because its chemical structure gives it high lipophilicity, which is to say, a heightened ability to dissolve into the fats, oils and lipids of the body. It therefore can penetrate the central nervous system more quickly and easily than morphine or heroin.
After its original synthesis, several analogues of fentanyl were developed including sufentanil, alfentanil, and lofentanil.
Chemists creating products for the recreational market have developed further analogues clandestinely. In Rhode Island, the spate of overdoses were linked to the analogue acetyl fentanyl.
3. New York Cops Are Hunting for Hoffman's Drug Dealer
According to The New York Post
, the NYPD has launched "an intensive citywide search to identify the drug dealer who sold heroin to troubled Oscar-winning actor Philip Seymour Hoffman."
Seventy glassine envelopes of heroin marked "Ace of Spades" or "Ace of Hearts" were found in Hoffman's apartment at the time of his death. According to the Daily Mail, those "brands" usually contain fentanyl.
The NYPD hopes to find the dealer responsible through a process called a "nitro dump." The Post's source explained:
Basically what that is, is any time we make a narcotics arrest we include the brand name on the arrest report and store it in our system so our investigators can see where those brands are being sold.
By mapping the brand's area of distribution, the police hope to be able to narrow their search until the suspect or suspects can be isolated.
4. Addicts May Be Attracted to Lethal Brands of Heroin
After the spate of deaths in Pennsylvania last week, CNN ran a profile of a 19-year-old heroin user identified only as Andrew, who had survived two overdoses last week, before a friend's death sent him back into rehab. Andrew told CNN that rather than being repelled by brands of heroin notorious for fatalities, addicts are actually attracted by the lethal potency associated with the fentanyl-laced "Bud Ice" or "Theraflu":
On the street, word of a new, potent drug traveled quickly. Andrew said he and other addicts sought it out, eager for an ever-elusive "better" high.
"That's the sick thing about addiction," he said. "When someone knows there are heroin bags that are killing people or making them overdose, then we know that those are the good bags."
5. Fentanyl Has Been Used as a Weapon
In 2002, when Chechen terrorists took 850 hostages at the Dubrovka Theater in Moscow, the Russian military ended the standoff by inundating the terrorists with a fentanyl based gas, causing most to rapidly lose consciousness. One hundred seventeen of the hostages and terrorists later died of complications related to the gas.