In February, the Lake County Crime Lab finished processing a case with more than 250 oxycodone tablets, something lab officials said is on the rise.
Some of the pills in this particular case contained only fentanyl. Some contained fentanyl with the powerful synthetic opioid analogs. Others contained a fentanyl with the seizure and nerve pain medication gabapentin, which is sold under brand names like Neurontin, Gralise and Horizant. Still others contained no controlled substance at all, said Doug Rohde, the lab’s supervisor of chemistry & toxicology.
In recent years, fake oxycodone pills made in clandestine labs in Mexico have been making their way into the U.S. A majority of the fentanyl coming in from Mexico enters hidden in vehicles at official border crossings around San Diego and Nogales, Arizona, according to DEA data.
Tucson, Arizona, Police Lt. Christian Wildblood told the Associated Press that in most cases the pills are made in primitive conditions, with pill presses purchased online. The amount of fentanyl in each pill varies widely.
According to the DEA’s 2018 National Drug Threat Assessment report, the variable amount of fentanyl contained in these pills contributes to their lethality. A DEA analysis of about 9 kilograms worth of tablets found a range of .03 milligrams to 1.99 milligrams of fentanyl contained in the pills.
“Clandestine pill mill operators create hot spots, or areas of higher concentration, of fentanyl in batches of pills due to improper mixing,” the report stated. “This means even fentanyl-containing counterfeit pills from the same batch and appearing simultaneously in a market could be very different in terms of their potential lethality due to variations in milling operations.”
Doug Coleman, the DEA special agent in charge of Arizona, told the Associated Press that the Sinaloa cartel’s ability to ramp up its own production of fentanyl and label it oxycodone shows the group’s business acumen and why it remains among the world’s top criminal organizations, even after conviction of its notorious former leader, Joaquin “El Chapo” Guzmán Loera.
“If they see a market for their stuff, they’ll make it and bring it up,” Coleman told the AP.
DEA data shows that the U.S. Customs and Border Patrol’s San Diego Field Office’s area of responsibility remains the primary entry point of fentanyl via the southwest border.
About 85 percent of the fentanyl seizures flowed through the San Diego point of entry. About three-quarters of the seized fentanyl came via personally operated vehicles.
The DEA notes, however, that an increasing amount of fentanyl is seized via the CBP’s Tucson Field Office. Tucson now makes up 14 percent of fentanyl seizures via the southwest border, up from 9 percent the year prior. San Diego made up 91 percent of the seizures that year.
The DEA’s report stated that the overwhelming amount of fentanyl found in the U.S. is in powder form, but “fentanyl in counterfeit pill form still represents a significant public health risk and law enforcement challenge in the near term.”
“Traditionally, fentanyl was mixed with or sold as white powder heroin, which potentially limited the overall scope of the fentanyl user market,” the report stated. “However, as traffickers have expanded into the sale of fentanyl-containing counterfeit pills, the scope of users who were exposed to fentanyl increased significantly; the prescription pain reliever misuser population is almost ten times that of the heroin user population.”
With the presence of fake oxycontin pills locally, the Lake County General Health District stated access to opioid overdose reversal medication naloxone, in conjunction with community treatment and response efforts, “is key.”
The health district administrators Project DAWN (Deaths Avoided with Naloxone) clinics in Lake, Geauga and Ashtabula counties. The clinics are part of a state-wide program, that teaches participants how to recognize the signs and symptoms of an overdose, perform rescue breathing, call emergency medical services, and administer intranasal Naloxone.
Project DAWN clinics are free and participants also receive a free naloxone kit.
Lake County clinics are held at 4:30 p.m. on the first Wednesday of every month at the health district’s 5966 Heisley Road office in Mentor. A second Lake County clinic is held at 10 a.m. on the second Tuesday of every month at Signature Health, 38882 Mentor Ave. in Willoughby.
Geauga County clinics are held at 5:30 p.m. on the first Tuesday of the month at Ravenwood Health, 12557 Ravenwood Drive in Chardon.